Wednesday, June 27, 2012

Top Ten Signs You're on Surgery

10. Your shampoo ran out and you're washing your hair with the tiny travel bottles you found under the bathroom sink.

9. Your "lunch" is a Cliff Bar in a bathroom stall, eaten while you pee.

8. You can't remember the last time you wore clothing with buttons or zippers.

7. 9:30 pm is wayyy past your bedtime.

6. You are developing carpal tunnel syndrome from holding retractors for so long.

5. By the time you realize the attending was addressing you, he already assumes you're an idiot.

4. You get annoyed if you have to park all the way up on the second floor of the parking garage.

3. You have lecture from 8 am - 5 pm one day and wonder what to do with all your free time.

2. You fall asleep mid-sentence trying to tell your roommate about your day.

1. You keep getting texts from people saying things like, "Are you alive??"*

*Actually, this one is just a sign that you are in medical school.

Sunday, June 24, 2012

Making the Most of It

The weekend, that is.

Most of my med school friends and both roommates took really big exams this past Friday, which meant that this weekend was party weekend.  I didn't have a test or finish a rotation, and actually had to work a 12 hour shift on Saturday, but that didn't stop me from enjoying the festivities to the fullest.  Because, in med school as in life, I think this is how you survive something that is hard: you show up and make the most of it.  

Everyone is always so busy and stressed and working long hours and studying during the few hours they have away from the hospitals and spending needed time tending to their relationships when they have an extra moment, and so time spent just hanging out with friends is rare and precious.  For me, when my friends are all heading out for dinner and drinks for the first time in months and I am already severely sleep-deprived, way behind in studying, and have to be up for work at 6 am the next day?  It's not even a question; it is a total no-brainer.  That is what coffee is for.  :)

The fun continued on Saturday night after I got home from the hospital and took a quick, unintended but clearly necessary nap to recharge the batteries.  One last-minute mass-text, and two hours later we had a full house and a stocked bar, of which we made efficient work.  Our new house, which I keep meaning to take pictures of to show you, is an awesome place for parties, and thankfully, all three roommates are of a similar mindset - namely, that a full house equals a full heart.

A house full of good friends, good drinks in hand, good stories to share, comfortable seating for all, mass transit to the next location, and then dancing after all of that??  Ahhh... so good.  So necessary for my wellbeing.  To make the Weekend of Happiness complete, I woke up today, after noon(!), only to discover my roommates starting to whip up a truly phenomenal brunch... and then more friends came over to help cook and eat.  Pure, unabated bliss.

Starting to see what makes me tick?  :)  Happy Sunday, everyone.

Saturday, June 16, 2012

My Furry Baby

Izzy, alive and well and snoozing away

So here's the setting for tonight's story: I am on labor and delivery at Grady right now, on the night shift this week.  These shifts last about 14 hours, from 6pm to 8am, with a usually pretty busy service of laboring patients, deliveries, c-sections, OB emergencies.  For some reason I was convinced that I was on days this week instead of nights.  I was so confident that I didn't even double-check the schedule on Sunday night.  So I showed up for my first L&D shift 12 hours early.  Better than being 12 hours late, I suppose.  

I was immediately corrected by my classmate whose shift it actually was, made fun of by the third year signing out, drove back home and tried to sleep through the day so that being up all night wouldn't be quite as painful.  But alas, I tossed and turned for hours in the bright daylight of my room, dozing and having brief bizarre anxiety dreams.  Definitely NOT restful.  Finally I just gave up and got out of bed, deciding to just make a big thermos of coffee and hope for the best.  The night went ok... I am guessing that no one ever feels like the first day of any rotation went really awesomely well.  At best, you are just trying to figure out what's going on, how things are done, where things are, what the personalities are on the team, etc.

Anyway, needless to say, I was exhausted and feeling rather brittle by the time I made it home at 8:30 the next morning.

I walked into the house and Izzy greeted me at the door, which is never a reassuring sign when no one is home.  Both my roommates' cars were gone, so I knew they had already headed to work.  Izzy is only about 10 months old at this point and not really reliable being left alone, so usually we try to make sure that she is either left out in the yard or put in her crate if everyone is leaving.  I dropped my bags and headed back to the kitchen/living room, surveying for trouble as I went walked down the long hall that goes the length of our house.  Everything seemed to be in place until I saw it on the sofa: my very recently-new, nearly-full cardboard container of chocolate calcium chews, empty.

I immediately burst into tears.

