Annals of Medicine – The Itch (warning, cut your nails before reading; you don’t want to cause yourself harm)

It is just not fair that a surgeon can write this well about non-surgical stuff. It especially burns when it’s about neurology. 😛 I’m just a wee bit jealous.

He’s supposed to speak at the Neurosurgery convention in Chicago sometime this year. I’m so tempted to crash the party.

It was one of those rare occasions where Chris and I both had the same day off work, so we made plans to meet up. Of course, as is always the case, his free day was rapidly trimmed from all day to just a few hours mid-afternoon, but as I have not talk to him more than a total of 10 minutes over the last two months, I grabbed at the chance to spend a few hours together.

The weather was gorgeous when I left around noon. Chris called to say that he had finished his 65 mile (!!!) bike race and we made plans to meet in about an hour. 30 minutes down the road, I pass a sign. “Freeway closed ahead.”

They weren’t kidding.

Suddenly, traffic was diverted from the 3 lane highway to a 1 lane, narrow country road that was heading south. The perpendicular direction of where I wanted to be heading. No matter, I’d take one of the east-west routes… only big signs were plastered that those roads were closed further on.

I drove on. And on. And on. And eventually made it out to another highway, where I discovered that I was now as far away from Madison as when I started out.

It took me 3 hours to get to Madison. THREE HOURS.

By the time I got there, found my way downtown (missed a turn, ended up in Oregon), argued about where to meet for lunch, got lost, etc, etc, my afternoon visit turned into a mere hour. We met with a couple of his friends, started to eat lunch…. and then it started to downpour. “Lunch” was spent huddled under an awning, and after the rains slowed, I drove them to their cars, and said goodbye, because they all had to get ready for a dinner that night.

I did manage to get a map this time and we plotted the way back (where I once again missed a major turn). The adventures on the way back were almost as fun. The road I was taking had a washed out bridge…something not mentioned until you were there at the bridge, so I had to back track. At one point, it started dropping torrential rain and hail, so heavy I could barely see the road and the wind was gusting hard enough it almost pulled me off. I did manage to pull over and wait some of it out, but I was concerned that if I waited too long, those rains would cause further washouts, so I crept my way forward, until I made it to the freeway. The east bound freeway was open and I drove it the rest of the way home. There was water from the overflowing rivers on the west side, so really, I’m a little glad that they closed it, although I certainly wasn’t feeling that way driving out.

All in all, I put 220 miles on my car, drove over 5 hours, for a hour lunch that got soggy. Somehow, I think it was worth it.

I’ve missed my friend so much, I don’t think I could ever find the words. For four years, he was such a part of my life, that this… “acquaintance”ship where we talk once every couple of months for 20 minutes and don’t share anything important is killing me (Sidenote to all of my friends out there who I talk to once a month–it’s different. You and I get on the phone and gab for hours. We really catch up on everything. You aren’t flitting off to your real life within minutes of getting the update that I’m alive). We do great when we get together in person, that old camaraderie is felt in full force–we tease each other and laugh and it’s great. So I’ll take any chance I’ve got to get that back, if even for an hour on a random afternoon.

(More pictures that I took during the trip can be found here. I unfortunately was not able to get the really cool pictures of the rain storm as I was gripping my steering wheel in fear of my life. Just take my word that it was awesome.)

For those interested, pictures of the damage and my new, carpetless basement can be found here.

I was about to take pictures of the pond that was my sidewalk/back door and the swamp in my backyard when I noticed that the drains were no longer working, so that’s not documented. And I missed getting a picture of me, after I had gone wading outside, with my hair more plastered than Audrey Hepburn’s, so ya’ll will just have to imagine it. I looked fabulous.

It already smells so much better down there.

