Ding, dong....

We got a new senior resident on our team today.

Hall-e-freakin'-lujah.

So I wrote this whole post, which Blogger promptly ate. Argh. But really, the point is, Betsy is GONE! Yee-haw! Our new resident is very nice. She may prove to be a little useless, we can't tell yet, but useless and pleasant beats the heck out of useless and narcissistic and controlling.

The other point? Don't believe it when it says it saved....

Thanks for your patience

That's actually an Alanis Morrisette reference. When I originally titled this, I wrote, Thanks for your patients. And then went, hmm, that doesn't look right....why?,,,,,

Hmm.

I'm so tired. As Barb so astutely pointed out to me, this is the sort of tired sleep just won't fix. Although it doesn't help that I'm so sleep deprived. And like, today, I had all these great plans for when I came home. Actually, I had all these great plans when I went in. Betsy was going to be gone all morning for her academic stuff that the Family residents do on Wednesday, and we only had 6 patients between us, and I only had to see two this morning, so I came up with this great idea that I was going to be ready to sign out when she got back (she was on call today) at like noon or one or something and then I was going to make Mike go have lunch with me at the Cajun place we keep trying to get to (but they close for the afternoon at 2:30) and then I was going to go to sit and knit at the yarn shop which is right down the street from the Cajun place and then I was going to come home and write this great post I've been composing for two days in my head and then I was going to do a couple other things and then be in bed by nine and ahhh, what a good plan.

It didn't quite work that way. Mike and I made it out of the hospital around 2:15. And we did go to lunch, but we went to this New York style pizza place in downtown Chapel Hill. Not bad, interesting pizza, good beer. We stayed and chatted until about 4ish, I got home about an hour later, and was like, okay, gonna do this and this and this, but then I was like, I'll just lay down here on the couch for like a half hour....and I woke up twenty minutes ago. And I would've just gone back to sleep except I have a phone call I have to make at 8:10....

I'm just so tired....but on the plus side, I did get to stick a needle in some guy's belly today and drain off two liters of fluid. I haven't done that in about three years. That was pretty darn cool.

Begin at the beginning

A piece of advice from the episode of CSI that DSR'd last night. It's one of my favorites. It's all about being saved.

I really need to go to bed. More tomorrow, I really, really promise.

Postdates

(That's an OB joke)

Look! My first official post-dated post.

More when I get home. Call was a monster. Someone died, but at least it wasn't me.

Post-Holiday Blues

So this afternoon was the psychiatry department Christmas party. Yes, I know it's January 27th. What we actually have is an annual Post-Holiday Blues party. Which, is funny, for a bunch of psychiatrists. Here's the rest of why it's funny.

The blurry guy on the right, with the guitar? That's my department chair. The woman on the drums (whom you can't really see in this picture, from the Treo) is his wife. This is Dr. R's blues band.

Post-holiday blues.

It was a fabulous party, at this funky little divey place in nearby Carrboro. A lot of my classmates were there. Some of the upperclassman came. A few of my favorite attendings, er, attended, and my program director was there. We drank. We danced. I finally met Fang's little blonde girlfriend (whom I like). Mike wore a leisure suit. Which led to me having a long discussion with another classmate's husband about what exactly was so leisurely about the leisure suit. I pulled out the FMBs - not that anyone could see them, because I was wearing long bootcut jeans, but they make me tall. They also hurt like hell, what with all the standing, and the dancing, which I'd sort of forgotten until I hobbled out of the bar at the end of the evening. But damn they look good. Even if I'm the only one who knows it.

It wouldn't be so funny if it wasn't dead-on true....

I had dinner at PenguinShrink and Chef's tonight. The food was wonderful, the company was delightful, and I haven't had that much wine in a long time (but it paired so well, so what could I do?). Plus, Chef showed me this. Watch. Laugh. Enjoy. Perhaps forward on to all the anesthesiologists you work with (ahem, Mom).



There'll be a substantive post tomorrow, I promise.

Some nights I'd be better off as a real call girl

So, here's my call in a nutshell: At 3:30 this morning, I called my shrink and left her a message asking if she still had that noon appointment open.

One of the points we're "working on" in therapy is how I never call her between sessions if things are bad.

Oh, my God, last night was pure hell.