Izzy just looked at me, with her big floppy ears all perked up, doing her adorable quizzical head-tilt, big brown eyes meeting mine.  I freaked out, imagining her imminent death due to hypercalcemia.  I called my vet, whose office wasn't open yet.  I called the emergency clinic whose number my vet's away message gave me.  The emergency clinic operator told me that they were closing since it was time for regular clinics to open and that I should call my regular vet.  I called back a second time and got the away message again.  I left a frantic voicemail.  I googled "my dog ate an entire container of chocolate calcium chews" and got a surprising number of hits.  I ended up on some website where you could chat live with a vet, who would answer your question for a mere $35, which I paid.  The online vet basically told me that as long as my dog was generally healthy, I could expect some upset stomach but that she would be ok.  I then found a much more detailed and reassuring response to my exact question from my previous Google search.  (I clearly don't make the smartest decisions concerning spending unnecessary money when under duress.)  After all of this, Izzy still looked like she was just fine, and I felt much better about just watching her and seeing how she did for the rest of the day, so I calmed down, collapsed into bed and passed out.

The short version of the rest of the story is that the next day, she was pretty miserable for about 24 hours, vomiting a couple of times and shitting out those silver foil wrappers all over the back yard, but she has since made a full recovery and is back to her cute energetic self now.  I know she is just a dog, and maybe there are those of you out there who think that it is silly to get so worked up over a pet, but I have been surprised since adopting her how much my little buddy has come to mean to me.  I am thankful for the love and companionship she has brought to my life, and I am so grateful that she is ok.  :)

roomie Elena enjoying post-work snuggles on the sofa with Izzy and Luna

Friday, June 8, 2012

Excuse Me, Doctor?

The patient was eclamptic, postictal and post stat c-section, intubated and sedated.  

Still a teenager, summer school cut short before it had even begun with the emergency early arrival of her first baby.

My job?  To watch her and go running for help in case she seized again.

I literally sat and watched her for hours.  Not exactly the obstetrical urgent care experience I had expected.  A glitch in the ob residents' schedules that night, and I was all but forgotten about back in this darkened room.  The patient's nurse on the short-staffed intensive care unit was grateful for my help all night, though.  She actually refused to let me leave, kept asking me to stay, giving me tasks.  

You're not leaving me now, right? she kept repeating.  She even told me she was going to make one of her famous New York-style cheesecakes as a thank-you gift, to keep all to myself.  The residents will be mad, they'll be so jealous, she said.  Everyone knows how good my cheesecake is, she said, chuckling and nodding.  I helped her shift the patient in the bed, change the bedroll, draw labs.  

I sat with this patient and watched as people came and went.  Just sitting there, mostly; observing.  Her mother.  Her high school friends.  Her father.  Her baby's daddy was a baby himself.  I watched as his punk 17-year-old cool-guy posturing melted away and he broke down, weeping as he leaned on the patient's bedrails, overcome.  His mother was there.  Friends and relatives came and stood by her sedated form, watching the timed rise and fall of the ventilator.  They took turns visiting the baby in the NICU.  

I watched nurses, residents, attendings all come and go.  Asking about the patient's stats to no one in particular, murmuring and conferring amongst themselves, checking monitors for pressures, leaving again without much word to those of us hanging out in the room.  I knew how she was doing in general, how her pressures had been acting, what had been done, what hadn't been done, why we were waiting for neuro, that the Fentanyl drip still hadn't come, despite having been ordered hours ago.  No one asked me.

The nurse came and told me, we're taking a road trip.  You're coming with me, right?  Don't go anywhere, I want you coming when we have to take this road trip, she said.  Don't worry, I'm not going anywhere, I told her.  I'll be here to help.

The patient needed to be brought to another floor for a CT of her head, to rule out bleeding, other causes for her seizures.  The nurse, the respiratory therapist and I all helped to get her ready.  IV bags hung on the bed, monitors switched over to portable machines.  We got the ok; bring her on down, they said.  I was too naive to be very worried.  But the nurse kept shaking her head, exhaling through pursed lips.  Whoooee, I hate road trips.  Oou!  They make me nervous.  I haven't had to do a road trip in two years, she said.  The respiratory therapist was tight-lipped and serious as we swung the bed down halls and around corners, into elevators and through doors.

We arrived at CT and maneuvered the bed into the room.  We were working on getting the patient into position for transfer onto the machine when a voice came over a speaker.

Excuse me, doctor?

We kept working.  The voice asked again.  Doctor?  Excuse me, doctor?  The nurse and the therapist stopped and looked up, expectantly.  I looked around.  There was no one else in the room.  I looked back down at all the lines I was untangling.

Doctor?  Are you the doctor?  The voice asked again.  

And suddenly I caught sight of myself in the tinted window that separated us from the technician's room.  Holy shit, my white coat.  The voice is talking to me!  He thinks I'm the doctor!  Dear God.  I shook my head furiously as I rushed to set him straight, feeling a hot flush in my face.  

