"I bet everyone's a great dancer without gravity."

So, this comment came from a discussion on my friend's Facebook page, about this very odd dream he had, which he described as a Bollywood-style extravaganza of everyone he'd ever met singing and dancing...on a spaceship.

I have no idea what Freud would say about that.

But, someone left the above comment in response, and gosh, I started thinking about that. You know, in a metaphoric sense. How much are we impeded by the things that weigh us down? How much do they define what we do? Many of us learn to dance within the confines of gravity, obviously, and there are some maneuvers that couldn't even be done without it (try to do a leap in space. G'head). Some people do better than others; some seem to transcend the laws of nature. But it's limiting, too, obviously, all that, being pulled towards the core of the Earth at 9.8 m/s/s. You know, and then there's the idea that life itself couldn't exist here if the planet didn't have exactly the gravitational pull that it does...how much do we need the things that hold us down? How much do they keep us grounded (as it were)?

Yeah, this really is the kind of shit that goes on in my head. You should hear the things that bounce around in there when I'm on the treadmill.....

So what's pulling you down?

(Yeah, it's entirely possible I'm being a little too esoteric about this. But it seems like a great metaphor, doesn't it?)

A noble holiday worth celebrating.

Happy Doctors' Day, everyone.

Hug your favorite doctor. Wait, no, maybe not....

In honor of same, I'm going to take my very tired, overworked, underslept ass to bed. At 8pm. Because I'm a loser resident. And I was so post-call hypomanic-y last night I tossed and turned until midnight, and then of course had to get up at a reasonable hour this morning (see above, re: loser resident), and so I'm waaaaaaaaaaaay underslept, and have a 7 am therapy patient tomorrow who probably wants me to stay awake for his session.

A poll...

Alright, so, I can't decide if this is funny or not, and I needed something to post today anyway (call was looooooong. I went to the gym today instead of napping. Kate is tired...). So, view, vote, tell me what you think.

Is this funny? Yes. No. What?? Current Results

I still have a feeling I'm going to be flipping through Comedy Central one day and stumble on a Prescott Hathaway Stand-up Special. I just can't decide if he's funny. But I think it's because he was like 10 when I met him and his sister and I used to refer to him and his friends as "Scotty and the little boogers."

You know what's definitely been funny, though? My phone has been calling PenguinShrink all day. By itself. She accused me of pocked dialing, but the first time it was on the nightstand, and the second time it was in my locker at the gym. I'm thinking this is a software glitch...

Hungry

So here's my call story for the evening...it's been a rough day, actually; we've been crazy busy and I got a whole pile of bullshit consults, including one on OB to evaluate a woman for postpartum psychosis, which it turned out she did not have an in fact her only problem was that she was KOREAN and thus spoke KOREAN. Not English. So, you know, they didn't explain anything to her and then decided she was freaking out and psychotic when she was running around with blood on her arm (she pulled out her IV) babbling in...wait for it...Korean. I also had a patient try to leave the hospital (he almost made it) when I came by to tell him that I was trying NOT to commit him.

But anyway.

So, Guido, my intern, and I decide we're hungry and we're going to order dinner. And there's this great service around here that, you order online from one of like twenty restaurants in the area, and they pick it up and bring it to you. For a fee, of course, but you can pay with your hospital meal credit that we get for taking call and let me tell you, it rocks. Okay. So Guido and I order around 7. Usually it takes around an hour, so when dinner wasn't here by 8:30 I called them. And the kid that answered was like, wow, yeah, sorry, we're really backed up tonight, some stuff happened, lemme call the driver, blah, blah, blah. So she shows up about half an hour later, looking frazzled, and we tip her in quarters (neither of us had real cash, but, college kids like quarters, right?) and get our dinner and we are happy campers. Well, at least we've stopped being hungry.

