Admitting defeat

Damn stupid virus.

So, last night, right, Sparrow and I had left it that I would go in for call this morning, insisting of course that I was fine, and then Cleo (who was on call last night) would assess me, and if she felt I lacked capacity to make the decision about taking call (sorry, shrink joke), she'd send me home and Sparrow would pinch hit, at least for the day shift. But, of course, I would be fine.

Ah, it was a good plan...

So I got all, like, I'm going to bed. I'm going to be well-rested and fine tomorrow. Ahh, bed. Except...once I laid down...I couldn't breathe. No, really. My nose was dripping, my sinuses were full of concrete, and every time I relaxed enough to get to sleep I'd shut my mouth and then start suffocating. Which was between the times I started choking and coughing as I kept drowning in my own secretions. Ugh, it was awful.

So I finally gave up around 12:30 and decided to do something about it. I put on some passable clothing, climbed into my car, and headed for the Walgreens.

::sigh:: I hadn't even made it past the hospital before I got pulled over.

Okay, fine, so my tags are expired. Because in Illinois, they send you a letter reminding you that your plates are about to expire. In North Carolina, they send you a letter reminding you that, hey darlin', your tags expired two months ago and you should really get that fixed.

How was I supposed to know?

Fortunately, Officer Friendly was "feelin' the holidays" and took pity on my snotty, pathetic, transplanted self. So I went to Walgreens, bought cough syrup, and Afrin, and nose strips, and saline spray. And wound up continuing to cough and drip and drown all night. Except I couldn't swallow, because my throat was so sore from the Afrin. And I was sweating and tossing and turning and, oh, yech, it was a terrible night.

This morning, when my alarm went off at 6:30, there was just no way I was going to be of use to anybody today. And, my temp was still 102. So Sparrow took the first half of my shift (did I mention she was a goddess?) and JD took the overnight (he is also fabulous, although - to his relief, I'm sure - not a goddess). Ohh, thank God.

Although...I can't even begin to tell you how guilty I feel. I know, I know, stupid, unwarranted (ahem, 102) - and not that I won't pay back the time - but there nonetheless.

So, Maggie and I sat around most of the day trying to nap (she was a lot more successful at that than I) and watching TV. The unfortunate part of that is, while Thursday and yesterday I had a lot of good stuff accumulated on the DVR...today, the TV was crappy.

Which did not stop me from watching it. Despite all the interspersed commercials about how part of a healthy lifestyle is limiting TV to two hours per day or less (ha!). And my increasing guilt about what a disaster the house is (because I haven't really moved in. For a whole bunch of ridiculous neurotic reasons and a couple of moderately reasonable ones - like I have too much stuff and a significant paucity of time). But I'm siiiiiiiiiiick....

I watched a documentary on the Jonestown tragedy (which was 30 years ago this week) on the History Channel. I watched a terrible Lifetime movie. I watched a couple of episodes of Scrubs, and M*A*S*H, and the Cosby Show. I forgot how much I used to want to be Claire Huxtable...

I watched a show on Freebirthing on Discovery Health that was...well, interesting. My cousin blogged about this (and the show I watched after it) earlier in the week, and I was intrigued. Hmm. As a former deliverer of babies, I cannot in any way condone what they're doing. Cannot condone no prenatal care (a drug store BP cuff and a fetoscope? Come on). Cannot condone knowing that you may have something wrong that could easily kill you and your baby in minutes and not getting it checked out. Cannot condone such over the top disregard of what we've learned over the past several thousand years.

There was this one woman I just wanted to slap (the one with the drugstore prenatal care and the possible low-lying placenta. Minutes). She was going on and on about how horrible her first birth was and, you know, if she'd only known how risky the interventions were that they were doing (minutes!! Bloody! Horrible! Traumatic! Well before your husband would even call EMS!). Please. Because a shoulder dystocia or a cord accident without the benefit of a trained attendant, yeah, that's not risky. She also ranted about how, at her first delivery, the doctors kept yelling at her that she wasn't pushing right. And she didn't know "what the big deal was, because, you know, it only took like ten minutes."

That's when I started yelling (well, rasping) at the TV.

Okay, now, I concede that I haven't delivered as many babies as she - oh, no, wait, I probably have a couple hundred on her. And I can tell you, when we start saying things like that in a situation like she described, it's because the baby's in trouble.

Which is the PERFECT indication to have a baby far away from any medical care. Idiot. Shouldn't be allowed to breed.

Ahem.

