Tuesday, June 16, 2009

Every now and then every girl needs...

Which is a reference to this song:



(I really like Leann Rimes. Like, as an entity. She's grown up quite gracefully.)

Today did not go especially well.

Call was fine. I was on with Scott and then Fang. Scott, who was on for the third time in five days and was supposed to leave by 10pm, left at 2am. Which was partially my (and Fang's) fault - we kept talking to him. If we'd just ignored him and made him write his notes, maybe he would've gotten out of there before I went to bed. But on the whole, the evening did not suck.

Strangely, I'm not as excited about this "end of call" thing as I want to be. I'm a little freaked out by it, frankly. Like, it definitely marks the end of something, a change, an evolution of my professional life. For the past seven years it's been part of my identity. Even when I was "on sabbatical" and not actively taking call, it was something I did, planned to do again, a fact of my life. It's something that is very different from normal people's jobs.

I don't think I'm trying to say I'm afraid to be normal. I just think, it's a shift. A harbinger of change.

I spent a good deal of time today contemplating the difference between novelty and change. I like novelty. Change makes me anxious. But I'm not entirely certain how they're different.

Gomer sent me a weirdly cryptic text yesterday afternoon, saying "be sure to watch the news tonight for important gym information." I was like, what?? I finally pestered him again around 11, because there was no "watching the news" in my evening, and he confirmed what I've been saying for over a month - our gym is closing. June 30th. Frack. So we talked about it a bit and came up with a plan because they were going to relocate him to the location Ruthie goes to. It's a meat market, and everyone from work goes there, but I like my trainer and so, fine, for him I'd go to Ruthie's club. Except then, this morning, there was this article in the local paper saying that the chain is closing all of the Triangle locations within three months.

I'm so not pleased. I like my gym. I like the people at my gym. My gym is comfortable and generally emotionally safe. I have gym friends. Where are we all going to go?

Allegedly, the gym that's next door to my apartment bought out all of my gym's current contracts. Which, I guess that's handy. I don't know what that means for me and Gomer. I like Gomer. Gomer and I work well together. He's pretty. He's also comfortable and generally emotionally safe.

Do they not understand how hard it is for me to go to the gym in the first place? Some day I'll post about just how unbelievably charged this whole thing actually is for me...

I also got my TSH drawn today. My doc and I have been steadily increasing my dose of thyroid hormone for several months now. At the last draw, it was down to high-normal, which meant it was responding to a reasonable dose of the meds. That was three months ago. Today? The highest it's ever been. What the fuck, people? That makes no sense.

I also got called into the principle's office today. Okay, because of a problem I went to her with, but I have to go meet with my program director tomorrow. I feel like I'm so very in trouble, primarily because of the way she worded her email, which was not actually indicative of me being so very in trouble, but rather of her paying attention to what I was saying. However, she happened to use the exact same phrase that my program director at the Emerald Palace used to basically tell me they wanted to put me on probation ("We should talk about this." Not exactly an uncommon bit of verbiage). That's definitely not what's happening here. But logically knowing that doesn't make me any less anxious about it.

A couple of other things happened. All in all, it was not a good day.

But then, I got a little nap, got a little shower (since I finally went to the gym today, and of course, now there's NO air conditioning at all), and went and picked Maggie up from the daycare. And then I went and got a cheap manicure at this place I went to a couple of times when I lived here first year. They're extremely reasonable and they do pretty good work. And then I went and had dinner with Sparrow and Rene at this local Mexican place I've been wanting to try (Ruthie got lost and Peng was on call, but I like to think they were there in spirit). And by the end of that, I felt so. much. better.

LeAnn knows what she's talking about.

Thanks, ladies.

Monday, June 15, 2009

You don't have to go home, but you can't stay here.

(which is a reference to this song. In case you missed it)

It's Last Call, people.

Barring extenuating circumstances, tonight is my very last overnight in-house call EVER IN MY WHOLE LIFE. This boggles my mind, because as an OB, I could've still been taking call the day I retired. Psych? Notsomuch.

This is beautiful.

It's also really, really weird.

And it's also 2am. So, I'm going to stretch out on our little pink chair for the last time and get some zzzs in while I can...

Sunday, June 14, 2009

Whew!

It's been a busy weekend.

Friday was Graduation. I, of course, was not graduating, but it was a really good time. There's a group of people in the program right now (whom I referred to several times as "the core group of smartasses") whom I just really like. Funny, smart, sassy, some are loud, some are more stealthy. And there are several of our faculty whom I just really enjoy both on and off the clock. I mean, on the whole, I work with really good people. But some of them are just particularly fun.

I was driving home Friday night and thinking, wow. I'm so grateful to be where I am. Several people in their graduation speeches referred to the department as "family," and, I agree. Things aren't perfect, and some days we like each other more than others, but when the chips are down, you know you can count on the people around you. I like that. It's a nice change. I was thinking how awesome it was that right now, things are hard because residency is hard work, not because the people who claim to have my back are busy sticking a knife in it.

Saturday was a lazy day, until Porkfest II (you'll remember last year's. The idea was, Mike made a few key dishes - including his phenomenal pulled pork. It's epic - and everybody brought something to share. But the caveat is, whatever you bring - salad, entree, side, dessert, whatever - has to have pork in it). Blogger, sadly, won't let me upload the pictures, so the full details will have to wait. But it was a good, good time. I got to meet May's girlfriend and June's boyfriend, both of whom I liked very much (I'm always impressed with people in residency who can meet and date people outside the hospital. And good people at that). A couple of Mike's local friends were there, as well as his roommate (whom I also like very much. He tolerates all of us remarkably well). We hung out and ate well and chatted and laughed and had a good time. Bernie's husband Scotty (who gets this pseudonym because he is - wait for it - Scottish) helped us out with our now-annual-tradition of prank-calling the crisis pager. Scotty told...uh...Scott (I didn't think this pseudonym thing through very well, but since Scott already had his...well, try to keep up), who happened to have the misfortune of being on call for Porkfest, that he was distraught over David Carradine's death ("Who's going to do all those Kung Fu movies now?!") and had been drinking for four days and now wanted to kill himself ("it should been meeeeeee in that closet!" he wailed). So Scott asks him who's with him. Scotty says, "my brother and my mum," and Scott asks to talk to his brother. So Scotty puts down the phone, talks to himself for a minute, and then picks it back up claiming to be his brother.

Scott may have gotten wise to us at this point, because he told Scotty, "I think your brother is suffering from multiple personality disorder. You sound an awful lot like your brother..."

But Scotty kept it up until we decided poor Scott'd had enough, and even at that Bernie and I practically needed to tackle him to get the phone back. I offered to bring Scott some food for being such a good sport. He was not especially amused by us, I think.

We, on the other hand, were totally amused by us. Oh, Lord, I almost wet myself...it was classic. Scotty did a helluva job, no joke.

We kicked around for a while after that. One of my favorite social workers showed up, which was a good time. I left around 1, and it was a good night.

Today, I got a lot done. I'd turned in around 3, and unfortunately woke up at 8:45. Bleh. So I stubbornly stayed in bed for another hour, and then got up, got dressed, and went to the State Farmer's Market, which is always a good time. I got a lot of fruit and absolutely no pork products (I'm a little porked out, frankly). I also bought a giant tomato plant, which I'm hoping to find a pot for (I think I may have officially killed the lemon tree I have that was older than me, although the other plant I thought was long since dead is showing some nice signs of life. And the other lemon tree has just exploded since we moved. I pruned everything today, so, we'll see). And then I went to the Fresh Market to get the rest of my groceries (still no pork). I did dishes, I did laundry, I washed fruit, I fussed. And then Sparrow called, and she and Maxine and Maggie and I checked out the dog park close to the hospital. We hung out there for a couple of hours, until all the involved parties were worn out. Maggie's been asleep ever since we got home. I've been finishing up the laundry and dishes and fussing and made dinner and she barely even lifted her head to pester me for my table scraps.

She's right. It's definitely time to go to bed.

Saturday, June 13, 2009

Late

I have much to tell y'all. But it's 2:30 in the morning and I want to go to bed. I got home about an hour ago from Porkfest II (will link tomorrow to the post about last year's festivities) and will tell you all about it tomorrow. Meanwhile, here's a preview:

(It's sausage. Wrapped in bacon)

Friday, June 12, 2009

Weird

Watch this:



I find this weird.

A, why was she looking at her own intestine? I mean, fine, I had my tonsils in a jar when I was a kid. And yes, I have laparoscopic pictures from my appendectomy. And my pathology prof in medical school kept slides of my appendix for me (he just never got around to giving them to me)...you know what, never mind, I think I have lost my right to comment on her having her own slides...

But good for her. I mean, I'm sorry she has Crohn's, but far better to know that now than to keep thinking she has Irritable Bowel until she perforates something. And good for her for being vigilant. And why isn't she planning on medical school? According to my friend the pathologist, the world needs vigilant pathologists.

I still think it's weird.

Thursday, June 11, 2009

Also counting.