But shortly after that, I get called to evaluate this college kid in the ER, right, who's complaining of "confusion" (as I was telling the kids story to my attending, he stops me and says, "Wait. She's a pothead, right? She sounds like a pothead." That...well, really says it all). And it turns out that what prompted this kid to come in was, she went to work tonight - guess where - and "kind of forgot I was supposed to be at work." Which ultimately translated into this: she went to pick up an order, then promptly went home and ate it. Her boyfriend walks into the kitchen and is like, wait, why are you home, and what are you eating?

Fortunately, it turns out that it wasn't, in fact, our dinner that she was eating.

Sweet kid. Really delightful family. Needs to cut back on the weed.....

Patience

So one of my patients dropped out of therapy today. It happens - it's not always the right time for the work that we do, you know? You've got to be in the right place, the timing has to be good, or you're working uphill. In the wind. It just is what it is. Kind of a shame, because I liked working with her, but, c'est la vie. See above, re: uphill in the wind.

But, in parting, in discussing the work that we'd done, she reminded me of a stanza from this song:



I was locked into being my mother's daughter
I was just eating bread and water, thinking nothing ever changes
And I was shocked to see the mistakes of each generation
Would just fade like a radio station
When you drive out of range.

I think it's a good point. Never fully the answer, but...a good point nonetheless.

And now stuck in my head.

(I'm also a little partial because this is one of my favorite Ani songs. I've long thought that this was a good point. Good choice, patient.)

Muddled

So....you ever have one of those days where there's just SO MUCH STUFF swimming around in your head that nothing cogent will come out?

No? Oh. Well, I'm having one of them.

Had intended to fly to the coast today, but it was foggy and there were too many people on the plane so I offered to not fly in the little tin can. It was a nice drive, actually. Foggy. I went out with one of the nurses, we found two of our four people, I was done by 1. Got some lunch, swung back, went to the gym. Had a pretty crappy workout - still trying to figure out all the reasons why. Came home, though, had a nice cuddle with my dog, and you know...that makes a lot of things all better.

So does a good night's sleep. I'm going to go pretend I might get one....

Li'l lizard

Gratuitous Tuesday cuteness

My mom sent me this today. It's a sweet story, with a good little moral.

(The embedding didn't work, so, click here.)

Aww.

See, 'cause, here in the real world, one of Ruthie's patients tried to cut out his own gallbladder today. Why not? Poor Peng had to deal with it, unfortunately.

And actually, now that I think about it...that's the second patient of Ruthie's that's tried to remove an organ on their own...

Our life is weird.

Absolution

So my last patient of the day, today, tells me, "Look, when I kill myself, I don't want you to feel like it's your fault. It's nothing you did, or didn't do, it's just...inevitable."

Yeah. Thanks.

I know sometimes suicide seems....well, painless. And like a viable option for ending what seems like an endless pain. And honestly, I'm not entirely sure why we as a profession spend so much time and energy trying to keep people alive who really are in interminable physical or psychic pain and have made a rational decision to end that. But...let me tell you something, folks. Suicide is never painless. It's universally devastating to families. And even if you think your family won't care - someone will miss you. Maybe the guy at the place you go for coffee. Maybe your neighbor, your paper boy. Your dog, the receptionist at work. Your shrink. Someone will mourn you. They'll ask themselves what else they could've done. They'll ask themselves why. They'll wonder how you lost hope when there's so much to live for.

Don't miss out on what's still to come. And don't let the legacy of sorrow and unanswered questions that always comes with suicide be what you leave behind.

I know I've said this before, but, reach out. Find that someone who will miss you. Call. Talk. Be heard. Speak about whoever or whatever it is that's hurting you. Because, after all, it's the confession, not the priest, that gives us absolution.

Up and down

It's been a day...

So I went to see my trainer this morning. He kicked my ass. KICKED my ass. I was a little whiny, and kept losing my balance (and dropped a 5 lb medicine ball on my head, but that's another story entirely. I'm not always sure why he puts up with me...I mean, except for the fact that I'm paying him to do so). But we get to the last set of exercises, these inclined crunches alternating with a set of twisty things...and I'm doing the twisty things, and I was like...oh.....shit. I'm gonna throw up. Like, now. Gonna vomit.