But on the other side of it...you know, I don't support unattended births. I don't even really support home births, because they scare me. I concede that women have been doing this for thousands of years. I absolutely concede that more births around the world occur outside of the Western medical setting than not. But I also would point out how many fewer moms and/or babies die in childbirth or have poor delivery outcomes in the Western world than in the third word or developing nations. But by the same token, I don't either entirely support the medical, institutionalized birth. I've said this before on here, that I dislike the assembly line, everyone gets an epidural at 4 cm, everyone delivers in lithotomy kind of birth, which we do because it makes us feel as practitioners like we're more in control of a chaotic process. But the truth is, I think it often leaves us less in control. I got in so much trouble for deviating from that standardized delivery, but I really felt like everyone was better for it, including me. As I told my patients time after time, my philosophy was this: look, it's your birth, your body, and your baby; I'm just here to keep everybody safe. So, within reason, we'll do this however you want it. Which involved any number of things, even in my short career - backrubs, perineal massage, mineral oil, olive oil, music, Wiccan sand circles, I delivered babies with their moms in pretty much any position they could come up with, and once or twice I was more or less on my back.

Interesting, isn't it, that as much as they complained about my "avoiding" the OR, the only time they commented on how I jumped in on the labor deck was to tell me I was somehow doing it wrong...

Anyhow. The bigger point is, I loved labor and delivery.

So there was this woman on the Freebirthing show who had this completely amazing delivery. It was a water birth (one thing I haven't done, partly because we didn't have the facilities, partly because it yicks me out), and wow, it was so peaceful. There was no screaming and raving and wailing. She just let things happen, accepted them as they came. She claimed it was more or less pain-free, which, I think that depends on your definition of "pain-free" (i.e., I've seen plenty of women control a reasonable level of labor pain with meditation and self-hypnosis). But it was just entrancing to watch. She was nearly silent through the whole thing. And her baby came out, sweet, beautiful, and didn't cry. I, of course, got worried, and apparently she did too, but the kid was breathing just fine. I guess he just didn't have a lot to say. She interpreted this as him being "relaxed", and I'm not sure I disagree with that. The whole thing was completely beautiful. The only thing I would've done differently (aside from being somewhere less than 500 feet from a functional OR) is that her husband didn't touch her the whole time, apparently to protect himself from some British law regarding unlicensed attendants at a birth. Which is sort of sad.

Still. Would it kill you to have a midwife on hand?

The other program I watched was on the "pregnant man." That was a lot more productive. I still don't consider him a pregnant man (uterus = not a pregnant man), but I really support what they did, and I can see his point. I had a lot more respect for them after I saw the program. They seemed like a sweet family. I really appreciated the wife's efforts to breastfeed. I did think it was sort of interesting how quickly they seemed to fall into traditional gender roles. They seem like they have been (the wife has two daughters from a previous marriage) and will be good parents (which is fortunate, because there's another one on the way), and really, can you ask for anything more than that? Everybody's family is different. Everybody's parents screw them up. And the show was an interesting and compassionate commentary on the issues that transgendered couples face. Plus, that kid's adorable. And, I do not envy any boy who comes sniffing around her in 15 years or so - she is so going to be daddy's little girl!

I did get two very amusing quotes out of today's TV watching extravaganza, though. The first, from the stupid Lifetime movie:

"Your son is looking at porn on the internet!"

"That's nice, honey. G'night."

(which, incidentally, was the correct response, at least initially. You know, before he developed his big porn addiction and started lying and stealing and the whole world came catastrophically crashing down...in typical Lifetime fashion...)

And, care of Dr. Huxtable...

"Regional forecast...warm, and no babies."

If I was an OB, I'd so totally steal that (hmm...maybe I can still make it work...)

Okay, yeah, I'm done babbling...

Atlas stomped her feet

I never took heavy words for granted
And I never took the undeserved advantage
No, I never took the easy way
So why don't you take it a little easy on me now?

- Dar Williams, The Easy Way

It's been a long damn week.

Next week isn't looking a whole lot shorter.

Okay, that's not fair. Because the main reasons last week sucked had very little to do with the fullness of my work schedule. But I've spent most of today alternating between worrying about how I'm way past broke (as in, my therapist and I are going to have a conversation Monday about how I may need to drop out of therapy because it's that or my rent, and believe me, this is not the time for me to leave therapy), trying to get the house ready for showing, getting completely overwhelmed and hiding in my bed, doing laundry, pretending to read, thinking about getting back on my bike, and trying not to kick things in sheer frustration.

It's days like this I really wish I drank more.