My very dear little niece, Annalise, is two today. I can't believe she's that old already!! I made her a blanket when my cousin was pregnant - it was the first real crochet project I ever did. I had to have Joyce at the yarn shop teach me how to crochet so I could even start it. That seems like yesterday.

Wow.

Happy birthday, kiddo!

Counting...

I can count two posts yesterday as covering my post for today, right?

Sweet Mary Jane, am I tired.

Drove to the coast today. I have one more week of doing that, then I'm done with AHEC. Potentially forever - there's an AHEC requirement in fellowship, but I'm hoping to be at the county child abuse and maltreatment clinic, which isn't technically part of AHEC but (I'm told) should still count for my requirement.

I like my ACTT people. And they just got a new substance abuse counselor, who seems nice. Fritz is going to be their guy next year, and I think he'll do well there. They'll like him. He'll be too tall for the plane, but he's probably used to that. Fritz is a nice guy, I hope it goes well for him.

I feel like the free-range crazy chasing has fallen, for me, into a greater pattern of unrest. As my supervisor so eagerly pointed out, I've been very unsettled this year. I really, really liked the people I worked with at the ACT team (I would've switched sites mid-year if I didn't. In a heartbeat), and I really liked the work we did, but I really wish I'd had a little more consistency. And with all of the not going because of call, because I was on day float or night float, because I was sick, because the weather sucked, because I was on vacation...it made it hard to settle in. Some of that would've been better if my location were closer - i.e., there were several days I could probably made it through a day locally, but I was feeling way too sick to drive five hours or have my eardrums explode on an unpressurized plane. The weather, obviously, would've been a trivial influence instead of what turned out to be a huge one. The rest, well...that's part of the scatteredness of second year. Which, in general, I'm happy to leave behind. Because it's funny how, even though I'm scattered to all sorts of places, I'm still plenty responsible to the places I've left behind.

It's exhausting.

Wednesday, June 10, 2009

Answers

Oh. And in answer to some recent queries...

1. Carol - I bought yarn at the yarn store. Ha! No, seriously, I bought two colors of this merino/silk blend and a ball of Kidsilk Haze for projects which I will detail later. Maybe this weekend, maybe after Peng's wedding, but probably this weekend because they're not exactly secret, and only one is for her. I just need time to sit and write about it.

2. Maggie only gets to go to daycare when I'm on call, which means, sadly, that she only has one more little visit to daycare left (that's sad for her, not me). I mean, she'll stay there when I go home in July and December and when I go to Hawaii in October and any other times I might choose to leave town without her, but for the day to day, next Monday is it. However, we have a very nice dog walker who comes every day. He's an older, retired military guy and she adores him. He's really very fond of her, too. I like having him come, but I wish I had the funds to maybe put her in daycare one day a week, because I KNOW she loves hanging out with the other dogs. When I'm not post-call, though, I rarely make it home before 6pm when their pickup hours end (which is why the dog walker comes this year, because my days are looong). So maybe when I'm a Child Fellow, on the day I'm at State Hospital all day. We'll see.

3. I have not, I promise, forgotten about the prizes from the lyrics contest. I've just been working too much and moving (Julie moved, too) and now I can't remember where the post office is. Plus, Jenn, I have some finishing touches to put on something that's going in your box. But I need to send that stuff out, soon, because I'm thinking of doing the lyrics contest again. That was fun. But...patience. I promise it'll be worth the wait, and I'll be more expedient next time (that's a lie. I just moved the box of Barb's stuff I was going to mail to her for Christmas. Which is lucky, because we had to add something for the puppy). Hopefully within the next couple of weeks. (Julie, you need to Facebook me your new mailing address!)

4. I had a really, really long day. So long, in fact, that I just typed "That was fun. But...patients." And then looked at it for a good twenty seconds thinking, no...that looks wrong... So I'm going to bed. Oh, but not before I add...

5. Anonymous - NO PANTS!!

I so should make one of these for my dad...

(Pattern here)

Tuesday, June 09, 2009

Post-post

Sometimes the day after the day after call is even more tired than being post-call. Add the fact that I was on walk-ins today (so, day call, really), and that leaves me beyond run-down.

Maggie gets all worn out on my call days, too, when she goes to the daycare.

We're tired, y'all.

It's storming out there, pretty badly, but Maggie doesn't seem to mind. I think we'll go to bed and knit and listen to the storm...

Monday, June 08, 2009

Mushy

I think my brain has liquefied and is now dripping out my ear...yesterday was horrendous. I had eight follow-up consults and saw a lot of patients in the ER and was up until 2:00 writing notes and then blissfully I got about four or so hours of sleep (thanks, Peng! Such a good Night Float) until Family paged me to try and dump a patient on us.

We had the world's longest checkout and then I had to call back one of my patients. Who called from the hospital. Which was weird, but at least he wasn't calling from the psych ward.

I was going to go to the gym after I left work, but, of course...I forgot my pants. Which, I can't work out without pants, at least not at the gym (no pants!). So I went to Target, where my weird headache turned into a full-on migraine. I was queasy. Things were loud, and smelly. Bleh. But 800mg of Motrin helped. All of the caffeine I drank finally kicked in. And so I ended up taking a very meandering trip to the yarn store (through two bookstores and an eco-stuff store) and lost about 45 minutes somewhere in the yarn store, so I was two minutes late (i.e., their pickup time is 5-6, I got there at 6:02) picking up Maggie from the daycare.

She's tired, too. There was some whimpering when we left the daycare - she looooves the daycare - but she's done nothing but sleep (and beg for cheese) since we got home.

Come to think of it...she's got a good idea.

Sunday, June 07, 2009

Worst. Consult. Ever.

So I get this page...

Me: Hi, this is Dr. Kate, I'm returning a page?
Her: Yeah, hi, this is so-and-so med student, I was hoping you'd do a consult on my patient.
Me: What's her story?
Her: Well, she has a history of Crohn's disease, and is on prednisone, and four years ago when she was on prednisone, she became psychotic.
Me: Okay.
Her: So will you see her?
Me: Is she psychotic now?
Her: No.
Me: ...um...then there's not really anything for us to do.
Her: Well, also, four years ago she was discharged on Abilify, which she hasn't taken in about three and a half years. Should we restart her on this?
Me: Is she psychotic?
Her: No.
Me: Well, then let's hold off on the anti-psychotics.
Her: So my attending would like you to see her because he's worried about keeping her on the prednisone.
Me: Well, she's tolerating it. And not psychotic. So I'd say, if she needs it, keep doing what you're doing and call us back if she gets psychotic.
Her: Yeah. Okay. Thanks.
Me: Anytime.

Apparently, this whole exchange actually started with her paging Scott, my intern. Who told her she was paging the wrong person. And then added, "So, I'd start out by telling her you're a medical student. Because, otherwise? I don't see this going well..."

Saturday, June 06, 2009

One-day weekend

Tomorrow? Is my very very last weekend call EVER. Which - thank GOD, because I hate weekend call, and tomorrow looks crazy busy.

But, nonetheless, I'm on tomorrow, so of course I had to try and cram a whole weekend into half the time. I slept in (sort of...I didn't actually sleep that late, but I refused to get out of bed). Gomer kicked my ass. A lot. There were wind sprints involved (Or as I like to think of them, "wheeze sprints." I had to go get my inhaler...argh) and throwing of 15lb medicine balls. And then I was going to do more time on the treadmill, but, damn, I was just finished. So I did a five minute cooldown and then took my funky, sweaty self over to the Whole Paycheck, which entailed buying a zillion pounds of fruit (I was hungry and had no oxygen going to my brain...), two bottles of this Syrah that I like (on sale. Much better price), and standing in the frozen food section for a good long while trying to remember what I was supposed to buy (see above re: lack of sugar/oxygen). I drove home, hung out with Maggie, showered, napped a little, and then had a nice night out with Peng - makeup fussing (wedding is in FOUR WEEKS. Ack! Where's my dress?!), then wine tasting (I acquired a nice Riesling) and dinner (not awe-inspiring, but decent). And then we went back to her apartment and she fed me homemade mint-chocolate chip ice cream, which Chef made with fresh mint that they had grown in their kitchen window. Seriously awesome. Plus, we're making headway on having a plan for the bachelorette party/wedding weekend festivities. So, really, rah.

But, looking at the consult list I have to cover tomorrow, I'd better get to bed. I don't need to be in until about half an hour later than I usually do (call starts at 8:30), but I have to drop Mags off at the spa first. She's excited. I think I'm going to have them give her a pedicure while she's there. I don't think she's very excited about that...

Last weekend call EVER folks. That? That's definitely exciting.

Friday, June 05, 2009

Enforcement

Today....you know, it really wasn't awful, but, I'm still glad it's over.

My day started with a very nice lecture on adolescents and substance abuse and I was reminiscing a little about what a "good" group of kids I ran with in high school. I mean, we weren't self-righteous or prudes, and I know some of my friends did plenty of stuff (one of my softball friends, who was, like, the last person I would've expected it from, taught me the meaning of the word "kegstand"), and - believe me - we got into plenty of adolescent hijinks, but when it came to stuff that could be smoked/ingested/inhaled, we were sort of like, "nah, we're fine over here. That's what college is for."