We had nine admissions. It was a busy night. And in fact, we got ten....except that the person I started admitting at 6:30 this morning...okay, that was a disaster. The psych resident saw this woman and said, well, gosh, I'd admit her, but we don't have any room, so, see if primary care will take her, sorry (um, how many people do we send out to other hospitals because we don't take their insurance or we're full or whatever?). She sees an FP, so they called me. I couldn't find the sheet that says which Family practices we admit for, but they have a copy in the ER, and the name sounded familiar, and he'd just woke me up from my five minutes of sleep I got last night, so okay fine. I was already pissed because this was a dump from psych - she came in because she was depressed and needed psychiatric help and when I got down there...ohh. She was this sweet, sweet sixty year old woman with a 20 year alcohol history who came in because she was depressed and drinking too much and she couldn't handle her life because she has lung cancer and her husband of almost 50 years is dying of brain cancer. I reassured her husband and her son. I held her hand. I did the most thorough psych intake exam she could possibly have gotten on a non-psych service, despite the fact that I had a large pile of patients to round on and a ton of work left and only like a half hour to do it. But how could I not admit her?

Well, apparently, I can't. Because we don't contract for that practice. So my on-call senior was going to call the ER and have her go to internal medicine and "take care of it."

I just spent how long reassuring the whole family I'd take care of her. That she'd be well tended and she'd have two psych residents on her team and her family trusted me enough to finally go home and now I wasn't even going to go down and tell them I couldn't admit her?

Thinking about it after I left today, I should've fought it. I'd already done all the work. I should've argued for her to come to our service.

But the real problem was the patient I admitted Wednesday before we left. She turned out to be a raging nightmare. She made me cry four times. I think I managed not to cry in front of her, but I cried in front of the nurses. In front of my attending at 11pm. In front of Mike and Betsy this morning. I've only had one other patient this whole year who made me cry and she was a crack whore sociopath.

The reasons she got to me so badly just go on and on (hence, the call to my shrink), but the root of it really was that she's someone I consider a friend. And I tried. I tried so hard to take good care of her. She sucked me dry last night. And to her credit, she called and apologized this afternoon. And, she's really sick. And she's got her own stuff going on psychologically. Which I understand - believe me, no one can relate to that kind of ingrained PTSD better than I can. But between spending my whole 30 hour shift wholly investing myself in her care, and, you know, the other ten patients we admitted, and oh, the twenty five or so I was cross-covering.

But this was really nice - My senior got to bed a good hour and a half before I did, at least. I finally got up to the call room at like 5, right? It's actually a call suite - there's a little bedroom with bunk beds and a common room with a computer and a TV and a futon. I always sleep ("sleep") on the futon. I usually leave it folded up, because I like to snuggle up against the back (I sleep with my bed against the wall at home). But anyway, I walked into the call room, and found the futon out and all made up with two pillows and a couple of warm blankets and the sheets turned down, waiting for me.

Betsy redeemed herself a little today, too. She was really supportive and did a good job trying to get me out today. She also tried to make it more about her and at one point outright called me fat, but, at least she said she'd want me on her side in a fight.

I'm really having trouble with how "out of control" I got last night. I can't believe I let anyone see me that upset. I can't believe I cried multiple times in front of people. Betsy and the Duke resident both made the comment, "I've never seen you like this!" Like they've known me for so long, you know? Still, I don't like it when the cracks in my carefully crafted facade are exposed. And I'm not sure Mike took my unhingement all that well.

And of course, me "unhinged" mostly involves crying while continuing my usual get-things-done shtick, and is still more way tightly bound than some people on a good day. But I don't much care how well they can hold themselves together.

My attending handled it well, actually...I think we were sort of in this together, which helped. He's normally one of the most unflappable people I've ever met, and this situation clearly had him...um...flapped. I mean, he needed to be the point person on this, and I kind of had to push that on him a couple of times (including a text page I sent him at about 9 or 10 pm that literally said "HELP. Sarah's out of control"), but he ultimately took the brunt of things this morning and was remarkably firm and really just did an excellent job this morning trying to lay down strong boundaries. I learned a lot from him over these two weeks, mostly in the behaviors he's modeled. The past 48 hours were obviously no exception to that.

