I did not end up getting a permanent account. I was really having a hard time justifying the expense of it and kept putting it off. I did convince myself yesterday that maybe it wasn’t that much money, but I was on call and that didn’t leave any opportunities to slip away.

I think I probably would have regretted it. I had been counting on the end of the year bonus from work so that I could indulge a bit and discovered that Uncle Sam had taken 40% of it, leaving me with less than what it’s going to cost to take get my medicine license, so I can’t even afford that, which is much more important in the long run. I’m so tired of money issues, so wearied. I was really hoping that with the very small cost of living raise that some of the money pressures that I’ve been drowning in for the last six months would ease, but taxes and insurance are going to suck that all away as well.

*sigh*

On a good note, I’ve completed my last call ever as an intern! Whee! Of course, things really aren’t going to be that much different next year. When I’m in the neurology department, I’ll be a “junior resident” which is really the exact same thing as an intern (still the low man on the totem pole) and when I’m on my medicine rotations, I’ll still have to take call as a senior resident (just not as frequent and I won’t have to write daily notes! Yay!).

And I just realized how confusing my life must be to those of you who actually read this thing. And that I’ve never explained what I’m doing. I have a tendency to assume that people can read my mind, and are really living my life with me (I should have probably outgrown that belief when I was, I don’t know 15 months old. I’m a little behind) So allow for a brief detour.

explainin’ stuff here

This was today’s “The Writer’s Almanac: Literary and Historical Notes” World War I

Sorry I’ve been MIA for the past few days (and I was doing so good with the “post every day” thing too). One of my patients died on me, unexpectedly, and it’s been chewing me up inside, wondering what I missed, what I didn’t do that lead to the situation. I was responsible for her overnight… why didn’t I realize earlier that something was wrong.

Also, all of those fears about becoming a senior resident are overwhelming me. I’m not prepared, as this weekend taught me. I was the first one to the code, and all I could do was stare at her. All of the ACLS training (from a year ago), vanished and I could barely even remember to check to see if she was breathing or if there was a heart beat. Luckily, there were others who responded quickly and were adept at setting up the machine and directing others–exactly what I should have been doing. We got a heart rate back, but she was without oxygen too long and the family decided to withdraw care today.

A year later and I’m still not ready for this.

I spent most of the afternoon browsing around a map store. And oh, it was heaven. I love maps. Maps of places that I’ve visited. Maps of places I want to go. Ethnic maps. Topographic maps. I’ve collected a few – I’ve got a lovely map of the city streets of Antigua that needs to be mounded and a historic map of Ireland that needs a frame. I hope to one day decorate my upstairs (and most likely my bedrooms) with maps and frames pictures of all of the places that I’ve been to. In Kenya, I almost struck out. The only maps available there were road maps (and as good quality as the roads themselves). So instead, I had a map made for me, on a large plate. It’s gorgeous (I shall definitely have to take a picture) and is hanging on my wall.

The map store was amazing. The owner, a grandfather type who followed me around, answering all of my questions, stated that they had over 6000 maps, and after seeing the place, I believe them. They didn’t have a map of Kenya, however, their map of Ireland blew mine out of the water (alas, it costed close to $500!). And the globes! Oh, how I want a globe! In the end, grandfather-owner did manage to talk me into a shiny antique map based on some explorer from the 18th century’s drawings. It’s soo gorgeous and I can’t wait to see it on my walls!

When I was in South Africa, I bought this map

It’s lovely and exactly what I wanted. Problem is, it’s huge (705mm X 670mm, which roughly translates into 27 X 26 inches). And rather square. And I can’t find a frame to fit it. I tried to get it priced this afternoon. $160 dollars. For a frame. Of wood. Does this make sense to anybody else?? I’ve come across this problem before, because I’ve actually framed some puzzles that now serve as artwork, which were odd sizes (All the World’s A Stage and Fairy Tales. Next I want to do The Oath) and I made the frames myself… went to Home Depot, bought the wood, sweet talked the salesboy into cutting it for me and glued, stained, everything. The first time, I used glass and my upstairs neighbors (I think they were the drug dealers) were having some kind of ruckus and it fell and shattered and I redid it in plexiglass. It was time consuming and it took me months (mostly because I’d lose interest). And Liz made me pinky swear that I would never do it again (I think she was really really tired of puzzles by the time she moved out). So I’m stuck.

Any ideas of where I can get a cheap (but decent) frame made?