So my new landlord, who is of course my neighbor, who, if I haven't already said this on here, bought my old landlord's house along with the two rental cottages, kicked Sparrow out of hers, partitioned the land on which it sat onto his property, said he was going to tear it down to build a garage, decided not to tear it down and instead use it as his office (neither Sparrow nor I can figure out exactly what it is that he does, but he clearly makes a shitload of money doing it), and cannot figure out that my automatic bill payer sends him a check in the mail, that landlord, finally put my house and the main house up for sale. Which means my house, which is a DISASTER and looks like I just moved in, needs to be showable, and soon.

Now, it's crossed my mind, I'll admit, that I could leave the place a giant, box-filled mess covered in dog hair tumbleweeds in some passive-aggressive protest against the fact that this is not the arrangement I signed up for, that my rent is too high (I knew that moving in, but, it was worth it for the situation I was moving into), that my lease had better be protected when he sells it, or about thirty-seven other things I could come up with to be pissed about (he hasn't made he repairs on my property the old landlord promised; the dead thing under my house apparently didn't get removed by the handyman, it got dragged out in the middle of the night by something that I frankly don't want to cross paths with in the darkness; he keeps parking in my spaces; etc). But I will concede that I have a vested interest in helping him sell the place, because, frankly, I don't like him, and don't especially want him as my landlord. Plus, I kind of want my house to be finished and feel like I live here for reals.

But that's a really big undertaking, to be quite honest. That's why I've been hiding from it for so long.

You remember how I couldn't even get in to the office when I first moved in?

Okay, in all honesty, I'm rather proud of what Maggie and I were able to undertake today (because she was an integral part, of course). I stacked the boxes of books along the wall where someday (when I can afford secondhand things again) the bookcases I need will go. And I finally got the desk where I want it (although I didn't know I wanted it there until I finally got it moved to where I didn't want it - although I thought I wanted it there when I started - and then went, oh, wait, what about over there...), and I got the TV set up (the cable box doesn't work, but, whatever, I'll call them). And I moved the sofa into the office. Which made it way more cramped in there. Waaaaaaay more cramped. But, oddly, I really like it. And there's still an aisle to the dog door.

Maggie was not quite as pleased with all of the fussing today, though.

She'll get over it. We already had a nice little snugglefest on the sofa, even though we both had to climb over the couch arm to get a seat. Whatever, it's cozy. Once the fussing is finished, and I get it decorated, it'll be a wonderful, comfortable room.

Which will undoubtedly be right before the moment my lease expires and/or Jud sells the house to someone who doesn't want a renter and I get kicked out.

::sigh::

The crazy thing is, though, I'm progressively more grateful for my life with each passing day. Yes, there are certainly many things that I wish were different. And, I'm making progress on a lot of those. And yes, I certainly have my moments of wanting to trade it all in for a rich, adoring husband and a tropical drink. But I can't imagine the horribleness of my life if I'd stayed on the track I was on four years ago. Or fourteen years ago, for that matter. I love my job. I need a break (I have two days of vacation coming up for my birthday. Okay, I probably need a longer break than that, but...), but I love my job. I have good friends. I have lots of people I consider family. I have a unique perspective on a lot of issues because of what I've experienced.

One of my patients gave me the best quote the other day, though, in that regard - he says to me, "just because I can explain it, doesn't mean I can handle it."

I like that. It's over my desk at work right now on a post-it note. Along with another patient quote: "Every day I spent in Hell, I chose to be there."

That one gives me a lot of perspective.

Nonetheless.

At least I have clean sheets. And a new comforter (clearance! Under $20! Flannel!), which I bought at Target this morning as part of the renovation effort. I know, I know, I'm broke, but dude, under $20. And as much as I love the one I currently am hiding under, I've had it since college, and it's been sewn back together way too many times at this point to be presentable. I also have to find a sheet to put over the armchair Maggie sleeps in (the one I want is in a bag somewhere around here). Because I'd really like this place to look appealing - for both me and any prospective buyers. I'd also like to look like a good, clean, responsible tenant, so they'll keep me and I won't have to friggin' move again.

Crap, I bet this means I have to start making my bed in the mornings...

Alright. Maggie and I are going to get some dinner. All the moving stuff and the fact that this place looks much like the day I moved in (not to mention the fact that I never really got to the grocery this week) has left me with a Bojangles craving. I'm sure Mags will be happy to help me with that....

Things people say

Life is like algebra: it goes on whether you understand it or not.

A quote from Allison's blog. Which apparently comes from her mom. Who is a wise woman.