Meanwhile...I'll call Sarah back tomorrow. We're going to be fine, at least from my end; I know this is beyond extenuating circumstance for her. And by the time I get back to work on Monday she'll be home recovering and all will be well.

Did I mention I have the whole weekend off? It's my "golden" weekend (postcall Friday, whole weekend off. So, um, sort of like the real world. Not sure what exactly is so golden about that, but, you know). I'm so excited about that, I can't hardly tell you. I think Maggie's a fan, too.

I cannot go to work today....

A little classic poetry from my youth, by Shel Silverstein. It just sort of sums up how I'm feeling this morning....


"I cannot go to school today"
Said little Peggy Ann McKay.
"I have the measles and the mumps,
A gash, a rash and purple bumps.
My mouth is wet, my throat is dry.
I'm going blind in my right eye.
My tonsils are as big as rocks,
I've counted sixteen chicken pox!
And there's one more - that's seventeen,
And don't you think my face looks green?
My leg is cut, my eyes are blue,
It might be the instamatic flu.
I cough and sneeze and gasp and choke,
I'm sure that my left leg is broke.
My hip hurts when I move my chin,
My belly button's caving in.
My back is wrenched, my ankle's sprained,
My 'pendix pains each time it rains.
My toes are cold, my toes are numb,
I have a sliver in my thumb.
My neck is stiff, my voice is weak,
I hardly whisper when I speak.
My tongue is filling up my mouth,
I think my hair is falling out.
My elbow's bent, my spine ain't straight,
My temperature is one-o-eight.
My brain is shrunk, I cannot hear,
There's a hole inside my ear.
I have a hangnail, and my heart is ...
What? What's that? What's that you say?
You say today is .............. Saturday?
G'bye, I'm going out to play!"

Somebody's gettin' on my nerves...

(Missed the reference? Click here. Before I forget that I'm a lady and give 'em what they deserve.)

People are driving me crazy tonight.

Today was a weird ass day. It was Wednesday, so all the Family residents scampered off to their academic stuff all morning. Which meant it was pretty much just me and Mike and a bunch of attendings. We rounded, I got my notes done, and was more or less ready to leave at noon. It was a nice morning, actually. Mike and I got stuff done, Betsy was gone...and then the attendings started talking about how Sarah, my attending from two weeks ago (remember her?) was in the ER and coming on to the Family Medicine service as a patient.

I like Sarah. She's kind of a lot sometimes, but she's a really good person. And we'd already agreed that we needed to stay friends after she relinquished her position of authority over me. So I went down to the ER to make sure she was okay, offer to take care of her dogs, whatever. We got to chatting and I said, Red Team's admitting, but you know they're going to let you decide whatever team you want to be on, so I'm sure you're just as good to go on Green. And she says, can I come to the your team? I said, of course. And promptly called the covering attending and told her that Sarah wanted to come to the blue team and I was already down there, I'd do the H&P and take her on as my patient. Even though, you know, I'm on call and thus the admitting resident tomorrow.

The attendings appreciated it. Sarah appreciated it. I'm not sure the on call residents were as thrilled, but, should they really care? It's an admission they didn't have to do.

And then I discovered my really manipulative patient we discharged last Friday was back. The one who was so freakin' personality disordered and like ate my whole day and then frakkin' Betsy comes in and plays right into the manipulation and triangulation and the next day we discharge her and she wants Betsy to be her real doctor (a-ok with me, sister, even though someone in my line of work is so much more what she needs. But, please, go play dueling Borderlines, with my blessing) and Betsy sends her out the door with pain meds. Wait, let me rephrase: Betsy sent a known narcotic dealer and abuser out of the hospital with prescriptions for oxycodone, oxycontin, and ambien.

My mind boggles at the street value alone of this little hospital stay...

So she's back. First, the on-call resident tries to get me to do that H&P too, even though, um, I'm NOT ON CALL TODAY. And then Mike and I decide that she clearly needs to be Betsy's to follow, because the patient and I do not get along (because I'm a hardass that sets limits), and because she's technically Betsy's primary care patient, Betsy should see her anyway. So I gave B the courtesy of text messaging her this info - she's yours to follow in the am, and oh by the way, we picked up Sarah on our service. The flurry of texting that ensued just pissed me off on so many, many ways. Suffice it to say, I'm seeing the sociopathic patient in the morning, along with my other four patients. Despite the fact that I'm on call tomorrow and thus admitting. Know why I have to see her? Because Betsy has afternoon clinic, and so she can't possibly see ONE FUCKING PATIENT tomorrow.