I also was reminded of how one of my therapy kids came in a couple of weeks ago and said that her friends, to show their support in a difficult time, came over with "cookies and monsters." I, of course, being the ever suspecting doc that I am, was like, that has to be a drug reference, right? But I'll be damned if I knew to what. So I said, I don't know what that means, and she tells me, "Monsters, you know, they're these energy drinks." Oh!, I said. Monsters. Duh. Got it. And then she looks and me and says, "And cookies. You know, they're like....cookies."

Believe me, hon. I know cookies.

So then I go back to my office, and am talking to Peng, and I get this page, "The police are here and need to see you ASAP." I was like, what?? Peng says, it has to have something to do with your patient (there's history to that comment, just trust me). And I go up, and of course, that's why they're there. I talk to the officer, my patient and I have our session, she's safe, it's fine, I send her home. You know, via the police, because, well, it's not like she can walk. And I go into my next session, and get paged out because the officer that brought her is all, you let her go? Are you kidding? I say, no, it's fine, we did our thing, she's okay. She didn't give me any reason to petition her. And the officer says, "her phone call to me this morning is enough for an emergency commitment" (which is wrong, by the way. It's enough for an emergency petition and custody order). I shrugged and was like, sure, it's enough to petition her and bring her in for evaluation (because that's what a petition means. It's not a commitment all by itself. Anybody can take out a petition, but to get the commitment you need a Qualified Professional's Exam, which - guess what, lady? That's me). I evaluated her and let her go. Cop lady, although very nice, was clearly not pleased. The hospital police, who know me (and the patient), were like, are you sure? Well, okay, Dr. Kate! But then, to her defense, they (and I) see a lot more of this every day. There's a reason all the hospital cops know me, and it has nothing to do with my killer smile.

Look, folks, we deal with this every day. Involuntary commitment doesn't really prevent people who really want to hurt themselves from doing so, anyway, it just delays them. And with the type of therapy she and I are doing, and her personality disorder and current situation, this was what I was supposed to do. I understand, totally, where she's coming from. I happily gave her my name for her report. But, you can't keep all the crazy people locked up all the time. There wouldn't be anyone left on the outside...

So I went back into session with my next patient. Meanwhile, Peng, who noticed I'd been gone longer than the standard amount of time for a therapy session, went out to the front desk to find out if they really had come with my patient or if they'd come to take me away.

(I suspect that the men who do someday come to take me away will probably be bringing me a pretty white long-sleeved jacket...)

The rest of the day was largely uneventful, fortunately. We had a very sad but interesting M&M (morbidity and mortality conference, not the candy. It's a protected forum - i.e., nothing we say in there is legally admissible in court - in which we can discuss things that go wrong and how to keep them from going wrong again) which more or less involves a fubar on the part of another hospital service, and ultimately comes down to the "scary psych patient" syndrome. Which, unfortunately (although, thankfully not in this instance), can in fact be fatal.

I found out shortly after M&M that my coworker Eva is pregnant, with twins. She's seven weeks and they already have faces (that is one wicked ultrasound machine. I wish anything I'd ever worked with had that kind of resolution. But I digress). And, actually, tails (you had one too at that age). I'm excited for her.

My afternoon, fortunately, came and went. I have this one patient who's been in the clinic as long as I've been alive, and unfortunately it's now fallen to me to crowbar him out of the clinic, since I'm not going to be following him next year. I came up with a good plan for this, and he took it much better than I expected. He actually seemed to agree with the reasons I provided him with why he should be seen in a private clinic. I was pleased. One of my kids no-showed, the other was doing awesomely. And she was even early, so we ended a little early, and I got to leave with Peng.

All in all, not a bad day. But still leaves me shaking my head a little and thinking, my life is weird. Nobody else's job goes quite like this....

Thursday, June 04, 2009

Love my mom Thursday.

It's my mom's birthday. Happy birthday, Mom! It's amazing how I keep getting older and she doesn't...

I know I promised you a rant tonight, but I was on Day Float today and it was INSANE. We saw like a bajillion people and still had to hand stuff off. And y'all, I'm ti-red. So, rant delayed.

But did I mention it's my mom's birthday? Happy birthday, Mom!

Tuesday, June 02, 2009

Coming soon to a blog near me...

So, I initially was going to post a link to a very funny site that I stumbled across tonight in my oh-geez-I-can't-move, post-Gomer, laying-like-a-big-lump-ness (work was long and crazy. Oh, so, so crazy. Gomer, whom I haven't seen in two weeks because he was off at the beach and then I was moving, apparently felt the need to make up for lost time. And the gym was like SEVEN THOUSAND DAMN DEGREES. I had so few electrolytes at the end of our workout that I could barely put three words together. I stopped and got Schlotsky's for dinner purely out of lust for the roughly swimming-pool-sized unsweet tea that comes with their - also tasty - vegetarian sandwich, and cranked the AC in the car. Then I came home, delighted in the fact that my dining room table is still clear enough for me to eat dinner there, showered, and commenced with the lump-like laying. It was needed. Of course, the caffeine from the unsweet tea kiddie pool was not, and now it's 10:30...but, I digress. Longly).

And then, I started thinking about the conversation I had with my shrink last night, which entailed things like, "So, I've decided to make Gomer stop weighing me during our assessments (one of which is due soon. I'm hoping he forgets). Because the number is kind of irrelevant at this point. I think the measurements and body fat analysis are more meaningful, but as my body composition changes, that actual number doesn't mean shit. Like, I calculated my lean body mass the other day, which turned out to be X. And then I back calculated what my goal weight would be if my lean body mass stayed exactly the same - which it's so not gonna, if I keep this up - and I were 25% body fat, which is reasonable, and it was Y." She says, "Okay. And?" I blinked at her and said, "Well...I dunno, people who weigh that much can't possibly be healthy, right? I mean, what doctor's going to be like, your BMI (speaking of totally meaningless measurements) is like seven billion, but good work, you're not unacceptably fat anymore?"

Yes, I know. I did go to medical school, remember? I didn't even wait for her to give me the "you know you're being irrational, right?" look to point out that I was being ridiculous.

So I'm thinking about this tonight, and was trying to remember the formulas for basal metabolic rate and caloric need and blah blah blah, thinking about getting more strictly back on the meal plan my wonderful dietitian from a few years ago devised (she's in Florida. And not answering email), and feeling like that might not actually cover my BMR, which, is sort of the anti-answer. So I Google, and follow some links, and then I end up with three new blogs I totally love and a rant about why being fat is the last acceptable bias and this crazy, evil, awful woman who's crusading against fat people. Because we're just that gross, or something, I don't know why she feels the need to do anything besides shut the fuck up (because, really? REALLY what she should do).

But, now it's 10:40, and I do have to go to work tomorrow, and I decided I'm going to table that blog post for Love Thursday. But to give you a hint at the coming attractions, watch this:



(I so love her)

(Also...shit. I guess this means I need to actually write something useful on Thursday...)

Monday, June 01, 2009

Monday.

So I'm at work.

After weeks and weeks and weeks of filled-to-the-rafters clinic days, I'm finally having a light day at work. I saw two patients this morning, the other two cancelled. I wrote some overdue clinic notes, and did all my little "learning modules" for next year that were due like two weeks ago. I read CNN.com. I walked to the cafeteria with Sparrow. I've been harassing Tyler over text message. I talked to my folks, who are on the road in West Virginia, currently. I've been emailing with Peng (who's at her AHEC), and just text-paged Ruthie to let her know that Dr. Jabba (who is one of my favorite attendings and mentors and who is currently on-service on the Crisis unit, where Ruthie is doing coverage this week) dropped by our office looking for her, and referred to her as "his minion." This made me giggle.

Currently my 1:00 patient, whom I talked to last week and assured me he was coming, is a half hour late (I just checked my voicemail. He cancelled like an hour ago. Just glad he didn't kill himself. That's a weird occupational hazard, to think like that...). I don't expect my 2:00 to come, my 3:00 cancelled, and my 4:00 is new to me, but was apparently fired by her old provider for missing appointments. So here's hoping. I mean, um, so we'll see if she comes. I still have a big bunch of paperwork to do, but I decided to take a break and play on the internet.

I've been trying to catch up on some of my blog reading, about which I've been very bad lately. I cracked up at Barb's post about Alternate Rating Systems. And I've been reading up on Megan's blog, on which I was really far behind. She's stuck in the hospital after a cornual ectopic pregnancy on Clomid. Which sucks.

She also, though, has been doing this x365 thing, which I find very, very cool. And as I said in her comments, if it wasn't hard enough for me to come up with one blog post a day as it is, I'd probably co-opt it myself. But I clicked on the link to the friend she referenced, and then tried to click on the "x365.org" link, and I got the big "BLOCKED SITE" error with this message:

Please discuss any blocked sites in the Global category with your Vice President or Department Chair.

Uh, yeah. I'll get right on that (although, now that I'm vice president of the Housestaff Council, I'm wondering if I can start a campaign to unblock Facebook at work). But I wondered - why the vice president, not the president?