My own life philosophies I've developed over the years? Sometimes life gets in the way. Sometimes the only way out is through. People occasionally suck. Sometimes when you get to the end of your rope, you just have to let go and trust that what you fall into is going to be better. People will disappoint you when you need them most, and amaze you when you least expect it. Life is like a box of chocolates.

Oh, wait, no, that last one's not mine.

Apparently, I'm very fond of "sometimes".

And if you were wondering, the title is actually a reference to this song.

I've been thinking a lot about words today, for a variety of reasons, not the least of which is a conversation I had with a colleague today about a lot of psychiatry-related esoterica.

But, for instance, I woke up this morning with a verse from this song in my head, which has in it this line: It's hard to make conversation when he's taking my breath away.

I really like that.

Actually, the first thing that was in my head this morning was something closer to this: Why are the neighbor's dogs barking? Wait...why is it so bright in here? Crap, what time is it? Awww, does that say six fif-....ugh, shit.

Hmm. Not as articulate. But as it turns out, I had left my phone, which is, of course, also my alarm clock, in the car. Helpful.

Anyhow. I digress.

So we've all started dictating lately. Because apparently this is faster than direct entry (it might be, actually). Now, some members of our class have been doing this for a while. Mike, for example, is a master dictator. Me? Not so much. I spend a lot of time saying things like, "Um....ummm....the, ah....." But what's been particularly amusing is how this all gets translated into text.

Seriously. You know that thing about how, if you set an infinite number of monkeys at an infinite number of typewriters for an infinite length of time, they would eventually produce the collected works of Shakespeare? Yeah, I'm wondering if maybe we could hire those monkeys.

We're all wondering what the heck is going on down in Transcription. They make up words, they input stuff that makes no sense, they take liberties with what we say...and it's so inconsistent. Yesterday, I was reviewing my reports, and like, they somehow understood the words "cacophony" and "cultural moree", but in that same group of reports was this sentence:

"Patient states that since that time, things have been ruff."

Wait. My patient was a dog? I totally missed that!

The mammalian theme continued today when PenguinShrink apparently had a patient who was "white as a sheep." She also had a patient who went from having Lou Gehrig's Disease to having "an LS".

I had another note regarding a patient who had some very strong things to say, and, as we often do, I included several direct quotes from the patient (in quotes. It's okay to swear in a note if it's in quotes). When I got the transcript, all of the expletives mysteriously became (INAUDIBLE).

Honest. You're not going to burst into flames if you type the word bullshit. I solemnly swear it. See? I'm not on fire.

Other amusing quotes of late, yesterday, Sparrow tells me (and I think she's right) that we may well be on the verge of World War III. Apparently, Russia thinks that Georgia brought this all on themselves. Sparrow says, "In general, it's a bad idea to invade people."

The other quote of the week? Ruthie. So, to fully understand this one, you have to understand two things. The first is that we're all supposed to be learning something called CBT, or cognitive behavioral therapy, this year. None of us are super thrilled about this. Because, among other things, it's this very formulaic kind of therapy with homework and worksheets and all that sort of stuff, but you know, it's not like we're going to know anything about the real meat of this stuff until after we've already started doing it.

The second piece of this story is our office. So Ruthie, Peng, and I are crammed into a two-person office. It's cozy, but, it's ours. Peng and I managed to find a few things for it...a nice little fridge, I had a little desk lamp, Ruthie had bought a microwave...and then, like, three weeks ago, Peng and I are on call together and hanging out in our office, and Ruthie shows up all of a sudden with a dolly full of...well...stuff. She brought a coffee pot and a grinder, another desk lamp, a bunch of random little things, a weird little black desk (that we promptly set the med student to work assembling), and this...well...there's this hot pink, cushioned, suede folding butterfly chair, and then there's this five-headed pink medusa lamp. So, basically, we have a dorm room (no really. There's even a bed...well, a camping mat...under my desk). Other words that have been applied are "bordello" and "trippy." John pointed out that he was walking down the hall and just "drawn in by the pink glow emanating from the doorway." So earlier this week, Ruthie and I were rearranging the office (all of our stuff fit just fine until we had to put, you know, Ruthie in there), and we solicited a second opinion on the layout from Tyler, and Edwina, who's one of the social workers. Tyler suggested we needed a stripper pole. Edwina suggested that we could use that as a means of teaching our patients a marketable skill. Like vocational rehab, I suggested.

So Ruthie and I passed this idea on to Peng. Who pointed out that she didn't really know how to use a stripper pole.

"Oh, no problem," Ruthie says. "Stripping is like CBT. You'll just pick it up as you go along."