I'm so ready to be done with her. Which will be Monday. And I have the whole weekend off. Thank God.

And just to add injury to insult to this day, Mike and I escaped the hospital about 3 and went to this cute place in Carrborro for lunch. I fell down. On the way in, before I'd even had anything to drink. In the middle of the street. Tripped over my shoe. In the middle of the street. Boom. Scraped my elbow. Felt like a moron. Mike, fortunately, picked me back up, hugged me, and then plied me with really good alcohol. It was an excellent response to the situation. I still feel like a moron. But at least lunch was good.

Cowgirl and Pumpkin

When we were in medical school, my friend Karen had this propensity for making up little songs. They were usually impromptu, funny, and endearing, although rarely Grammy material. There's one in particular that's stuck with me over the years. She made it up when she was on call one night, I think on surgery. I often find myself singing it in my head in the wee hours of my calls, and every now and then on nights like tonight, when I'm just freakin' tired. It goes like this:

I'm a tired cowgirl and I wanna go to bed
That's what the tired cowgirl said.

Simple. Succinct. Capable of being stuck in one's exhausted brain like a sing-song little mantra.

I am a very tired little cowgirl.

Pumpkin the Wonder Mutt over here just buried my cell phone in the blankets on the couch. I think that may be a subtle attempt at telling me that I need to stay home more. She's been getting very upset in the mornings when it starts becoming obvious that I'm not going to be staying home that day. I feel bad, but she deals with it okay. Soon enough, puppy, soon enough.

And in case you're wondering, yes, that's still Maggie I'm talking about. She has many nicknames. Her full name is actually Margaret Mae (and then we have the same last name), but she's also known as Maggie, Mags, Mutt, Muffin, Pooch, Spoochie, Baby, Pumpkin, Dog, Goofball, Nutbutter (which is an extension of "Nut"), Punkin Head Doggie, Crazy, Magpie, Skilimou (which means "my dog" in Greek), and Best Girl Ever, to name a few. My old roommate used to call her Magglio, after the White Sox player (knowing full well that Maggie is a Cubs fan). What's amazing is that, a, at this point she answers to any and all of them (as well as things like "Donde esta mi perro?"), and b, they're still better than her original name when I got her at the shelter, which was Sweet Pea. Which, she's so not a Sweet Pea. I mean, it still pops up occasionally as a term of endearment, but, as her actual name? No way. She never answered to it, and I refused to use it the first few days she was mine, which meant that she didn't actually have a name. And then about three days after I got her we were sitting on the back patio under the stairs that led to the second floor mother-in-law apartment, and we were playing and I looked at her and I said, "Your name is Margaret, isn't it?" And she licked my face, and so it was.

And it's quite possible that was the last time I called her by her given name that she wasn't in trouble for something or about to get into trouble for something.

Have I mentioned that I'm exhausted? I think he q4 thing is already getting to me, but I also was thinking in the car on the way home tonight that I've really been dealing with a lot of the more concrete manifestations of illness than I'm used to. Like, today Mike and I googled one of the patients we discharged home late last week (to hospice) and discovered that she'd died on Sunday. She was such a sweet little old woman, and oh my God, she was so miserable. She was in so much pain there at the end (she's the one, for those of you who've heard this story, who GI came in and did a somewhat urgent colonoscopy on her at midnight during my first call). And I as thinking about her on the way home and how horribly swollen her legs were, to the point that they were disfigured and the skin was all translucent and they looked almost unreal. And then I thought about how many times I've seen that in the past month. How many diseased and distorted variations I've seen on the physical human body this month. Not that I'm not sort of used to that, it's just so much more in your face, so much more concrete, than what I've become "used" to dealing with. Which, it strikes me, is a reason so many people don't like doing psychiatry, because it's so abstract and kind of existential and so rarely concrete. I think that's actually a little bit easier for me, a little more congruent with my way of thinking. I wonder what that says about me....

Well, whatever. Snugglepuppy and I are going to bed.