And furthermore, apparently it blocks x365.org and Facebook, but not things like PostSecret or Dickipedia (which, is a website referencing people who are jerks, not actual penises. But it sounds a little like a porn site, doesn't it?). Because that makes sense.

Alright. More note writing. Because it's going to be a long-ass day, even if I am doing nothing, currently (left home at 7. Work. Gym. Store. Shrink at 7:15. Drive back home. Shower. Bed. Repeat). Although my commute this morning? From 25 miles away? Took me less time than my drive to Starbucks and then to work program I'd been on when I lived a mile from the hospital. I love it).

Sunday, May 31, 2009

Golden

Happy birthday to my dear friend Ali. I'm not sure she reads the blog, but, well, this is what's replaced birthday cards in my life. Ali and I have been friends since I was four. We went to grade school, high school, through college together. I rented half my house to her husband for two years. I was in their wedding. That girl has known me longer than I think either of us cares to think about.

It's her golden birthday today (she was born on the 31st, and she's 31 today - I'm sure she loves that I'm telling you that). Her husband said he was making her Golden Grahams for breakfast and taking her to the Golden Arches for dinner. Someone on Facebook pointed out that he'd better be tossing some gold jewelry into that mix, too.

My golden birthday was fine. I was 13. It was a year, whatever. Actually, it was my eighth grade year, which sucked. But the birthday itself was decent. Claud's was a few years ago - we had a good time on her birthday (Cubs game with Ali and Jer, actually - Jer gave her nacho cheese for her birthday. I think he'd already eaten all the nachos), but 27 was a really terrible year for her, if I'm remembering right.

Girl, I hope this one goes well for you.

Saturday, May 30, 2009

Official

So, my mom and I went back to the cottage today and got all the rest of the stuff that was there. It's clean, the fridge is cleaned out, the trash is at the curb, and the keys are locked in the designated key-leaving location. I'm still paying the utilities for tomorrow, but beyond that, I'm officially out of the little house.

I was looking around today realizing, it really is pretty tiny.

And there was enough dog hair on the floors to make a whole new dog.

I think it was a good place to be, for the year. Mags of course LOVED the dog door (I never did find her Kong. I assume it's buried in the back yard somewhere. Along with at least one bag of walnuts and a Parmesan cheese container, which I found in the dog run today). I liked the freedom of the dog door. And I liked living where I was, for the year. I really especially liked it when Sparrow was right next door.

But, I had to leave, and, I like this, too. It's nice to be back, and it's doubly nice to have just moved somewhere but still know where everything is...

The dog walker came by yesterday evening. Boy, was Maggie excited to see him! He's going to be taking her out on the weekdays in the early afternoon. Because I may have most of my weekends next year, but I suspect my days are going to be looooong. He was pretty excited, too. He really likes Maggie...I mean, who wouldn't, but, really.

Will put some pictures up soon of the new place, messy and full of boxes though it may be. Don't worry, Carol!

But, for the meantime...I think there's a bed in my future...

Friday, May 29, 2009

Bleh

So I woke up this morning just feeling like crap. Crap-tastic, even. I had a weird migraine-y thing going on. So I snoozed for half an hour whining in my aching head about how awful I felt and how my tummy was unhappy and how I got kind of dizzy whenever I picked my head up...but I got up, and I got dressed, and I slumped down the stairs...and then had a conversation with my mom, who was like, are you nuts? Be a real person. Take care of yourself and go back to bed.

Wise, my mom.

And wouldn't you know it, a couple hours' sleep in a dark room helped a heck of a lot more than six hours of distracted therapy and two lectures would have. And as guilty as I felt about cancelling, my mom also pointed out that for the hourly rate they charge for me (which is, what, about $180 an hour more than I make), my patients deserved to have a doctor who was actually paying attention and not trying not to throw up on them.

I did get paged twice, though, out of my quiet, dark little den. One was Magical Corrina the All-Knowing, who needed my parking application (why do they create all this paperwork? I had parking. I'm still employed here. I want to keep my parking. Done. Is that so hard? Magical Corrina and I have other things we could be doing with our time), which was fine, because Peng was already on it and forging my signature on the paperwork I left on my desk and forgot to sign. The second page was this woman from the medicine service. It went something like this...

Medicine: Hey, I just had a few questions about this guy.
Me: Um, yeah, so, I think I only saw him, like, once. Remind me who he is?
Her: He's the guy with CF.
Me (amazed that that description actually did the trick, because, you know, like there's only one patient in the whole world with cystic fibrosis): Oh, yeah. What's up?
Her: Well, he's in the hospital.
Me: Okay.
Her: (silence)
Me: ...with a CF exacerbation?
Her: Yeah.
Me: Okay. So...
Her: Well, you know, there's a significant psychological component to it, too.
Me: Um...can he breathe?
Her: Oh, it's getting better.
Me: Uh-huh.
Her: Right.
Me: So...um...how can I help you?
Her: Well, I was wondering if you wanted to do anything.
Me: Uh, you know, I only saw him once, in the intake clinic, like a week ago.
Her: Right. And he's been taking the medication you prescribed, and went up to the full dose about two days ago, and seems to be doing pretty well on it.
Me: So, psychologically, he's doing better?
Her: Yeah.
Me: And...um...he can breathe?
Her: Yeah.
Me: (pause) Okay.
Her: So we were just wondering if you wanted to do anything else, you know, while he was in.
Me (trying to think of a way to put this tactfully): I...um...no.
Her: Oh.
Me: I mean, I guess if you feel like his medicine needs to be increased, you could go up another 5mg, but I think the thing he really needs is therapy. And we've discussed that, but if you could reiterate that, it'd be great.
Her (clearly frustrated that I just prescribed "therapy" for a "psychological problem"): Yeah, okay, whatever. Thanks.
Me: Well, glad I could help.

Here's a tip, for all of you consultants of psychiatry or future consultants of psychiatry or people upon whom others may consult psychiatry... Corrina aside, we're not magic. As our chairman is fond of saying, "We heal minds, we don't read them."

I still have no idea what she wanted me to do. The real reason they sent the guy to me was because they want him to stop coming into the hospital. I failed to do that with one 30 minute visit (he was 30 minutes late for his intake appointment) and ten days worth of homeopathic doses of an adjunct medication.

Uh....NO KIDDING.

I got a consult this weekend to come "talk" to a kid in the ICU who drank himself into alcohol poisoning because the team was too busy to find out "what was really going on." Yeah, like this kid's going to tell me. Surely they must realize that "Hi, I'm Dr. Kate, I'm one of the psychiatrists on call" translates, in the patient's head, into "Hi, I'm another random doctor. Clearly the team thinks you're crazy, which is why they called psych to come talk to your crazy ass." And when I balked a little at the consult, the resident call it in was like, "okay, and, so this is the second kid in two weeks we've had from his peer group with the same problem. We need to you to find out what's going on with them, see if there's like some abuse issues or something."

I? Am neither Colombo, Kreskin, nor DSS. And I do not speak the mythical language that makes teenagers give polysyllabic answers (I, too, still get "fine," "yeah," and "stuff"). But I couldn't actually seem to get out of doing the consult, and I figured (like so many of the ones that we do) it would actually be better for the patient to talk to me about it than the crazy Pedes lady who was overestimating my ESP, so I went and saw the kid. And discovered that, a, he'd already figured out this alcohol poisoning nonsense was a stupid thing to do, and 2, the other person from his peer group who'd had the "same problem"? Was a kid on our unit who tried to overdose to kill himself, not one with a raging case of bad judgment.

Sometimes I really have to wonder...what is it that everyone else in the hospital thinks we do?

Thursday, May 28, 2009

We know. We're lame.

But it's been a long, tired day here. But, my aunt came over today and helped my folks unpack the kitchen, and it looks great. The house is more or less livable at this point. The 'rents are going to go back to the cottage tomorrow and clean out what they can in the morning, I'm going to stop by on my way home from work and get the rest of it. Which will easily make for about a 12 hour day for me, what with the commuting and the fact that Fridays are typically long for me anyways.

But there's a weekend a-comin'. And bringing with it, naps.

Have I mentioned, though, lately (it is Thursday and all)? I love my family. My parents have been such a huge help with this move. I think they packed up like 70% of the cottage, and it's just been nice having them here. And my aunt and uncle (whom, I think I've mentioned before, are not actually related to them at all, but my parents met my aunt in a tour group in Hawaii some 32 years ago or better, when she was like 19 and they were, well, not. And, here we are...) also have pitched in a bunch. And they brought us homemade dinner last night, and she brought cupcakes (AWESOME cupcakes) today. An army travels on its stomach, you know? This move has totally been fueled by my mom's and my aunt's baked goods.

My folks are staying through Monday morning, which will be nice, to have them here all weekend. I have a friend's going away party on Saturday night, which will be nice, and I'm sure they'll enjoy the quiet without me here. And Sunday night we're going out with my aunt and uncle to the restaurant where Chef chefs, to celebrate birthdays and fellowship and life in general. Good company, plus - Gruyere mac and lemon tart, here I come.