I laughed my ass off. But, yeah, that was probably only funny to us, wasn't it....?

Sweet baby girl

(Which is, of course, a reference to this song.)

Love Thursday is a couple days early this week.

I still have so much work to do that didn't get done. And my poor dog had to wait and wait and wait because the dog walker didn't get my message in time to come by today. Doesn't matter. Maggie managed just fine (although she was SO happy to see me when I got home, and barely spent enough time outside to pee), and the work's just going to have to wait, because, I had something much more important to do.

Crazy pregnant lady? Had her baby today.

Her day didn't start out that great. I called L&D around 8:15 to say, hey, when did you want her there, anyway? And the nurse says, "She was supposed to be here at 8." So there was this flurry of activity to get her off our unit and fuss, fuss, fuss. You know, honestly, my day didn't start off so well, either (I think I'd been at work about a half hour when I turned and said to my social worker, "Oh, I am so not in the mood to be fucked with today, so everybody just needs to stop").

On the whole, a really, really stressed-out day. My crazy patient (the non-pregnant one) is now crazier than ever and has now failed four medications. We're now looking for the outlandish and ridiculous explanations, like, thalium poisoning and porphyria. My patient load is just huge and sick and bad. And call, at least was mostly just hand-holding.

I did get a great quote today, though, from one of my patients on the ward. "I've learned not to say never no more, because you never know when never's gonna come."

But then, when I was done with call, I went over to L&D.

I checked in on my patient, of course. She was fine. She actually looked better than I'd seen her in a while. I mean, still hates me, but less vehemently. And I just popped in, because she'll come back to our unit tonight and we'll keep an eye on her for a few days, because she's at very high risk for becoming more acutely psychotic. But then...then I went upstairs and met Molly.

Oh. There are not words to say how sweet and adorable this child is.

I held her. And I snuggled her. And I told her how glad I was that she was out. I kissed her little head and wished her luck in things to come. I gave her a little advice on life...play nice with others, seek therapy early, try to always do the right thing, and get a dog. I apologized for dumping all those drugs in on her and her tiny little brain. I told her I was sorry she was never going to know who her father was, and that I hoped she got a real daddy someday soon (Jenn, I'd so send her to you if I could). I cuddled her and cooed at her and couldn't bring myself to put her down. Oh, she's just so sweet. I wanted to take her home and snuggle her for the next five days or so, help her with that crucial bonding time, just wander around with her in one of those baby pouches (what the heck are those things called again?) for a few days and keep her close. And then give her to a good family. She deserves so much more than she's going to get. She deserves love and cuddles and adoration. She deserves parents who love her to bits. She deserves to keep her sweet, pure, unmarred innocence as long as she possibly can. She deserves to have a full and wonderful life full of love and happiness and the elusion of her genetic loading after starting with such auspicious beginnings.

I totally hadn't anticipated how relieved I would feel once she was out, but I just am. So relieved. Now I can treat her mom like a real schizophrenic and not worry about what I'm doing to her little baby brain. I no longer have to worry about her randomly dropping the kid on the unit and not telling us about it. All the fighting about sterilization vs. Depo Provera vs. an IUD has lost a lot of its urgency. And this beautiful, perfect creature is here with us now.

Welcome to the world, baby girl. It's a hell of a ride.

Serious as a gas attack

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

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

And. Bones is back.

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

And got great quotes like the title, and these:

Booth: What are we, brook trout?

Cam: The body was braised like osso buco.

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

Booth: Special Agent Seely Booth. Special.

Brennan: Oh, we're not blue fish.

Booth: That's very damn poetic of you.

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

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

And my personal favorite -

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

Ohh, how I've missed Booth and Brennan.

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

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

A Happy Single People Awareness Day to you

Ah, Valentine's Day.

So I'd been meaning to swipe adopt this Love Thursday thing from Barb for a while, because I like the idea - what I got from her blog (Barb, correct me if I'm wrong here) was that somebody at some point declared that Thursdays were a day for accentuating the positive and discussing what all is good. What I got from a quick Google search trying to decipher the origins of this thing is this, that the original charter was from two women who don't seem to be blogging anymore who advocated the posting of pictures reminiscent (see, this is why I need the spell checker to start working again!) of hearts and love and loving things. Eh, whatever. I like my interpretation. And it seems (again from said Google search) that many other Bloggers out there share my take on the topic.

I thought about being all "different" and going with Love Tuesday or something like that, but since it happens to be Valentine's day, and I discovered I was writing a whole post full of things I love, it seemed like a good time to initiate Love Thursday on my own blog.