Nap, interrupted

Oh, I was having such a nice nap until Mike called and woke me up. But, whatever, if he wants to be all "responsible" and find out about the patients he has to see in the morning, fine. And then he starts telling me...he had his first medicine call at State Hospital this weekend. He hasn't done the medicine service yet, so this was a little bit of a trial by fire thing anyway. But I assured him, dude, so not anything to stress about. Saturdays are slow at SH, oh my gosh I got so much knitting done last month, really, you'll be fine. So he tells me that he ran all day. First thing when he gets there, he has to transfer someone out to a real hospital. Then he has an admission. They paged him all day long for all manner of things. And - are you ready for this? He had a code.

PenguinShrink and I had a multitude of Medical Stats, which are a step down from calling a real code. We still ran to them. They still brought the crash cart. And usually it meant that someone had DFO'd (done fell out. They do that in the South). And occasionally we had to call an ambulance. But I don't think they've had a real Code Blue called at State Hospital in at least a year.

No, really. Piece of cake. I got so much knitting done last month.....

My call yesterday was not nearly so bad. We had four admissions, no one was super sick. I spent a lot of time coordinating stuff and had a couple of weird outside calls. But on the whole, it was a fairly chilled out day. Two down, five to go.

I talked to my friend Bianca back home today. You remember her as the mother of my nephew Basil. She just started repping for a line of really wonderful children's books called Barefoot Books. It's a grassroots company started by two women from Texas who abandoned the corporate life and started up something they hoped would make a difference. They've got stories from all over the world and they're just beautifully illustrated. So all of you folks-with-kids type people, or you other people who might know some kids who like presents, should go check it out.

And then my best friend emailed me this. This is a cute puppy.



Also gives me a better perspective on our half an inch of snow. Although it's freakin' cold down here in NC. It was 17 degrees today when I left the hospital! Brr-rrr! I mean, okay, back home that'd be pretty warm right now, but we're not set up for the cold down here like they are up north!

Alright, I think it's time for me to meander towards my bed. Because I have to go back to the hospital in the morning. As always. Wow, I'm really tired. Kind of in general.

And don't worry, Paige, I'll post about my tat by the end of the week.

Blues in the night

So, I'm on call. And my team (although, on call, we cover all three teams) is the blue team. Hence the title.

It's been a slow day, which almost guarantees us a bad night. I guess we need something to look forward to, right?

I'm on call with one of the third year Family residents as well as the Duke resident, who's also a third year. It's been a fine day. We ate well. My senior's husband came by with her ten month old little girl, who's just the cutest little thing ever. I ran into my med student from State Hospital, who's on Surgery now. And we even took care of some patients. Not a bad deal, really.

Guess we'll see how the rest of this night goes.....

I have more to say, but I think I'll say it later. Keep your fingers crossed for me that we maintain our smooth sailing.

Snow and Ink

So I'm driving around doing errands this morning, and I hear this story on the radio. Apparently the chief surgery resident at the Mayo Clinic in Scottsdale just got fired because he took a picture of a patient's penis with his cellphone during a cholecystectomy and then showed it to his friends. Horrible, right?

I'm having a little bit of trouble feeling sorry for this guy.

Yes, that was really unprofessional behavior. Yes, that was a violation of his trust and the doctor-patient relationship. Yes, the surgeon really should've known better than to create evidence. And it was jocular and silly. But...the guy had "Hot Rod" tattooed on his penis.

Not for nothin', but...hmm. Did you not think that would attract some attention? I mean, I have an unusual tattoo, too (different from a ta-tutu), and I knew when I got it that people would comment. And mine's nothing like that. So, come on, bud. What that resident did was wrong, but, really, the way he's carrying on and being all outraged and horrified is a bit...dude, you let a total stranger with a needle tattoo the words Hot Rod on your penis. Not to mention that now everyone in the literate universe knows about your, um, little secret. I? When that doc had called me, would've been like, fine, sir, whatever, let's just never mention this again.

We're not even going to talk about the number of times I photographed women's genitalia during surgery when I was a GYN resident because they had some clinically interesting or relevant finding. A couple of those pictures even got published, I think, in a journal article, of one woman's vulvar cancer. Not the same thing, I know, but, I'm not sure we told very many of those people we'd taken pictures of their cooch. Our ability to take photographs during surgery is in the standard release form. Now, I concede that the "clinical utility" of these Mayo photographs is questionable, and I was either taking them with the hospital's digital camera or a laparoscope, not a cell phone...but anyway...