So we stopped, two sets from the end. I could barely talk for trying to keep down what little breakfast I'd had. Gomer says, you need to eat something.

I would've laughed at him if I hadn't thought it would guarantee that I'd puke on his shoes.

He says, you need to eat something. Do you have anything? I shook my head, because, you know, see above, re: shoes.

So he goes into his desk and hands me a banana. I shake my head again. He says, really. Eat the banana. You'll feel better instantly. Eat the banana.

(Freud would have something to say about this.)

(Freud would have even more to say about the fact that it worked like a charm.)

Like a charm. I finally got a couple bites of banana down and was like...oh....that IS better.

I was telling this story to my friend, a family doc, whom I had lunch with, and she was like, duh, your blood sugar dropped. But it came on so suddenly. And I wasn't shaky or anything beforehand. And, and, and....

(No. Seriously. Duh.)

But, in better news, I had a lovely lunch with a good friend. It was delightful. She's in private practice now, and paints a wonderful picture of life in the real world. Plus, the food was good. And Maggie may have a new puppy play date.

In less better news, though, I sent my dad to the ER, because he's sick, although, he probably just has the flu (they sent him home after a really looooong wait). And Little Maxine is spending the night with us, which is nice. But she had a little seizure, which was a little scary. It's not the first one she's had, but it is the first time that's happened with us. Maggie was ALL OVER HER - so worried. Poor little bit. She's fine, though (and Maggie and I have recovered, too).

So, tomorrow, back to work. It's going to be a busy week, and then I'm on call on Saturday. Bleh.

We're all going to pile on the bed and have a rest....

Coolness

Have you heard this story, about the guy who pulled a man off the subway tracks in Manhattan this week? Saved this guy's life, and subsequently disappeared into the crowd before the police, paramedics, or any one else noticed who he was?

Y'all, I went to college with this guy.

It was funny. I was at the gym (which is of course where I get all my news, on the treadmill, which also means I can't hear any of it), and this story was on MSNBC or something, and I was like, huh, that guy looks familiar. And then over on the CNN screen it was in the ticker a few days later, and I thought, hmm, that name looks familiar. But I still didn't connect it until one of my friends posted it on her Facebook page.

And then I had one of those headslapping moments. He was a year or two ahead of me, but many of my friends were theater people, and so our circles overlapped. We weren't bff, but I remember him as a nice, reasonably funny, generally unassuming kind of guy. And let me tell ya, my college community is pretty darn proud.

Way to go, Chad!

Sick day

(I get them on the blog, too)

Had a wicked migraine today. Pain is better, but I'm still not quite right....need to go hide in the dark some more...

Lotta Thursday

So it's Match Day again.

We got a whole new batch of incoming interns today. A couple of my favorite picks were in the group, and a couple that I hoped would be joining us will not. But there's fresh blood a-comin'! People to take the intern pager so the current interns can take my pager! Which is what's important, here, right?

In other news, I went to the coast today. It was goooooooorgeous. I had a relatively light caseload, and then I stopped at this place called the Coastal K-9 Bakery. Because, you know, I might have a puppy who just had a birthday. It was very cute. The woman who runs the place was very nice, and assured me that not only were all their products human-grade and organic, but that the Parmesan snaps make very good croutons.

I ate one. It was okay. Not as flavorful as I'd like in a human treat, but not bad.

So I bought a small bag of assorted treats-by-ounce, and this:

It's a Crabby Pup-cicle.

Maggie loved it. She ate half and then mysteriously disappeared out the dog door with the other half and came back in all muddy.

Love that dog.

(She sends birthday wishes to little Mr. Scrat as well. She'd send him a treat, but, well, she'd eat it before we got it in the mail...)

It was a nice day. I ran around the coast, got out reasonably early. Had a nice drive back, and a good workout. Came home, gave the puppy a Crabsicle, had a nice shower, made dinner, and then there was new Bones on. Plus, there's only one more day until the weekend! Can't beat that...