So, without further adieu, here's ten random things I love today:

1. My dog. You know that I could not possibly initiate something called Love Thursday without starting with my dog.

The rest are in no particular order or actual relevance to my life. Obviously.

2. Oprah. I have been an Oprah resister for a very long time. I roll my eyes when people say "I saw this or that on Oprah". Please, Oprah. I mean, I'm from Chicago, where Oprah is even more of an institution than she is in the rest of the world. But come on, she's just Oprah. She's so overdone and really, what-ever. And so then I'm quarantined and trapped in my apartment home sick all week, right, and my aunt, the one who isn't really my aunt but I grew up with them and they live down the street from me now and who is a HUGE Oprah fan, is like, oh! You have to watch Oprah! She's on every day at four! Alright! Okay! Bye! (That's how she ends every phone conversation. I also love having them so close, in case you missed that)

I'm hooked. ::sigh:: I'm so going to have way too many things piling up on the DVR that I'm never, ever going to have time to watch...

3. That Oprah did a whole big segment on shelter dogs as part of her Valentine's Day show. That, truly, is what did me in.

4. Sassy comebacks. Like this line, from the episode of CSI I'm watching right now. Kathryn and Warrick have just shown up at a scene thinking they were working a missing persons case, and discovered that the missing Paul Sorenson was in fact, a painting, not a person. And the homeowner looks at them and says, like they should've known, "Paul Sorenson was an artist." And Warrick says to Kathryn, "Yeah? What does he know about the forensic analysis of a friction ridge?"

5. This line, from this email I got today. Apparently NaBloPoMo rides again, on a month-by-month basis, encouraging members to blog daily for a month on the given theme of the month (i.e., March is "lists"). And in their email they say,

This is not the same as Blog365 (http://blog365.ning.com). Those nuts are blogging every day FOR A YEAR.

Please. I've been called a nut for lesser things than that.

6. Bright copper kettles and warm woolen mittens.

7. My new felting buddy. Look, there he is on the washer!


So you know I've been having trouble felting with the frontloader. And yesterday, I finally managed to finish a project I've been working on (that is several months overdue and no, I can't show you yet, 'cause it's a gift), and was like, crap, how am I going to felt this? And I haven't really liked the results I got with the complex's Speed Queen. And my afore mentioned Oprah-loving aunt has offered me her washer, but you know, if you're not a knitter, and you've not felted before, you don't really know what you're getting into, what with all the fuzz and wet wool and whatnot. So I started thinking. I used to toss my Downy Ball in for added agitation. And I thought, hmm. Maggie's not really the tennis ball type, but I bet we've got something...

It's an old toy. She doesn't really like it anyway. I? Love it. It felted, um, my felting project, SO WELL. Oh, my gosh, it was a beautiful thing. I can't wait to show you how this thing turned out.

8. Crusty pox. I have TWO pox now that are all crusted over. Hooray!!! Finally.

9. This quote, which I found on the Center for Mindful Eating website:

Preach not to others what they should eat, but eat as becomes you and be silent.
- Epictetus, Greek philosopher

Sage advice. And further proof that way back at the beginnings of recorded history, the Greeks were still saying "just shut up and eat it."

10. Y'all. Sappy, I know, but I do.

Oh, it's so naptime...

Yesterday's post? Was supposed to automatically post at 8:30am. It just showed up now. What the heck? Clearly, Blogger and I need to have a talk about being responsible...or maybe I just need to learn how to use the dumb thing...anyhow.

So, who watched Bones on Tuesday night? There was this great moment, where she's interrogating this Jeffersonian Institute professor guy who's all smug and better than everyone, whom they suspect of murdering his mistress. It goes like this:

Aldrich: Dr. Brennan, surely I merit someone higher up the food chain than an FBI consultant.
Brennan: Kyle. I know you get everything you want by flaunting your superior intellect. But that won't work with me.
Aldrich: Why is that?
Brennan: Because I'm smarter than you are.

I? Love that.

I think I had more to say, but I'm also really, really tired. I had an interesting, but exhausting call. And I have to be at the hospital really freaking early again tomorrow. So, maybe I'll just go to bed...