I am 9 days from completing my internship, the first year of my residency. After this, it will be me in charge of the interns, directing the team, and helping the fresh-faced, confused recently-made-doctors in taking care of our patients, making sure that nothing is overlooked, that we consider everything that could be potentially causing our patients symptoms and that it gets worked up properly. A whole new level of responsibility. Instead of 5-10 patients, I’ll be responsible for knowing about 15-20. It’s the next step to becoming a Real Boy independent physician. I know that I have areas of weakness (still hate EKGs, still hate drugs), but overall, I think I’m doing pretty good. I’ve even gotten praise from my attendings and residents in reviews, stating that I’m performing above the level that I should be. Maybe I let some of that go to my head…

I missed the diagnosis of an aortic dissection yesterday. Completely and totally missed it. Granted, my patient didn’t come in complaining of the classic symptoms and we thought we had the reason for the other chief complaints–once we got the blood pressure controlled, the headache disappeared and the abdominal pain was gone as well. I was ready to discharge, had all of the paper work ready and was rather upset at my attending for wanting to get an echo, and then a CT scan on a patient who already had a reason for a murmur and was doing fine. Eating, breathing, walking, with no complaints. But there’s a reason for the hierarchy, and I got the scan without too much arguing (just a lot of internal grumbling).

Even then, I missed it. I looked at the scan yesterday morning, saw a little fluid at the lung bases and that was it. I completely missed the large bulge in the aorta, as the blood leaked out. I didn’t get it, until the radiologist called and informed me what the pictures really showed.

Aortic dissections are deadly. They can rupture, causing instantaneous, massive blood loss. In medical school, it is one of the “red sign” diseases that are always top on the differential, as they are the worst case scenario.

And I missed it.

It was my four year LJ anniversary last week. Wow, time goes by fast. Just yesterday, I was primping for my first “date“, choosing my words ever so carefully, wondering if LJ and I would forge a lasting relationship. We drifted apart those first few months, time creating a wedge, but slowly, I was drawn back to LJ’s charisma and listening ear and we’ve been steady every since. *smooches LJ*

Linen, btw, is the traditional gift for the 4 year anniversary. Or flowers. I would accept both from my adoring readers.

On a related note, permanent accounts go on sale tomorrow. Each time, I’m tempted and then talk myself out of it. I calculated it out. Between my paid account and my user pics, I’ve easily spent more than $150 dollars in my 4 years here. I could, you know, go back to the basic account, with a basic layout and 3 user pics, but uh, I’m kinda addicted. It’s my place. My friends are here. My life is preserved here. But then there’s that “forever commitment” that putting down the money entails. And what if one day, LJ and I part our separate ways, that we no longer have anything in common and all we do is bicker? And what if I decide that 138 userpics isn’t nearly enough to express myself and I go looking for greener pasture.

Or maybe I’m just a commitment phobe. 🙂 Maybe LJ and I should just run off together into the sunset, and I should just stop worrying what the next day or year or lifetime will bring?

Decisions. So many decisions. My mind would be eased with flowers….

Last week, when I looked at the nice neat row of blue boxes on my mini calendar, I thought to myself, “Self,” (and then I giggled because I rarely speak to myself as a proper noun), “you know what would be a great goal? To fill that little calendar box with blue boxes. To write a little something every day.” And I was cheered and excited by the plan, and made little ideas of what I would write.

And then of course, I’m on call. And at the hospital until 10 at night. And somehow living a life. And lo, 5 days passed, and there went that idea. It was fun while it lasted. 🙂 At least I didn’t post that lame idea here. I figured that if all of you read that I was going to say something every day for 30 days, you’d run away screaming and I’d be promptly DEFRIENDED. I just couldn’t bear that.

Does everybody note the little happy, lilting tone to my voice? Notice that the gloom and doom has left the building? Yep, it’s true. Things have definitely gotten better. I’m down to 3 patients (who I can’t seem to discharge); one of my difficult patients I discharged a few days ago, the other has yelled at me every single morning (and every other person who walked into the room… I stopped taking it personally). I’ve been finalizing plans to send her home for about 5 days now, today I walked in and she actually apologized and smiled, so I think I won her over as well! My favorite patient was here for clinic today, which was nice (someone that I’ve actually been able to help a little). So all in all… things are better. 🙂

details about my little life

It’s been such a rare thing for me to be in a good mood the past 14 days (day off tomorrow! 1 week without call (already 5 days into it, boo)! Discharging patients! I’m positively euphoric!), that I hope you’ll forgive the multiple posts. Soon I’ll slink back into the dredge of daily life, but for now, I don’t want to be thinking about how this is one of the worst months I’ve had as a medical student and a fledgling doctor.

In the meantime, one of my entries last week got me thinking. And in turn, I’m submitting it to you:

What are some of your favorite hugs from tv/movies/art/media/etc. They can be romantic/playful/friendly/comforting (do I need to go on?). I’m thinking about changing around my icons to a bunch of hugs for every mood and I’d like a good collection. Pictures would be helpful (nothing pornographic or graphic please!), but not necessary. Obscure is welcomed!

(And now to bed go I. Have a busy day. Kristin is coming over to help me make bookshelves and Kara might come over as well. The neuro gang is meeting up for Jazz in the Park downtown and Chris might drive out if he decides that an 1 1/2 hours each way isn’t too bad (I think he’ll back out). So I must get my beauty rest!