I guess it wasn't the first time someone had asked me if I was the doctor while I was wearing my white coat.  But it was the most off-guard the question has ever caught me.  A tinted pane of reflective glass in between us, and without seeing the questioner's face, it didn't even cross my mind that I was the person being presumed the doctor.  It's gonna take some getting used to, which is a good thing, since I am nowhere near being one yet, and to tell the truth, I probably feel even further from it than I actually am.  In this case, it was an especially odd and hilarious juxtaposition between the role I had played all day in this patient's care and this man's assumption in the CT room, and once I recovered from my initial, flustered, red-faced panic, I had to laugh.  

The nurse winked and laughed along with me.

~ ~ ~

Summer evening in our hammock, joined by two furry friends:

Final note; for Dr. M:

Friday, June 1, 2012

The Run-Around

Wanna know one thing about med school that is really, genuinely challenging that you might not have ever thought about? (I certainly didn't before I came.)  

The logistics.  They will kill you if you're not careful.

Say, for example, that you are on a rotation like the one I'm on now, and that rotation requires you to be in a different place pretty much every day.  Say that you have never been to any of these places before. So first you have to figure out where in the heck you are going in the first place, and then you have to navigate the parking situation, and then you have to go searching for the right office and then you have to find the correct person you are assigned to be with for the day, and if you are lucky, they will actually be there and have clinic that day and they might even be expecting you.  If you are really lucky, you might even manage to do all this and still be close to being on time.*

(*By this, I really just mean when I get really lucky, I can figure out where I need to be and how to get there and then still arrive at clinic almost on time.)

Anyway, by the time all of this happens, I feel like most of my metal energy for the week has gone into just getting to where I need to be, when I need to be there.  It's sort of exhausting.  By the third time you go to the same clinic location, it's no longer even a second thought, but just imagine going to your first day of school at a new school, with new teachers and a new schedule, every day.  And now that I think about it, that is actually exactly what this situation is.  You know, and you want to be dressed like all the other cool kids and stuff.

On Tuesday, I started my ob/gyn rotation with a day of orientation.  Wednesdays are didactic days, so day 2 this week looked something like this: get up, drive to Emory Midtown Hospital.  Tell the parking attendent that I'm a med student on the first day of a rotation so he would let me into the lot.  Find the correct lecture hall for a 7am anatomy lecture.  Try not to fall asleep during Grand Rounds.  Rush down to the Public Safety office (which, thankfully, I already knew where it was located) to get a parking pass for the month at Midtown.  Get there first (yesss!).  Feel thankful that I have my license plate number memorized.  Parking pass in hand, hurry back to the lot, get in car, try to figure out the fastest way to Grady Hospital from Midtown.  Try to figure out the best way to the visitor parking lot via lots of different one-way streets.  Rush to the wrong building for a lecture that was supposed to start ten minutes ago.  Find the right building.  Luckily step into the elevator with someone else whose ID badge works for access to the floor I need to get to.  Arrive late, but still beat most of the rest of the group making the mad dash from Midtown.  Lecture, lecture, lecture.  Lunch hour - cross the street to the main hospital to try to get a scrub card and activate my Grady badge and get a parking pass for the month for Grady.  Run all over the hospital, getting different directions from everyone I ask about the offices I am trying to find.  Get told repeatedly "I have no idea" or "I don't think that is on this floor."  Take, like, at least five different elevators and four different stairwells to finally find the world's most well-hidden secret hiding place, aka the Grady Public Safety Office.  Hand in a form.  Follow directions to make my way through another super-secret short-cut maze to the parking deck.  Pay for my parking pass and chat with the parking office guy about how some character on a show I have never seen has my same last name.  Run back to lecture, get there late.  Learn how to suture on pigs' feet.  (By the way, I brought my lunch with me and have been carrying it around with me this entire time, and at this point have not had a single second to eat any of it.  And I am starving.)  Lecture.  Scarf some of my food while learning the cardinal movements of labor.  Lecture.  Race back to the office where I am hopeful I will find my scrub card waiting for me so that I can get the scrubs I need to wear the day after tomorrow.  The card is actually there, with my name on it.  Win!  Am told by at least three people that "there is no scrub machine on the 4th floor" even though that is apparently the only machine my card will work in.  Finally locate the scrub machine on the 4th floor.

Ok, by now, it had been a fairly long day.  I was with my friend Kristine, and neither of us had ever seen these particular machines before, so it took us a little bit to figure out how on earth they worked.  The scrub machines struck us as hilarious for some reason.  We were the only two people in the room, and we just took turns swiping our cards and cracking up when the machine would spit out a little green set in the size we requested as if it were the funniest thing in the world.  I don't know, maybe you had to be there.  But the good news is that I now have access and parking and attire for the next six weeks!

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