More Must-See IFC

So, sadly enough, Trapped in the Closet has drawn to a bizarre and bewildering conclusion (it was actually the "hip-hopera" itself that was bizarre and bewildering - but oh so completely hilarious - more than the actual conclusion it was drawn to. Ooooh, the package! Chuck has AIDS. We get it). But if you click on the tab marked "More Cool Shit", you will find a short film (very short - the credits are as long as the "film") entitled Don't Fuck With Love: A Cautionary Tale in Three Fascinating Dimensions. The "film" part is moderately amusing - a Victorian pop-up book come to life - but the song, the song, is fabulous. Whoa, my god. It proffers such completely fantastic lyrics as "don't let Johnny Mathis lead you astray" and "first it may come as a gas, 'till Cupid, that bitch, puts a cap in your ass."

Not to mention my personal favorite piece of practical advice, "don't lead her on and think that's enough." A-hem.

So, go check it out. It won't take long.

And as long as we're offering up good quotes, I'm adding this one from last night's CSI (which is on the DVR. Have I mentioned how much I like the DVR?): We're all carrying prehistoric genes in a postmodern world.

I like that.

This growin' up stuff, man, I don't know...

(Missed the reference? This time I don't blame you, it's sort of obscure...)

So tomorrow, I have to be an adult again and go back to the real world (or, at least, as real as it gets in my world). I'm highly ambivalent about this. I hate not knowing what I'm walking into tomorrow morning, especially on a call day. But at least I'm only on call once this week, as opposed to the three call days I have next week. Oy.

Well, I guess we'll see how it goes. My service will have changed completely in my absence - that's one of the things about the short term unit that is both a plus and a minus. Like, I have no idea who these people will be that I'm seeing in the morning. I could have two patients on my service or I could have, like, nine. And who knows what they'll have been admitted for. But on the plus side, maybe they'll be a little less criminal than the group I left. Or maybe not. I dunno. But to pull a quote from my current favorite episode of CSI (which is so because it takes place at a state forensic mental facility, and which also just happens to be on Spike right at this very moment):

"Crazy or not, here we come."

I...for Pete's.... AAAAAAAAAAAAHHHHHHHHHHHH!!!!!!!!!

Ahem.

But before I explain the subject line, yet another CSI quote, that just happened to be from the episode I'm watching as I type this:

Someone asked the Buddha, how do we escape the heat of a summer's day? And the Buddha said, why not leap into a blazing furnace?

- From, Felonious Monk. And, I happen to know that's an actual Buddhist proverb.

Seemed appropriate.

So. Today. Day Two on the medical unit. Going along fine. Having a reasonably slow day, actually. And then. My Chief resident comes down, looks at the resident who'd been filling in for me whilst we all awaited my license, and then at me, and says, "I need to talk to you two."

After I reestablished a normal cardiac rhythm...because, I turned white, swallowed my tongue, and said, "wait, just...I still have a license, right?" and she assured me that I did...she then pulled me off the medical unit and reassigned me to the Men's Acute Stabilization (read: psychiatric intake and crisis) unit.

So now I'm on psych.

And now I'm on call tomorrow.

And there's like 27 patients on that unit. There were 3 when I left Medicine.

Plus, as I told them like eight times, I haven't actually done any psychiatry - any real doctor-in-charge, sanctioned psychiatry - in like four years. Since I was a medical student. By training? Gynecologist. Freakin' awesome to have around if any of these guys go into labor. But...that's really unlikely to happen. And I thought I had three more months to read and acclimate and learn something so that when I said "I don't know anything about psychiatry, you know" I wouldn't really mean it.

Oyyyyy.......

Plus, the reason I went over is unsettling (in a more personal manner). And I don't know many of the details, actually, which makes it even more upsetting, because the details I fill in are undoubtedly worse than what's probably happened. What I suspect is actually closer to the truth will probably just make me sad.

I guess we'll see.............really, I guess we'll see how much crazier this ride gets....

The first day of the rest of my life (or something like that)

Every day we meet people on the worst day of their lives.

-Grissom to Sarah, in one of the seventy thousand episodes of CSI I've watched over the past three weeks. According to a Google search, and subsequently, this site, the episode is called Too Tough to Die. So there you have it.

I kept thinking of this line on Friday. Which is not to say that I saw a whole hell of a lot of patients, or even that I'm doing psychiatry yet, really, mind you. I am, for these three months (well, now, nine weeks) working on the Internal Medicine service at the state psychiatric hospital with which my institution is affiliated (there are actually two in the area, which are going to conglomerate into one big new one, allegedly last spring, oops). So it's general medicine, except, on psychiatric inpatients. And as far as I can tell, usually ones who've been committed against their will, or they'd be at one of the "nicer" hospitals (although, this one is pretty decent). It's an interesting idea, and actually, I think the fact that we get to do our general medicine in this setting is a serious strength of the program. Because, really, whose general medical problems am I most likely to be treating in my career, except, psychiatric patients, with all of the comorbidities and special issues that label evokes?