In other news, it's snowing in North Carolina.

I think it's sort of funny. In the few hours since I started this post we've actually had some accumulation. We're supposed to get more tomorrow. Maybe it will keep people home and make for an easier call night? A call girl can only hope.

And in still other news, Tiny Tyrant sent me some very cool sock yarn in a yarn swap. Which I promptly tied into a great big knot (with the help of my ball winder) that took me two episodes of Bones to untangle today.

It's very cool. I'll post more about it later now that it's in actual balls and I have a tiny bit of it knit up. Maybe I'll have some time to write tomorrow (keep your fingers crossed for me), but right now, I've got to get to bed....

Something worthwhile

I rarely endorse those click-for-a-cause sites, but, I'm a little partial to shelter dogs, you know....so click here, and feed them. I'm thinking about putting this link in the sidebar, even.

So much to say. And so very tired, so, going to say it tomorrow....

1 down, 6 to go

So, my first Family call has been survived. My upper level said he felt useless.

It was a moderately busy night, and things kept coming in a steady stream. But it was an emotionally draining night. And even more so today. I'm so freaking tired I can't even really see straight. Maybe I'll write more later. I'm hoping to, but I would really like to sleep a little and there's a recruitment shin dig I really want to go to tonight...we'll see how it goes.

Testing, 1, 2, 3...

Okay, apparently I can blog from the hospital, or at least here in the FP call room (remember how I could never actually log in when I was on call for Neuro?). We'll see if I have time and/or privacy enough to actually write anything of substance later. As for now...wish me luck tonight!

On the runway

I have the cutest dog ever. No, really. I have photographic evidence this time.

My dear, dear friend and fellow fiberworker, Penguinshrink, was kind enough to make me a Christmas present (hers? Unfortunately....ugh, still a ball of yarn....maybe for her birthday...). You'll remember her as my partner in crime from the mass crocheting of the Intern Retreat gifts. She's a fabulous crocheter and in fact, on said intern retreat, helped me figure out a problem with my technique which has made my crocheting a whole lot easier. And she's also a darn good doc and a kickass co-intern. Girl, you rock!!!!

She made me a very lovely shawl and hat combo. Just perfect for the climate down here. The color is fabulous, the yarn is soft, it's quite wonderful.

And you know I have this policy about not putting pictures of myself on the blog. But it didn't seem quite right to just do the standard laid-out-flat-on-the-couch picture.

Fortunately, I was able to find a model.

Now, Maggie has those big coyote ears, right? And she really doesn't tolerate having anything on her head for very long. But she did okay with the hat.



Actually, she was kind of a ham.



Come on, come on, give me attitude....



Work it, girl. Yeah, yeah, good girl, goooooood, good girl.



Seriously. This dog cracks me up.

Oh, and PS, she clearly approves, because as soon as our photo shoot was over, she promptly stole the shawl and buried it in the couch cushions. You know, for safekeeping. She does this...

Theoretically possibly potentially

So you remember my patient who had the stroke and had to shave her head and then I knit her that hat?

I'm in our 11am teaching conference today, right? And I get this page. And it's the research nurse from Neurology. She's like, hey, do you remember me? I said, of course I do. And then she tells me my patient with the stroke is in clinic for her 60 day follow up (wow, has it really been that long?) and would really love to see me if I could get away.

Of course I could.

She looks fantastic. Amazing. I think she talks better than I do right now. She has no motor deficits. And holy cow, is she rocking out the short hair.

She was so excited to see me. She hugged me twice. Her fiancee was also thrilled to see me. Wow, I can't believe how good she looks. And I can't believe how happy she was to see me again. Or how impressed with me the research nurse was. I....what did I do, really?

You know, I think maybe I'm a good doctor.

And I don't mean that sarcastically. It was sort of an interesting day in that regard...Betsy spent a lot of time undercutting me today. She laughed at me when I suggested on rounds that nebulizers were equal in efficacy to metered dose inhalers (they are. There's data). She acted like I was being ridiculous when I went to give my pneumonia patient a flu shot (it's protocol) and then called me five minutes later to tell me to give her a flu shot. She kept telling me that I needed to present in a problem-based format. I finally said, "um, I thought I was." She pointed out that if I'd really been organized, the attending wouldn't have had to go back over the systems after I was done. Not that it was his first time meeting our seven fairly complicated patients or anything like that. Not that he needed to get a lot of information organized in his own head.