Birthday girl

My baby. She's a good, good girl. And now she's officially a senior (she's 7), which almost makes me a little misty....



(And a happy belated b-day to Carol, too!!)

Luck o' the Irish

Ohhh, it was a day full of angst, badness, and stress. Which was made infinitely better when Sparrow handed me a glass full of homemade Sangria tonight (it's not very Irish, but she makes the BEST).

So in honor of everyone being Irish today, I give you the following. Enjoy.



(And PS - xronia polla, Mom!)
(PPS - No, Danielle, it isn't really my Mom's name day - I address this to you because I'm guessing you're the only one who's going to get that the above phrase wasn't a typo... - my great-Aunt, however, declared that it must be, and so used to send her a card every year on St. Patty's. We miss her...)

Meme-y

A little Monday meme-ing, stolen right off my friend June's Facebook page. I need a little something like this today...feel free to tag yourself.

Firsts.

1. Who was your FIRST prom date? Didn't go to prom. Hmm, maybe I picked the wrong meme...

2. Do you still talk to your FIRST love? Not the first person I thought I loved, no. But my first boyfriend and I are Facebook friends. We were engaged, you know. Then again, we were six, and I think our relationship started after he barfed on me in kindergarten...

3. What was your 1st alcoholic drink? Is it bad that I can't remember this? Probably beer. I can tell you my first legal drink was an amaretto stone sour, which my dad bought me at lunch at my favorite restaurant on my 21st birthday, after we went to get my new blue drivers' license.

4. What was your FIRST job? Mary Kay lady was my first official job. The first one that really paid anything was doctor. And, so far, that hasn't paid great.

5. What was your FIRST car? Geo Metro. It was a straight-3, 1.0-L, rolling Easter Egg. Hot.

6. Who was the FIRST person to text you today? Corrina. With something she wanted me to pass on to Tyler. It hasn't been a text-ful day.

7. Who is the FIRST person you thought of this morning? My patient who paged me yesterday.

8. Who was your FIRST grade teacher? Ms. Catterson. I loved her. She just died a few years ago. We still keep in touch with her kids.

9. Where did you go on your FIRST ride on an airplane? Colorado, or so I hear. I was 10 months old and kept waving over the seat at my grandparents. That was NOT on a flying tin can, by the way.

10. Who was your FIRST best friend & do you still talk? Ali. Yep.

11. Where was your FIRST sleep over? Oh, gosh, I think it was at Becky's. I mean, I slept over at my cousin's before that when I was little, but I don't think that counts.

12. Who was the FIRST person you talked to today? Maggie. She counts, right? Otherwise, it was the barista at Starbucks...

13. Whose wedding were you in the FIRST time? My cousin Tom's. My cousin Dimitri (whose house I used to sleep over at) and I totally stole the show. We were cuuuute.

14. What was the FIRST thing you did this morning? Swore. Really.

15. What was the FIRST concert you ever went to? I think it was Dizzy Gillespie. My first real "concert experience" was Lilith Fair.

16. FIRST tattoo? Only have one. On my back, in the usual tramp stamp location.

17. First piercing? Ears. Still the only piercings I've got.

18. First foreign country you've been to? I think Canada

19. FIRST movie you remember seeing? I think it was a Care Bears movie...

20. When was your FIRST detention? Never detained. I was naughty in more covert ways...

21. What was the first state you lived in? Illinois

22. Who was the first person you kissed? On purpose? I think it was a game of spin the bottle at my cousin Danielle's.

23. Who was your first crush? See above, re: engagement.

24. First election you voted in? 1996

25. First Presidential Race you voted in? 1996

I'm almost ashamed to admit this...

...but I'm watching this movie, Fireproof. It's got Kirk Cameron in it, which is not, in itself, that remarkable. The embarrassing part is that I'm taking it on the recommendation of the Duggars.