But, for now? Going to bed.

Enjoy a gratuitous picture of my sleepy dog.

(Also? Love my dog. She had a long day yesterday protecting us from the movers - whom she loved - and the cable guy - whom she adored - and whatnot...I think she slept most of today away...)

Tuesday, May 26, 2009

3....2...1...

Well, we're pretty much packed up. Almost ready to go. I think the movers will not laugh at me in the morning. We'll see. Everyone keep your fingers crossed for us....

Monday, May 25, 2009

Ohhh, tired.

So we packed today. And we packed, and we packed. Peng and Chef came over and packed (they brought lunch AND told funny stories AND worked their asses off. AND Peng had fudge. What more could you possibly ask for?).

Y'all, I'm tired.

Poor Ms. Mags is starting to get really freaked out. She spent most of today making sure I wasn't leaving or lying in the spot on the floor of our bedroom where she stays during thunderstorms. My poor baby.

But we got a good ways through, today. We'll see how tomorrow goes. I have to work, so I'm leaving my folks with the lot of it. It should be doable, barring catastrophes. But we'll see (I'm looking for some wood to knock on...).

I'd rather be here. A, I think I could be more useful, and two, at least two of my intake patients tomorrow are referred by the pain clinic. Which...rarely goes well. One of them is listed in the chart as exhibiting "pain-seeking behaviors." I think, actually, they meant med-seeking behaviors. They seem to be a chronic seeker of opiates and benzos. Which...ugh. Actual pain-seeking behavior - now, that we might actually have something to talk about.

Keep your fingers crossed for us, folks...

Translation

(Re: the previous post - Jim? Is the gym. Several of y'all have asked who Jim is. See, sometimes, when I'm really tired, I think I'm funny....

Much packing to do today. After breakfast. Need to get moving.)

Sunday, May 24, 2009

Sit. Stay. (Maggie Speaks)

Hi everybody! Hi! Hi! It's Maggie. Kate...well...Kate seems to have passed out in the middle of the piles of stuff on the big bed. So I thought I'd write the blog for her. She's snoring a little, so I'm pretty sure she's not dead. I keep trying to tell her, the longer she stays away from here, the more tired she is when she gets home, and so she should really stop that. Frankly, I don't know why she leaves here, ever. Unless maybe she goes to the Daycare. That's a good place to go. I always need a nap when I get home from there, too, even when I stay overnight.

She doesn't seem to be going to my Daycare, though. Last time she was gone all night, Sparrow and I went for a big long walk. It smelled really interesting, and at the end we found Kate!! It was so exciting! Tyler was there, too, and Sparrow, of course, and these two other guys who rubbed my head, but neither of them smelled like they have packs at home. The Daycare they were at was really big, and smelled kind of funny. And there weren't other dogs there. And they didn't seem to have a pool. And everyone seemed tired, and the little screaming black box that Kate clips on her pants kept screaming. I'm not sure why she goes there so much.

Oh! Did you hear that? Is that a squirrel? Or maybe someone's invading. Or maybe they've got food. I'd better go check...

Today Kate smelled really good when she got home. She was all salty, too. I think she said she was with Jim. I don't know who this Jim guy is, but she's spending a lot of time with him these days. And she always comes home all damp and salty. Apparently he knows Gomer. I think maybe they're part of the same pack. So she went to this Jim today, and then came home and ate some of those salty triangles with the red stuff on them and she didn't drop nearly enough of them. They're better with some of the red stuff on them, but Kate never gives me much of that.

Oh! Oh! Guess what! Mom and Dad are here! They came this afternoon in the big loud white thing. Dad seems to have more fur on his face now. Maybe he hasn't been to the groomer recently. Mom brought cookies. Kate said I couldn't have any, but when they went for dinner, they came back, and Mom brought me a Jumbone! She let Kate give it to me, because Mom doesn't like it when I get too close. Kate said she had a dog in her pack when she was a puppy who was mean to her. I think that's sad. I like Mom, but I try to let her have her space so she won't be sad. Dad rubbed my head, though! And my tummy. I miss them. They go away for much too long.

They kept bringing in all these boxes. I'm not sure what that's about. They don't seem to have anything in them. I think it means we're going somewhere. I really hope Kate takes me with. I always get worried, when this happens. Sometimes, she just packs up that one black box with wheels, and then she's gone for too long. When she starts packing boxes like this, though, we usually wind up living in a whole different den (she calls it a "house." Whatever). She's never left me behind before, and we've been in a few different houses at this point. But I worry. I worry that she might leave and not take me with. I worry that she might leave and never come back!! See, I think the best option is just for her to never, ever leave. Or, you know, take me with her, always. Because packs need to stay together.

Okay, well, I've been awake for, gosh, like an hour now, so I'd better take a nap. I think tomorrow's going to be busy. Kate keeps saying things like "packing extravaganza" and "how in the hell are we going to get this whole place packed in two days?" Mom seems less worried. But, yep, better get to sleep. Thanks for coming by! Next time bring food, okay? Maybe Kate will let me write the blog again soon. It's kind of hard to type without thumbs, but, I think I was a good girl.

Wait...where you goin'? But...why? Are you leaving? Ohhh....okay....ooh! Look! Shiny! Okay, see ya later, 'bye!

Saturday, May 23, 2009

Nosh safely

There's a patient in the ER with a chief complaint listed as "snack bite."

Looking at the actual note, it's possible this could be a typo, as the story involves a snake, not a hamster covered in steak sauce or perhaps a rogue potato chip.

Still. Be careful out there tonight, people.

I'm hoping to get Doritos to sponsor the blog...

No, not really.

But I was wasting some time this morning (I'm on call. And pleased to have a little time to waste. Did I mention that today is my LAST SATURDAY CALL EVER? 'Cause it is. That makes me happy) and came across this, which made me a little nostalgic. I remember watching Wayne's World in junior high, while I was babysitting for the little girl across the street. I made microwave popcorn and tried to make hot cocoa on the stove. It was terrible. We drank it anyway.



Ahhh, Wayne and Garth. Still think the skits were generally better than the movie, but it was iconic. Even if the Cars on a Memo Spike thing was in North Riverside, not Aurora.

Party on.

Thursday, May 21, 2009

Technical difficulties

I can't get blogger to work tonight. So I'm trying this blog-by-text thing. Which of course means I only have like 140 characters...nevermind, I'm going to bed...

Wednesday, May 20, 2009

Best call ever

Today did not start well. I slept fitfully last night...had trouble getting up this morning, even though I got to sleep in. I'd planned on going in to work late, I ended up going in early. I was cranky. I was sore (I think muscles hurt today that I'd completely forgotten about. Seriously. I'm pretty sure my sartorius muscle hurts. That's kind of a rough one to make sore, frankly. I think it was the whole "bob and weave" thing yesterday). We had a meeting, and then lots of lecture, and then I was on call. I washed my scrub pants this morning so I could wear them for call tonight, but didn't actually remember to dry them before I had to leave. So I left them on my chair in my office to air dry. And then, of course, there was the actual being on call.

But then guess what happened.

My puppy came to work!!

(Okay, that's an old picture, from when she used to go to work with me at the yarn shop.)

Don't worry, Peng, we didn't let her in the office. Sparrow decided it was a nice night for a walk, and brought her up to the hospital. We were all hanging out writing notes when Sparrow called the workroom and was like, "Hey, I need a STAT psych consult on a nine year old female out here on the loading dock" (Maggie's only 7, but she didn't seem to mind). I hung up and said, "My dog's here, folks, I have to go." So my intern Julius was like "...can we come? I could use a little pet therapy." And so Tyler, Julius, the med student and I all went down and stood outside in the lovely evening for as long as we could manage without getting paged, which was actually a decent amount of time. Maggie was thrilled, and beyond wiggly. She dragged poor Sparrow clear across the parking lot when she saw me. It was the sweetest thing ever. Certainly made my whole night. Might have made my whole week.

Gosh, I love that dog.

(We're both pretty fond of Sparrow and Maxine, too.)

Tuesday, May 19, 2009

Ouch.

Everybody think encouraging thoughts for Chef. He and Peng headed out for a nice weekend in the mountains and ended up having his appendix yanked. I told him (well, I told Peng to tell him) I haven't missed mine for a minute. Still, yeowch. So, send good mojo his way.

Today was long, as Tuesdays always are. I had a much better show rate today (7/8). Two of my intake patients today were actually very enjoyable, even if one was 30 minutes late. One was a big ol' help-rejecting complainer (Fix me! Nothing you do will work!), although, I understand his frustration (I was still annoyed). My Tuesday afternoon is my psychotic disorders clinic, which is always interesting. I said goodbye to two of my patients today, as they will be following up with new residents (the current interns) the next time they come in, because next year we're only half time clinic (half time inpatient), so we have to pare down our clinics. Both are doing fine, will be delightful patients for whomever gets them, but one of them is one of my very favorite patients. He, unfortunately, may need more care than I can make available to him (I'm keeping 9 psychotic patients; they suggested we keep two or three) if circumstances advance as they might, so I'm passing him on, but, it was sort of sad. He was one of the patients that was in the NIMH trials back in the day when they decided to try psychoanalysis for psychosis. It doesn't work. But it gave him some really interesting perspectives on things, and he's a really smart guy, so he's always so interesting to talk to.