This all, of course, after she called me last night to tell me Mike was off today and so I then had to round on all seven patients. Because she was on call today (they don't really start admitting until noon. There was no way Betsy was going to be holding the call pager. And in her spot in the rotation, there are three residents, not two like every other night, because the Duke resident takes call, along with her and an intern). So she couldn't possibly write any notes.

For Pete's sake.

My shrink and I had an interesting conversation the other day about what it meant for me, symbolically and fundamentally, to be sequestered with an actual bad resident. In the context of my old life where I was just told over and over again that I was a bad resident, when in all likelihood, I really wasn't. I mean, I'm not a different doctor here. And my patients loved me there. I won a teaching award from the medical students. Several patients complained bitterly when I left. But if you'd asked me then....if you'd asked me a lot more recently than then...I would've agreed that I was a worthless human being and a dangerously bad physician. They had me convinced for a brief while that I shouldn't be allowed near actual patients because I was bound to do something harmful. Not that there was evidence of this, but, they had me convinced.

My shrink had a term for that, too. It was, "brainwashed." She's a good psychiatrist.

It's really hard for me to admit this, but I think maybe I am, too.

Why I do what I do

I also got this yesterday. One of my patients from back when I was on the Women's unit at State Hospital is down in rehab in Florida right now, and she sent me a Christmas card. It took a little while to reach me, because technically I'm not on staff at State Hospital, but it finally got to someone who knew who I was and passed it on.


Truly, that's everything I can ever hope for.

Wired

I have had way too much caffeine today.

But at least I've been productive. I left the hospital, went and picked up the Maggie, and then we stopped at Starbucks. I came home, loaded the dishwasher, swore at the Treo for a while, and then gave up and went to Circuit City, where I hemmed and hawed and was very indecisive for a very long time about what navigator to get. Then I went to the grocery store, stopped and got lunch, came home, took the trash out, swore at the Treo some more, and now, I'm babbling on here. Good times.

Someone said to me, back when I got the VZNavigator on my phone, if you get the navigator, you'll never learn your way around. I said, nonsense. I'll just not get as lost when I do get lost. But I'll know the town just as quickly. It'll be fine.

Now I say, alright, fine, shut up.

I lasted three days, and one of those days I was on call. I got so rip-roaring lost on Friday coming back from lunch downtown that it was ridiculous. Especially considering there was another physician with me, who also works there, who didn't know where the hell we were, either. And "downtown" is neither that big nor that far from the hospital. For all the IQ points in that car on Friday, I'm just sayin'. But alas, no. The only reason we didn't get lost on the way to lunch was because I was following Mike, who, a, gets out more than I do so he knows his way around "out" better than I, and 2, lives four blocks from the restaurant, so, he really ought to know where it is.

So, adding to the gadgetopolous in which I live, came the TomTom.

There was much wailing and gnashing of teeth over this vs the Magellan. Because I can talk to the Magellan. And the sales guy thought it was easier to use overall. But I couldn't get into the interface, and I really like the look of the TomTom maps. And I got the stripped down version, because I concluded that was really all I needed. But, like, it couldn't find the grocery store. So I ended up googling the Fresh Market on my Treo and then entering the address into the TomTom and feeling a little like the bionic woman. Especially now that I've taken to wearing both my phone and my pager on my hip (because I'm not leaving anything as expensive as the Treo in the pocket of my labcoat). I'm wired for sound, baby.

And I had immediate buyer's remorse as soon as I took the TomTom out of the package. D'oh, I should've gotten the Magellan! Except that this was all triggered by my inability to find the Fresh Market, and who's to say that that Magellan would've been able to find it, either?