*blows kisses*

A discussion of the Doctor Who episode, Blink, and how a certain TARDIS got moved from one place to another.

HERE (slight spoilers)

I giggled over that one for a good five minutes.

Blink, by the way, was one of the most brilliant episodes of the season. It doesn’t quite stand up to deep questioning and probing (but the serious time travel episodes on any sci-fi show rarely do), but it was scary (I’m a wuss) and funny and the guest girl was phenomenal. Great times. (That wasn’t spoilery, was it?)

Found at bookish

Re: Ella Enchanted

The movie is one of my favorite movies ever! I actually wore out the DVD watching it…

The book is good as well, but it’s so very different from the movie. It’s much darker, and the plot is quite different. It’s still a really good book, but if you go into it thinking it’s going to be like the movie, you will be disappointed.

Ah yep. *sigh* The only good thing about that movie was that it only cost me a dollar and was truly one of the best mock fests that Liz and I have had. “Dirty Dancing: Havana Nights” probably squeezes by a hair, but otherwise… My friend Brooke put it best in her blog, when she was talking about her ten favorite children’s books that ought be made into movies, with Ella as her first choice: “Yeah. And let’s get it right this time.”

Question. Name me one movie that you liked better than the book. I’m really curious, because I can’t come up with much.

Found randomly browsing through Myspace, when I clicked on the link for people who attended my medical school and found this (if you’re not LDS, probably won’t make much sense):

http://profile.myspace.com/index.cfm?fuseaction=user.viewprofile&friendID=180898107

Somehow, I’m just not seeing the General Authorities spending their free time browsing around adding each other, filling out memes and choosing their favorite MoTab song to blare every time you click on their profile. But maybe I’m wrong. Maybe they’re much more down with it than I thought. 🙂

I almost started crying at work today. Tears of frustration mostly, at my patients who aren’t getting any easier to deal with, at being tired (stayed up too late), and to top of matters, being told right as I was leaving an hour early that I had to stay because the rest of my team had taken off, the overnight intern was in clinic, and therefore, I was the only one in the hospital and had to stay until the intern got back. It was just too much. Luckily, one of my colleagues was willing to cover and I headed home. I’m so weary of this month. Weary and ready to be done. And I’m only a third of the way through the month.

But I’m not on call again until Saturday, I should be discharging most of my patients by then, which I am really looking forward to. I took a nap this afternoon (yes, I do find it pathetic that I get off early and I spend it sleeping). And best of all, I got that hug that I so desperately needed, from the one that I really wanted it from, and dinner and a movie, and I now have a friend from home in the same state as me, so things are definitely getting better. 🙂

We went and saw Ocean’s Thirteen, which was a gazillion times better than Twelve. Many even better, since I don’t recall anything that happened in Twelve. A really, good, engaging time, much like the first one, and definitely the light hearted fun that I was needing. So, highly recommended if you liked the first one.

And I think that’s it. I’m trying to have my friends over for dinner on Wednesday, we’ll see if it happens. But I’ll need to spend tomorrow night cleaning my living room (I did manage to get my kitchen, bathroom and bedroom cleaned before Chris’s surprise visit, so at least that’s done) and putting together the bookshelf and drawers that I bought months ago. It’ll be the first time that I’ve entertained at my place. I’m rather excited. I hope it goes well.

The opportunity to sleep trumps all when you’re on call (except the pager, but that’s unavoidable).

But uh, that has never been tempted against watching Dr. Who. Even if it is just a rerun of “World War Three.” (I had forgotten how much I love Harriet Jones! And Ninth Doctor!! He’s sooo fantastic!)

I guess the most important question is how is it possible that I actually have time to debate between watching tv and getting sleep??? I am not complaining one little iota.

I think sleep is going to win this battle today. 🙁

It just dawned on me tonight, what I really need to make this week better. Not just a day off (although, I’m enjoying every single minute of my day tomorrow, and not thinking about work one iota). Not just an entire new set of patients (my attending, resident and co-intern hate my patients as well; I at least feel better that I’m not the only one), so that I can feel like I’m helping someone, not fighting the demands of entitled, drug-seeking, whining, not-sick patients. Or better yet no patients, since I’m carrying the entire team (yesterday – 12 patients on team, 10 were mine. Today 9 on team, 8 mine and I had the only admission. *sigh*). Not only more sleep. Not sleeping in (this 5:30 thing is going to kill me).

What I really, really, really need is a hug. A good long embrace, where I can weep a little and rest and recharge in the warm, protective arms of another. And as much as I appreciate the virtual squeezes from all of you, it’s just not the same.

It’s got to get better. This month has got to get better.

Nothing like a call night with absolutely no sleep.

And get this. I just discovered that I went to four years of medical school so I could become a professional, legal drug dealer. Isn’t that fun.

5 more hours. Just five more hours and then blissful sleep.