I've told a couple of my patients already that they probably won't be seeing me again. But, our psychotic clinics are smaller, and we tend to know the patients better, so this is the first time I've really been sort of sad about it. But it's the first of many of these goodbyes, since I'm only keeping 30 patients or so (ehhh...or so) next year, and then am giving those up the following year when I start fellowship.

Something about closing doors and opening windows, blah, blah, blah.

But I made it out almost in time, and headed to the gym, because I had my weekly ass-kicking scheduled. Gomer and I had rearranged this appointment, and we happened to be texting about this shortly after some annoying stuff had happened. We've been talking about pulling out the boxing equipment for a while, so I was like, "Can we hit things tonight?" And so we did. And it was good. He wiped the floor with me (actually, he made me stop after about 20 minutes when I couldn't especially breathe...), but I loved every damn minute of it. And I didn't even barf on him. And I did another 30 minutes on the treadmill afterwards.

I'm always the girl who fixes things, you know? Keeps her shit together and takes care of everyone else. I never get mad. I get incensed, but mostly about things that happen to people I care about, you know? And so even in this small, controlled, removed sort of way, being able to be a bit more forceful was really cathartic. And believe me, I've got plenty of untapped latent aggression yet to be liberated...

But then again, I'm a shrink. It's always either about sex or aggression with us, isn't it?

Monday, May 18, 2009

I knew it!

So, my nephew Luke's birthday was actually Saturday. Which is what I had written on my calendar, but, as we all know, I'm easily confused. So, happy 367th day of life, little guy. I promise you'll get that baby blanket sometime before you have your own kids.

(PS - here's how that cake thing went Saturday...



Don't worry. It got better.



Is he not just the cutest thing or what?)

Today was long and irritating. I had three patients show up all day, out of eight scheduled (I think it was originally nine, but one disappeared before last night, so they don't count). Only one cancelled. So I spent the day doing disability paperwork and making lists for the clinic people and talking on the phone to my "No really, I'm gonna do it, I will!" chronically suicidal patient who always makes me a little sad.

I went to the Staples, though, between work and my shrink, which always makes me a little giddy. What is it about office supplies? I'm such a junkie. I think it's all the possibility that exists in blank reams of paper and brightly colored pens. The sheer potential of an unsharpened pencil. It's quite heady. Anyway, today I bought new pens, a giant box of forks (you heard me), and a brand new July-August planner for my third year clinic. That's exciting in its own right.

It struck me today - isn't it interesting that "academic year" planners go by a residency year? I think it's probably coincidence, but, well, it's the sort of dumb thing I find "interesting." It's helpful, for me, at least.

Yeah, that's probably a sign I need to go to bed...I only got half the dishes done, but I think the others can wait until tomorrow.

Sunday, May 17, 2009

Back to the grindstone

So, it was a nice day. I got some things done, I had brunch with a friend, I took a nap, I went to the gym. I could still use another week of vacation, though...

AND, my nephew Luke had his very first birthday today!! There was a party yesterday, and apparently, our little guy wasn't so thrilled with the idea of cake. He'll learn. Happy birthday, buddy!!

Saturday, May 16, 2009

And, as a bonus...

Click here and go over to Barb's blog and check out the videos of her new puppy, Austin. Even those of you who aren't necessarily dog enthusiasts (Mom) should go watch this, because the sheer and utter cuteness is off the charts.

I especially love when Scout is trying to teach the pup how to fetch the morning paper (which the cow dog only gets most of the time, himself...).

Plus, I think maybe Ana has a career in directing.

Answers

So, in answer to the quiz posted yesterday....

1. My very first car was a red, three door hatchback Geo Metro. I got it when I was 16, and we traded my grandmother's Buick for two identical red, three door hatchback Geo Metros, except my dad's was a stick. Mine lasted about 60K miles; his lasted until I left for residency the first time (ten years, roughly) and might still be going if he hadn't sold it. I have owned all the other cars listed, though. I traded the Geo in for a black Jeep Grand Cherokee, which I traded for an olive green Pontiac Aztec when it started whispering about transmission problems. The Jeep had two broken bumpers and a ketchup stain I couldn't get off the back seat from one of my friends during our road trip to South Carolina first year of medical school. The Asscrack, as Brett has been known to call it, was a really awful shade of green, so they gave me a $200 discount ("the Ugly Car Discount") to get it painted (I also got a really good deal in general, but, alas, it never quite was the Jeep...). So it turned blue one day, but the interior frames of the doors were still green. It was funny. I rolled the Asscrack off the road in New Hampshire, minutes (okay, a week?) after I'd bought the current Silver Jeep ("There's no way in hell I'm moving to the Northeast without four-wheel-drive." I think that was said the day I matched at the Emerald Palace) and my dad took possession (and title, and insurance) of the Aztek. The end result of that whole deal was that I got a mild concussion and a bruise on my scapula, and he got a new Subaru, which he totalled not too long after I moved back home...

2. I was a lunatic, and did three majors in four years - Biology, Chemistry, and Humanities. The Humanities major kept me sane and got me out of the science building once in a while...

3. It's very pink in our office, which we blame on Ruthie. I concede that I have contributed to the pink a little, where as Peng holds steadfastly to her black and purple motif. Mostly it's the big pink chair in our office....

4. I do not like meat on a pizza. I'm not such a big fan of meat in general. Plain old cheese is just fine, veggie is usually also doable, but when given my choice, I'll pick broccoli, green pepper, and feta every time. Much like I did last night when Peng and I went for Chicago Style deep dish after the wine tasting. It was gooooood....

5. I didn't realize until later that this was some tricky wording. My ink is on my low back, which, technically is still my back. But my friends informed me a couple of years ago when I was home that a tattoo in this location is now called a "tramp stamp." Which cracks. me. up.

6. I have never been a gym teacher. Between doctoring stints, I worked in a yarn shop, sold yarn, and taught knitting. It was not lucrative (I was paid in yarn. No, really), but it was a good time, I learned some valuable business skills, and met some really awesome people. Because of whom, I started this blog. So, blame the yarn shop.

7. I do love ice cream. I'll go for months without eating it, because it just doesn't occur to me, and then be like, oh! Wait! Ice cream! My very favorite is Ben and Jerry's Half Baked, which is a mixture of chocolate brownie and chocolate chip cookie dough. B&J's makes the very best cookie dough, ever. Also good in a pinch are Cherry Garcia frozen yogurt and Breyer's mint chocolate chip. I don't know that I've ever eaten Dressler's, but I think it's what Edy's calls itself in some parts of the country.

8. Much to the dismay of my early education teachers, I wanted to be a paleontologist. Which is a person who studies dinosaurs, of course. But it's hard to spell when you're doing the "All About Me" poster for Kate day in Kindergarten...

9. Maggie was originally named Sweet Pea when she lived at the shelter. We were having none of that, so she was "dog" for about three days until she named herself Margaret. No, really. I was sitting in the backyard with her and my roommate's dog, and I looked at her all of a sudden and went, "You're a Margaret, aren't you?" And she licked my face, and so it was.

10. Did the song lyrics contest teach you nothing? (And yes, yes, I know I still owe two of you yarn and one of you a felted bag. Deal with it, it's coming.)

So there you go.

Today was good. I went to the branch of my gym that's by my new/old apartment. It was decent...not a whole lot different from my current place when you get right down to it. Except the people are different, and that's what I like most about my gym. OH!! And the showers are co-ed. I was like, what, now? Are you kidding me???! I think they're intended to mostly be showers for coming in and out of the pool, but, whoa.

Anyhow.

So then I went back over to the complex and signed my lease. We're moving in like two weeks, assuming I can find movers. Yikes!! Fortunately, my parents very graciously offered to come pack me up next week (since I'm doing all that pesky working and whatnot, and spent so much time finding a place this week that I haven't yet gotten a box packed...). And when I was looking around this morning, I realized, I never really unpacked all that much. So, it may not really take that long....

But it's official. We're going back from whence we came. Only down the street a little. And this townhouse is a mirror image of the one we lived in last year. That's going to be weird for a minute.

Peng and I journeyed over to the local Greek Festival this afternoon, put on by one of the local Greek churches. It was reasonable. Not quite like the ones that populate the Chicagoland area, sadly (there were no thiples. And they drizzled honey sauce over the loukoumathes. How you gonna do us like that?). But it was enough to make me a little homesick... Oh, and I bought copies of their "award winning" cookbook for myself, my mom, and my nouna (Godmother). The woman who was checking us out was like, oh, I'm the co-editor, would you like me to sign them? I was like, uh, sure. So she inscribed every one of them. It was cute. And then gave me her home phone number in case I had trouble with any of the recipes. Which was adorable.

Alright, I'd better go get something done....

Friday, May 15, 2009

The Kate quiz

So, it's Friday. I haven't packed a single box and I still don't have a place to live. I woke up late and went running off to yoga class this morning, only to walk into the gym and discover...no yoga on Fridays.