Once I gave it the address, though, it did find it. And I fulfilled what's become my Sunday routine...go to the Fresh Market when it opens, buy produce and yogurt and other random (usually impulsive) things, then go to the Char-Grill next door, and get a very yummy burger for me with mustard and onions and a plain cheeseburger for the pup. Today's burger was especially good, and they have the best fries in town. I also made three particularly good finds at the FM. One was vanilla chai, which has become my new addiction at the hospital coffee shop. I also discovered that my new favorite wine also comes in a red, and the other...oh my gosh....I was in the cheese section, getting shredded Parmesan to go with the salad fixin's, and I saw this little half-pint deli container with a really white, softer looking shredded cheese, and I thought, huh, I wonder what kind of Parmesan that is....but it wasn't. It was...are you ready for it? Mizithra! Which is this dry, salty Greek cheese that I could live on. No, really, a little butter and some Mizithra on pasta is the best thing going. It's the food of the gods, I'm telling you, Athena herself invented that dish. It has to be new this week, because I look for it pretty much every time I go past their cheese counter. And there it was! I let out an audible gasp in the middle of the cheese section this morning when I discovered it. There may even have been a Mizithra dance. I'm telling you, this is exciting news. Especially after having conquered the TomTom to get there in the first place.

If I could figure out how to sync the effing Treo, by the way, I'd show you a picture of the TomTom taken with the Treo. Because I thought that was funny. But, alas, I still can't get the laptop to talk to the phone. It was a fluke, one-time deal, apparently. At least it worked long enough for me to load a couple good pictures of my dog onto the phone, so I could show her off at lunch Friday.

Technology is my friend...

Lunch, as an aside, was very nice though. Sarah took Mike and me (Betsy was post-call) out for Thai food to celebrate our surviving the past two weeks (the attendings rotate off service after two weeks, so we'll have a new attending tomorrow. I'm hoping this mellows Betsy out, but, none of us are optimistic). It was very pleasant. The food was excellent, we had a very good time, it was very laid back, and I still left early. Very nice. Plus, Sarah and I have intentions for a doggie play date shortly. She has two dogs, one who she picked up at the roadside after he got hit by a car - a German Shepherd who's probably about twice Maggie's size - and a Leonberger she rescued from the shelter who was so little when she brought him home that he used to sleep in the cats' bed...he's now close to 200 lbs, and he's not done growing. He gets his head stuck in the cat bed now because he doesn't realize he doesn't fit there anymore. He barely fits in her car. I can't wait to meet this big furry mountain.

Those two are going to terrify Maggie, though. She likes cats and little dogs. Unlike my old dog, Wolfie, who was this ninety pound Husky-Akita mix and had a heartbreaking, pining crush on the 125-lb older-than-God German Shepherd next door, Bob. Wolf would run over to the fence when Bob was out and just watch him, awed, tail wagging like crazy. And then he'd look over his shoulder at me all excited, like, "It's Bob! Do you see? Do you see?? Oh, Kate, it's Bob, it's Bob!!" But he'd never bark, and he never dared actually approach Bob, who, incidentally, was this very sweet, toothless, grumpy-old-man kind of dog. No, my dog was a groupie.

Bob died shortly after Wolfie did. And then the big mean old Rottie they had got stomach cancer or something (I told my neighbor, it was probably someone he ate), and he was put down. So shortly after Mags arrived, they got this very obnoxious pit bull puppy. Maggie and Kedzie, my roommate's dog (who's like 13 now or something and is a TOTAL grumpy old man) were both sort of like, what the hell did you bring him here for?

The best Wolf story, ever, though, was when one day we were out for a walk. And these six little rat dogs come tearing out of the house down the block, like, in formation, barking and snapping and squealing and they start circling Wolf, nipping at him, barking, huffing, growling. And Wolfie, bless his little poochy heart, stops, and looks down at these little knee-high (to him) annoyances with this quizzical look on his face. And then he calmly looks up at me, completely baffled, like, "Dude. Really. What the hell are these things?" And he kind of watches them for a minute (in contrast to his owner, who's flailing about yelling "Get out of here! Go! Go! Stupid little shit dogs, get!") and then looks at me again like, "These things are stupid, and noisy. Can I eat one?" Fortunately, their owner happened to notice about then that they were missing and called them back into the house. And he - I'm so not kidding - watched them go back into the house, looked at me, shook his head, and then started back down the road towards our house. I totally would've let him eat one.
That's my Wolfie. He was such a good boy.

Well, Mags and I are going to go spend some quality time napping, and then there more dishes to be done and laundry as well and I still have two discharge summaries to write up. Mi vida loca...