But I digress.

My first day went fine, and thank you all for being so eager to hear about it (I actually tried to leave a blurb on here Friday night, but Blogger was having an off day or something, it wouldn't take....anywho...). It actually was fairly uneventful. I sort of picked up one decidedly now-stable patient, took a very disorganized history on her, took bloody FOREVER to write my note on her (because, seriously, the last time I wrote a gen med note was, what, four years ago when I was a third year medical student?), and then my cohort discharged her back to the psych service at the end of the day. I got orientation-ed to within an inch of my life again. I got very lost and confused on a couple of occasions. And we had a nice talk about acid-base disturbances and another about benzodiazepine withdrawal. All in all, a good time.

On the whole, no one was mean to me, I like my co-residents, and one of these days I'll be able to find everything. And my attending seems cool, and he teaches a lot, which I really appreciate, rather than being demoralized for my lack of telepathy. But I couldn't quite shake the feeling of being a fish out of water, still, which was a very weird thing for me in a setting where I used to feel quite, well, wet and fishy. I think part of it was coming in late when the rest of the team already knows their way around and gets the routine. I think a lot of it is still feeling like I'm supposed to be the gynecologist, and where does a gynecologist fit in the medical unit of a psych hospital? And part of it, certainly, is still that feeling of not being worthy of being on any unit, left over from my last experience (my therapist once referred to this component of said last experience as "brainwashing"...).

Those last two are going to be pervasive themes this year, I think.

The latter, well, it's just something I've got to work on. But I do miss that feeling of...not even of knowing what I was doing, because I still do, but of knowing that I did. Of course I didn't have all the answers; we never do. But there was a time when I knew that I could find them, or the people who knew them, that I was intelligent and well-trained and facile enough to do what I was doing. There was a time when I felt worthy of what authority I carried and confident that I could manage what I was given. There was a place when I questioned my decisions a reasonable amount - and I do think that's wise, it keeps information fresher and perspective sharper - but I did not question myself to this unreasonable degree. I miss that. I feel like that's been forcibly taken from me, like so many other things have. And I'm sure, with time, it'll return, but you know something? It really does suck.

As for the former...I'm certainly not the only one in my program who's coming from a non-traditional background - two of my colleagues were out in practice elsewhere. So, they didn't just come out of their fourth year of medical school having done a boatload of psych electives, either. And no one here seems to expect me to be a font of psychiatric knowledge right out of the gate, especially since my first four blocks are primary care. It's going to be fine.

But it's also definitely an adjustment, and that's where that quote kept popping up on Friday. When I was a gyn, I saw a lot of people on the best day of their lives. Or, the first day, for that matter. I saw them on some anxious days and some complicated days, but, like...I had this very simple case, medically speaking, on Friday. Yet, for my patient, there was absolutely nothing simple about that day. It was scary as hell. She ended up in my care through almost no fault of her own. She ended up needing psychiatric care because something unthinkable had been done to her by someone she trusted. She didn't have nine months to plan, even poorly, for what happened. There was no pre-op visit, no explanation of risks and informed consent to sign when her life was shattered. I'm sure the sheriff was occasionally involved in my old practice, but rarely if ever did my patients come to me as a direct next step after meeting him, and I don't remember anyone waking up in handcuffs. If I were ever to go to court and sit opposite my patient (which, let's face it, as an OB, I would have eventually), it would've been by their charge, not by some third party's, not by mine, and I certainly wouldn't have wandered across the street to some little stone house (which is where the magistrate's court or whatever it's called is located at our state hospital) to do so. The day you come in to the hospital to have a baby or to have an ovarian cyst removed or, really, even to have your cancerous tumor removed, it's probably a remarkable day. But not in the way it the day you come to the psych ward, especially if you don't come of your own accord. I'm not really qualifying that as better or worse than the OB/G populace; it's just...different. And going to take some adjusting.

Oy.

In totally unrelated news, though, I have spent a good portion of my weekend reading the seventh Harry Potter book, and I have to say, I was pleased. I liked the ending. I even liked the epilogue. I really liked Chapter 33 (partly because I also really like being right, and I called that, like, three books ago). I have some minor complaints about it, and things I really appreciated, neither of which I'll air here just yet for fear of being stoned for spoiling the plot, but I will say, I thought it a fitting end to the series. Which, as much as I enjoy them, I agree that they need to conclude. But I look forward to whatever else Jo Rowling decides to write now.