(Le sigh...)

So I came home, and I'm going to shower and head out and look at potential apartments again today (before wine tasting tonight with Peng, yay!), but in the meantime I'm screwing around on Facebook. And they've got this application which lets you create a quiz about yourself. And it amused me, and my friends who've done it before me, their quizzes amused me, so I wrote a "How well do you know Kate?" quiz. Which, for those of you who don't Facebook, I decided to post here, so that it might also amuse you.

1) What was the first car Kate drove?
a) Black Jeep Cherokee
b) Red Geo Metro (aka, the rolling Easter egg)
c) Silver Jeep Liberty named Kate
d) Green Pontiac Aztek (aka, the Asscrack)
e) Blue Pontiac Aztek with suspicious green portions

2) What were Kate's college majors?
a) Beer, pizza, and body shots
b) Biology and Chemistry
c) Biology, Chemistry, and Humanities
d) Scientology and Accounting
e) Kate went to college?

3) What's the overwhelming color in Kate's office, and whose fault is that?
a) Red; Sparrow's
b) Pink; Ruthie's
c) Purple; Peng's
d) Orange; Bianca's
e) Black; Iron Maiden's

4) What's Kate's favorite pizza topping?
a) Meat. Lots and lots of meat.
b) Ham and pineapple
c) Kale and anchovies
d) Pepperoni
e) Broccoli, green peppers, and feta

5) Where is Kate's tattoo?
a) Arm
b) Back
c) Tramp stamp (low back)
d) Ankle
e) This is a trick question! Kate doesn't have a tat!

6) What are Kate's three most recent jobs?
a) Psychiatrist, waitress, OB/GYN
b) Psychiatrist, knitting teacher/yarn whore, OB/GYN
c) Psychiatrist, regular whore, OB/GYN
d) Psychiatrist, Starbucks barista, OB/GYN
e) Janitor, crack addict, gym teacher

7) What's Kate's favorite ice cream?
a) Breyer's English Toffee
b) Dressler's Chocolate
c) Ben and Jerry's Coffee, Coffee, Buzz, Buzz, Buzz!
d) Ben and Jerry's Half Baked
e) Anything with a spoon

8) When Kate was 5, what did she want to be when she grew up?
a) A doctor
b) A dog-sitter
c) A Starbucks Barista
d) A paleontologist
e) A mermaid

9) Kate's current dog's original name was what?
a) Maxine
b) Maggie
c) Wolf
d) Trixie
e) Sweet Pea

10) Kate often finds herself thinking in (and obnoxiously quoting) what?
a) Song lyrics
b) Sylvia Plath poetry
c) TV shows
d) Book quotes
e) Greek

Correct answers will be posted tomorrow, but feel free to post/email yours. I hope someone other than me actually finds this...well...amusing.

Thursday, May 14, 2009

Commence to spinning wheels...

So I'm on day three (officially) of my vacation. I've gotten a few things accomplished that I wanted to - Maggie had her yearly comprehensive checkup today (they kept her for FIVE HOURS at the Banfield. I think they did a tire rotation and chassis lube or something, too). I went to yoga once and might go again tomorrow, and will likely go Sunday. I'm probably going to get my oil changed tomorrow. I went to the grocery and cleaned out the fridge. And I've driven approximately 83 bazillion miles looking at potential places to live.

Currently? I'm thisclose to moving back to my old complex. I liked it there. The commute was long, but I'm not always sure that's bad...

Am I a total moron if I move back to where I came from?

I dunno. More searching tomorrow...we'll see what I find.

And I haven't packed a single box, and my house is still a disaster.

Oy.

Tuesday, May 12, 2009

Funny stuff

So, today was my first official day of vacation. Which I celebrated by driving around for like four-ish hours looking for apartments. I dunno, I saw a few that might be viable, got a couple more websites to check out. Eh, we'll see.

I also got my ass kicked at the gym this morning (Gomer pulled out those damn step things. Wow, do I hate it when he does that) and watched last night's episode of House (I'm intrigued to see where they're going with this. And am going to stay off my doctoring high horse for the moment, on Claudia's orders). And then I had dinner with Peng and Chef, which was delightful. We went for Cajun food. It was yummy. And then Chef shared this with me:


Oh, sweet Mary Jane, that is just too damn funny...

Monday, May 11, 2009

Twice the Speed of Life

I'm on vacaaaa-tion. I'm on vacaaaaaa-tion.

Well, okay, not technically until tomorrow. Today I'm really post-call. Yesterday was decent. I saw three consults, two people in the ER, got about 6 hours of sleep. So, not bad at all.

Today has been generally unproductive - there's been some lounging, some napping, some time at the gym, and some planning what I need to do in the next week. And a lot of random driving. During which, I kept hearing this song:



(The lyrics aren't quite right, but you get the idea, and the audio was the best on that clip. I thought the actual best version of the song was this one, except the handheld video will make you seasick and someone passes out in the middle of the performance.)

It's called It Happens, and it's by Sugarland, who is one of my favorite bands. And I just totally love it.

It's sort of funny, actually, because I was walking out today in the rain, and before I actually got outside I was thinking about how gorgeous and sunny it was yesterday and how I was a little confused this morning when I got up and looked out the window and was like, what? Where'd the sun go? But I go out the ER and was walking to my car being all wet and found myself thinking, gosh, I'm so glad it's not raining any harder than this. And my inner critic made some snarky comment about silver linings and I started thinking about how I've been so, like, "Ohmigod, what's coming next?" recently, and I really need to adjust my mindset. Which made me think of one my very favorite lyrics, from a different Sugarland song, which is, I want to find what it means to be the girl who changed her mind and changed the world.

And then I heard this song all day. I'm taking it as an omen (not an idea of reference, so back away from the Zyprexa).

And then I tried to buy the single on iTunes and realized that, somehow, I missed the fact that I already owned this whole album. I was wondering why the previews all sounded really familiar...apparently I last listened to it last July.

Oy.

I mean, what a pleasant surprise.

So maybe I need a little practice at this positive attitude business...

Sunday, May 10, 2009

Still what I think

First and foremost, a happy Mothers' Day to all of you who are moms, will be moms, or have a mom (so, if you were born, I'm probably talking to you). But, most importantly, to my mom. Hi, Mom!

Go read this. It's Bob Greene's column on this Mothers' Day. It's lovely.

I had this whole blog post written, ranting about silly things like transcription software and being on call (which I am), but then I decided I was done being grumpy.

I probably should go see if my intern wants me to see anyone in the ER...there's a couple of people down there for us, but he has a solid medical student, and I don't know who we have and haven't been called on, yet. So I'm waiting for him to call me.

I saw the consult list this morning, passed the buck on a couple of them, nodded at a couple others ("You still okay? Okay."), wrote some notes. I got caught up on my dictations, read CNN.com, called my mom and dad (Hi, Mom and Dad!). There's people everywhere outside, because it's graduation day at Baby Blue. I'd complain about how they took away my close parking (that's the only redeeming thing about weekend call!), but, I said I was done being grumpy. And, on the whole, I can't complain too much about today.

I could wax philosophic, I suppose, on mom-ness, but, I did that at length last year. I still think parenting is the most important job, ever. In all the ways it can be done.

It's been brought to my attention this year that one of the benefits of having child therapy patients is, to quote one of my mentors, "you have a real opportunity to be, yourself, a developmental object for them." I think about that a lot, with my two adolescent therapy cases. It's interesting to me, actually - I feel like I'm way more invested, far more present in the room and "settled" (ahem) in those cases than I am with my adults. I wonder what that's about. I suspect it says something both about how I respond to them and how they respond to me. Gosh, I do enjoy those two kids, though. They really are just amazing, amazing women-in-training.

I will say, though, I'm glad they're still attaching to me and I'm not the object of their separation-individuation efforts, yet. Wow, Moms of teenagers, that's rough for everyone involved.

It's so funny, really, to me, to think about where I was 53 weeks ago (completely terrified of the Child and Adolescent rotation) compared to where I was one week ago (freaked out about potentially not getting a Child and Adolescent fellowship). The beginning of my personal statement was this story from med school:

In medical school (back when I thought I was going to be a high-risk obstetrician), I remember having a conversation with a friend of mine who was going to become a pediatrician. He was discussing how he was thinking of doing a fellowship in Adolescent Medicine, and I shuddered a little. “Adolescents are mean,” I told him, “even meaner than kids.” He laughed and said he knew me better than to believe that I meant that, and added something contrived about how one day I would change my mind. “Nuh-uh,” I declared, and in my best childish form, stuck my tongue out at him.

Five years later, he has a general pediatrics practice, and I find myself yet again humbled by my life’s irony.


(Have I mentioned how excited I am that I get to be a fellow? That's just so weird...)