Last week, I was channel surfing, and wound up watching an episode of 18 and Still Counting. Which, I have to admit, I really rather enjoy. There's something very comforting and real about the Duggar family, as unconventional as they are. Anyhow, so they took the family tour bus and went to this big Christian film festival, and raved and raved and raved about this movie.

And....well....I kind of have to agree.

So, basically, Kirk Cameron is a fireman with a failing marriage. And his dad convinces him to try and save their marriage, and gives him this 40-day "dare," a plan of ways to change the way he thinks about his wife and his marriage, to be a better man and a better husband and a better Christian. With some Bible verses to go with it, of course.

It's not the best acted movie I've ever seen. And it's a little contrived (there's this whole "porn is the devil!!!" subplot that's a little like, oh, whatever...). But it's already made me cry like six times (which, I also concede, is not hard). And not as formulaic as you might think. It's definitely a Christian movie, in that there's a lot of talk about God, but there's something to be said about the kind of values it endorses, too. And I appreciate that it's not smack-you-over-the-head religious. And it's got this very...genuine quality to it.

I definitely recommend it. And it's safe to watch with your kids (or your parents, for that matter), which is kind of nice.

The one thing that still weirds me out, though...there's this very nice kiss at the end. And during the Duggar episode, Kirk Cameron revealed that he won't kiss any woman he's not married to, so they had his actual wife stand in for the actress who played his movie wife. Which, I guess that's nice. It just seems...I dunno. Fussy? Isn't that sort of the thing about about...you know...acting?

I did really like the salt and pepper on the cake at the end, though.

There's an interesting quote, though. At one point, his father says to him,

Don't just follow your heart, because your heart can be deceived. You've got to lead your heart.

I don't know if I agree with that. I think, maybe, you can not listen very well, you can let other things be louder than what's truly in your heart, but if you really listen, I don't think it'll ever lead you down a path that wasn't meant for you.

One more reason...

...I'm glad I love my job.

Read this.

Are they kidding? The Eagles really "r" retarded.

(And yeah, Gigi, I'm totally thinking of you, here!)

It's been a lazy Saturday here. Last night was wicked. My intern and I were both up until like 4:30, and of course, I woke up at 4am on Friday for no apparent reason and couldn't go back to sleep, so I was dragging all day to begin with. I had a rare hole in my schedule yesterday afternoon, so I tried to go take a nap in the call room, which was cold and noisy and housekeeping tried to come in and it smelled, very weirdly, like institutional lunch. Cafeteria Salisbury Steak, to be exact. I don't know if that's really what they served yesterday, or if it was, like, the new paint in there or whatever, but regardless, sleep just wasn't happening. I tried to sleep there last night, too, but it was similarly awful. And the paging system went down, so they were doing all of this overhead paging....bleh.

But I did manage to get a little nappage in today, which was nice. It was one of those cold, rainy, nasty days, perfect for snuggling up with a puppy, watching Dollhouse, and sleeping. Sparrow, Ruthie and I went to this Turkish restaurant for dinner (it's a good thing my Greek grandfather is dead; that might have made him have a little stroke). It was tasty, but it was on Greek time - er, Turkish time - for sure. A fairly simple three course meal took over three hours. Good company, though, which was very nice.

Still. More sleep still needed. Gonna do that...

Yeah...

That's kind of how I felt about going back to work today, too....

All I need is a couple (more) days off...

(A la Huey Lewis)

So I'm at Starbucks. It's my last day of "vacation" and I'm debating how much more I want to be productive vs being a bum. Bum might be winning, especially given that my first patient tomorrow is at 7am and then I'm there all night. Bleh.