Oh, and in totally unrelated news, did I mention that, when I leave in the morning, I'll be on vacation for a week? I'm not actually going anywhere...I'm going to try to find a new apartment and figure out when I can move and pack up as much shit as possible. And sleep in, and eat things that don't come from a freezer, a drive-through, or a hospital cafeteria, and hang out with my dog, and watch the TV shows I follow, when they're actually on, even if they're reruns, just because I can. And not see patients, and leave my voicemail to the very competent Peng, and maybe read a book that has nothing to do with psychiatry. And pay my bills, and go to the gym, and see my shrink (who's been on her own vacation for three weeks).

I might need two weeks...

Oh, but when I was looking through last May's postings to try and find the one about moms, I realized that once again, I'd missed the fact that May is Mental Health Awareness Month. I don't think that's such a good sign, that the psych department doesn't seem to be very aware of this...so, I don't think it's workin', y'all....

Saturday, May 09, 2009

If you give a Maggie a margarita...

No, I did not actually give my dog alcohol. But I commented on my FB status that Maggie was all freaked out by the thunderstorms, and my aunt in Texas suggested a margarita might be a good solution (a little hair of the dog, if you will). So then I started musing about what turned into the title (a reference to the If You Give A Mouse A Cookie and If You Give A Pig A Pancake books, which, are, like, a couple of my favorite children's books EVER). If you give a Maggie a margarita, she's going to want a wedge of lime. If you give her a lime, she's going to think it's been far too long since you dropped any food on the floor...hmm. If you give a Maggie a margarita, she's going to want some salt for the rim. If you give her some salt, she's going to think it's been far too long since you dropped any food on the floor...or, okay...If you give a Maggie a margarita, she's going to think it's been far too long since you dropped any food on the floor...

I do love that dog.

So I tried to wear the goofy ski boots last night. Remember how I said I couldn't even keep socks on my feet at night (by which, by the way, I meant that I take my socks off in my sleep if I can even stand to keep them on that long. I could totally wear socks with the boots if I wanted to)? I had 'em on for like an hour before I actually went to bed, and then managed to sleep about 45 minutes before I woke up because I was kicking myself trying to take them off in my sleep. And, honestly, my legs hurt a LOT more today. Which may have been all the walking of yesterday, or all the manipulating of my feet, but I think a big part of it was all the fussing with the boots.

So now I have a large, furry hot pack applied to my left shin and I'm NOT wearing the boots tonight. Because I'm on weekend call tomorrow, and as the second year, I get to walk all around the hospital seeing consults. Which is painful in so many ways.

Stupid defective feet.

Gomer, today? I said, "So the podiatrist said this and blah blah blah and then he gave me these stupid splints I'm supposed to wear and is going to make me special orthotics or something," and he gets this devious little grin on his face and says, "You're like Forrest Gump!"

So now we both have sore shins.

(No, I didn't really kick him in the shins. I said something really clever like "shut uuuuup!" and then let him kick my ass around the gym for half an hour...but, the story's always better with a little secondary revision.)

The podiatrist also told me, incidentally, that he'd "be remiss" if he didn't mention my weight. I was like....really? He then went on to tell me that, well, obviously he wasn't going to manage my weight loss but I needed to pay attention to my calories as well, not just my physical activity.

....?

I resisted the urge to say, "What? My weight....oh, my god! When did I get fat?! Why didn't anyone tell me this before you did?! Thank God you were here, I never would've known!" or "uh, yeah, jackass, I get it, because, see, I'm a real doctor, not a doctor of feet." And I resisted the urge to kick him, too (which was hard, because he was right at prime kicking height when he said this). And I said something like, "right, yeah, no, I know that, and part of the reason I came in now, since, you know, I've had pain like this pretty much for the last quarter century (I distinctly remember my pediatrician telling me, "Oh, you'll grow out of it." Oops), is because it's starting to impede my progress at the gym. And it's probably worse now because of all the time I'm spending there."

And furthermore...why...well, I mean, don't assume, period. But why the comment about "watching my calories?" It's not like I was sitting in his office eating a donut. Do I have the best diet? Of course not. I'm a stressed-out, overworked resident. And in fact, I'm a stressed-out, overworked, PTSD-addled resident with an eating disorder. But that doesn't mean I live on chocolate cake, know what I mean? I generally do okay. Don't assume you know.

Which may not have stimulated much more than a big eye roll from me on a good day, but I also spent an hour on Wednesday getting criticized by one of my psychotherapy supervisors. Apparently she thinks I'm "too unsettled" and it's "interfering with my learning experience." A, how the hell does she have any idea what my "learning experience" is? That would be the very nature of an experience, in that, it's mine, and defined by how I, well, experience it. And 2...I mean...come on, lady. It's no great insight that I'm unsettled. I get the sense that she thinks I should be so grateful for these big interpretations she makes (because, remember, she's the one that told me they weren't admitting me to the institute - although they weren't not admitting me, either - because they were concerned that I didn't seem to have much reflective capacity), but in point of fact, I'm a big ball of reflective capacity. I reflect, ponder, analyze, debate, discuss, and ruminate on every morsel of my life until it's ground into a fine powder. I don't always see things right away, but sometimes that's because of the defenses in place, not because I'm shallow and not paying attention. Chances are, if she asked me what was going on instead of told me, I'd have plenty of ideas about it. And I don't mind feedback, because sometimes people who can see less detail have a better grasp on the big picture. I'm more than happy to listen to considered, measured insights - right or wrong - in the right context. But I think she's just trying to take my inventory without really knowing what's in stock, and as it stands, I don't feel like I can disagree with her, lest she decide I'm just being obstinate and defensive. So I shut up, stay defended, and take it. Which, let's face it, is not helpful.

And, let's face it, is a common response that I have, which has gotten me in a world of trouble before.

::sigh:: I just want to be normal, Spud.

Friday, May 08, 2009

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::...?

Wednesday, May 06, 2009

Good news.

So the decision finally came down today - I'm going to be a child fellow for the '10-'12 fellowship class!

It's going to be me, Peng, Mike, Cleo, and Fang, and JD is going to be doing a research-based fellowship. I'm really glad they managed to accommodate everyone and their interests, because I really like these people!

Peng, Sparrow, Ruthie and I went out to celebrate tonight at the restaurant where Chef chefs. I had this phenomenal mac 'n' cheese made with Gruyere (mmmm), and of course more lemon tart (gosh, that's a good restaurant, although I have to say, the main draw is, of course, Chef). And they sent us out a bottle of champagne, with which we toasted, as Sparrow put it, good things happening to good people.

I'm so excited!!

Tuesday, May 05, 2009

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.

Monday, May 04, 2009

Epic-demic

So I'm on call (shocker). And Tyler and I are cruising the ER whiteboard program for crazies, and cracking wise about some of the stupid reasons people come in to the ED. When he suggests the newest impending pandemic -

Manbearpig flu.


I laughed so hard I almost passed out.

(And then I would've had to go to the ER. Can you imagine what that chief complaint would've looked like...do you think they would have taken me cereal?)

Sunday, May 03, 2009

Tired....again...still....

Ohhh, it was a long day. Of course, after sleeping through yesterday (I did make it to Starbucks, but that was about it), I woke up this morning at like 3:30. So Maggie and I watched some TV, and fussed on the internet, and then long about 7 I finally got up and went...um...to the Starbucks (I'm sensing a theme, no?). Until the gym opened up (it USED to be 24h...not so much these days), and then I spent too long there (that was a feeling-the-tired-but-too-stubborn-to-stop kind of workout), and then went to the Whole Foods, where I spent too much money. Came home, laid around for a while, then finally got my ass in gear and showered and headed for the Lane Bryant, where I spent (again) way too much money buying all manner of things that cannot be mentioned (which is fortunate, because things have been raggedy for a while in the unmentionables drawer. And to quote Warrick on CSI, "Ain't nothin' sadder than a girl with raggedy drawers").

But then I met Peng at the mall and we fussed around with makeup (Peng, not so much with the makeup-wearing. She has Chap-Stick. And occasional - very occasional - nail polish) in preparation for the wedding. I think we found a look that works, at least preliminarily (we'll let the Mary Kay lady weigh in on that, later, too). And then we had a lovely dinner at the restaurant where Chef...um....chefs. I had this lemon tart that was absolutely to die for. The cassoulet was good, too (although meat-ful...I'd never had cassoulet with meat in it), and the salad, the wine, the company - all delightful. Tart, though? Makes you a little weak in the knees. Ah, French desserts.

Peng? Had (I'm so not kidding) sweetbreads and head cheese for dinner. Also mussels, but those weren't nearly as amusing.

I have a 7am patient tomorrow, and then am on call AGAIN tomorrow night. I meant to be in bed an hour ago, but dinner took a while and then I had to go snuggle Little Maxine (Sparrow's on call) and gosh, that was just rough...but perhaps I'll get my tucas to bed now....

Saturday, May 02, 2009

Having slept all day...

I'm....um...going to bed.

At least I'm consistent.

(Stupid night float...)

Friday, May 01, 2009

Ohmigodahmsotired.

Yeah. That.

But, because I actually have a lot to say (just...not the use of my words to actually say it...), I promise to make a real attempt at posting tomorrow. Meanwhile, enjoy this (sent to me by Bianca, but posted especially for Peng, who's unfortunatly for her on call tonight):

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