So, to answer Danielle's question from the comments the other day, here's how you become a subspecialist physician in two short decades: you start with four years of college, heavy on the sciences. Somewhere in there, you take the MCAT, do the first scary application process, and then you go to med school for four years. At the end of that, you're an MD, but you can't do a whole lot with it. So during your fourth year you go through the match, which is insane, and roughly this: You apply to residency programs, they can then offer you an interview, and after all the interviewing is done, you rank all the places you want to go in the order of preference, and they rank all the candidates in the order of their preference, and then some big computer in Texas matches everybody up. Sometimes this works well, sometimes they send you to Hell. Anyway, assuming this works out, you do between three and eight years of additional training (residency) in your chosen specialty. And when you're all done with THAT, if you're really insane, you do sub-specialty training, Fellowship, which is typically between one to three extra years. And if you're completely crazy, you might do more than one fellowship. Some of these fellowships are "accredited," i.e., recognized and regulated by the governing bodies that, um, govern these things. Some aren't, but can be equally valuable because they provide additional training in some area that just hasn't been approved by the big folks yet.

So, let's recap/project my career as an example, not including the false start between med school and psych residency. College (4 years), medical school (4 years), psychiatry residency (4 years - I'm currently in Year 2), child and adolescent psychiatry fellowship, which is an accredited fellowship (2 years, but your first year of fellowship can overlap with your fourth year of residency, so it only adds one year total to your training), and possibly an unaccredited fellowship in Traumatology (1 year). And then, THEN - 14 years of training after high school, not including my year of OB/G - I get paid like a real doctor and get to start paying back my loans in earnest.

Fun, right? Well, okay, actually it is, a lot of the time....

So, of course, every step of this process is full of applications, personal statements, references, interviews, and uncomfortable shoes (although - yes, Allison, Dansko does make dress shoes! They weren't bad, actually, just new). And my interview for THIS particular step in the process was Wednesday. It went....well, I'm never a good judge of these things. I'm sure it actually went fine. I mean, these people know me, right?

The problematic thing, for me, was that I felt like I spent the whole day talking about the Emerald Palace. All five of my interviewers asked about it. One pointed out that it "raised concern." Three of them asked me if I'd had any problems with anyone here, and then agreed they hadn't heard that I'd been trouble here (so why ask??). It was probably fine, but on my side of the couch, it's really frustrating. Haven't I done enough penance? My life fell completely apart. I'm still dealing with the financial and logistic aftershocks (which says nothing of the psychological fallout). I mean, I got out of an abusive situation. How long am I going to have to apologize for that?

My program director up North threatened me when I left, that they were going to haunt me for the rest of my career, that this was going to "follow me" and they'd make it so I had to "explain myself" every time I applied for a license, a job, or a training position. Turns out, she was right.

Fuck. What the hell was I supposed to do? It was bad. I got pulled into their enactment. My job, my personal life, my well being were in peril. So I left. I wasn't the first one. I wasn't the last. It's completely amazing they still have accreditation with their rate of attrition alone. But fortunately for them, those of us who have left are either so glad to be out or so traumatized that no one's taken formal action. So they just keep going.

Look, we all make bad choices. We all stay in situations we shouldn't because we want to hold onto hope, or we're scared of the consequences, or we think we're the primary problem.

And I suppose if I were divorced, my prospective new spouses would want to know what happened. I guess this isn't a whole lot different. Except, in this analogy, I've been dating this program for a year and a half. If it's thinking of proposing, shouldn't it look at our time together instead of worrying about my tarnished past? We've had a pretty darn good relationship, I think. I like it here. I like the people here. It's why I want to stay. I've worked hard, I've taken good care of patients, I've done some interesting stuff. Why not focus on that?

And, ultimately, maybe they won't. I'm sure it was fine, and it'll work out the way it's supposed to. And as Corrina (the program coordinator. Her full name is, of course, Magical Corrina The All-Knowing) pointed out, my odds were less than 1 in 10 when I matched here in the first place, and they're currently 5 in 6. I just really, really want to be one of the 5 (see above, re: really liking it here). And I think it's a great training program. And I like to think that maybe some day, they'll be like, oh, Dr. Kate? Yeah, she was one of ours, back before she was one of the most prominent names in trauma/wrote that New York Times Bestseller/opened that cool yarn store (you know, whatever).

And maybe then I'll be able to say, well, that false start just was what it was - a chance to learn a whole lot about myself.