I’m hoping that this is the end of the saga…

I came home today and was overwhelmed by the musky smell from my basement. I managed to borrow a carpet cleaner from a friend and used that to suck up tons of water last night, but it was no use. The carpet was still wet and the glue was so saturated that the carpet was just peeling back from the floor. So I continued to help it along and pulled up all the carpet squares, except for those under the couch (which will get down when I get some muscle men here tonight). I had thought about saving it and trying to put it back down once it had dried, but I don’t have anyplace to hang them up to dry and they’re already sticking together, so they’re going to the trash. The floor is a rather dull gray, btw, but I’d take puce if it means that the smell is gone.

We’re going for a rug next time. A nice, easy to lift up when the flood waters come again type of rug.

Still on the list to do to make my house better for the next rain:

Clean out gutters
Silicon seal the window pane/sill
Buckets and towels (bad decision to leave all of my crappy towels behind)
Buy new window sill covers ($40 for a piece of plastic!)
Laundry of all of the wet clothes that got caught in the uprising

So much to do. Too lazy to do it.

I’m so thankful that the damage wasn’t worse. My next door neighbors had water coming in their back door, flooding their kitchen and spent all night Saturday and Sunday hauling water. Another friend had sewage backup in her basement, which is wayyy worse. And you’ve probably all seen the video of the houses that floated away and the dam that broke. That would have been truly terrifying. All in all, I’ve been blessed by friends who were willing to come when I called, a drain that only backup for 20 minutes and then cleared, leaving my furniture, furnance, water heater and washer/dryer and TV functional and mostly dry. And I’ve got easy to remove carpet as well.

In the last 5 minutes, the entire sky has turned black. I’m on the 5th floor of the hospital in the room with the big bay windows, so that I can check out a MRI on a patient, and it’s freaking me out. An “attention hospital staff: code grey” overhead announcement just went out… severe weather warning (black is the imminent danger/thornado, so I guess it’s a bit better) until 11 pm tonight. But this storm system is supposed to last until Wednesday. I’m not sure I’m going to be able to last until Wednesday!

There were at least 5 other people today with tales of woe and floods, including one of my attendings, whose fancy car was buried in 3 feet of water, as he lives at the bottom of the gully. From what it sounds like, Milwaukee has a problem with the drains on the municiple sewer and when the flash storms come, the water is unable to drain and backs up into everybody’s basement.

My basement flooded.

Yeah.

I’m now the proud owner of an emergency sump pump (I got one of the last ones at Home Depot–there were a lot of desperate looking people there), my couch and my washer/dryer are up on cinder blocks, and I’ve got to make another stop and rent out a Rug Doctor so I can soak up more of the water.

I’m on call tomorrow, so at least it happened today.

ETA: It’s been alternating thunderous downpour for 10 minutes, followed by drizzle for 5, rinse and repeat for that last 2 hours. My home teachers helped me out earlier this evening and we got the water drained out of the window sill, but it’s filled up again and the little waterfall into my basement has spurted to life again. So far, my drain has continued to work, but there’s water dripping from the wash room now as well. I didn’t bother going to get the water sucker vacuum; weather.com is predicting this same weather for the next 2 days and I’ll just save my money until there’s a chance I can dry things up.

So I went to a noon conference yesterday at the adjacent Children’s Hospital. As we were walking back, my fellow was telling me some juicy gossip about some of the pediatric attendings (who I don’t know) and we walked by a couple of residents, who she knew and we greeted them.

As we continued on, it dawned on me why the one who had refused to make eye contact looked so familiar.

Kyle Jensen is apparently a fellow at the Children’s Hospital. Has been for an entire year. Of all the people to be out here in the midwest at MY hospital. I was irate the rest of the way back to my hospital. Instead of it being a joyous reunion with a fellow Utahn, an LDS Utahn at that, it was the same old snub.

I browsed through my entries to see if I had wrote about him in the past; there’s one passing mention of him on my fond look back of third year in the pediatric rotation section. Once upon a time, when he was a med student and I was a pre-med, I had a wee crush on him (which was all Suz’s fault because she had liked him a bit before she started dating her husband and gushed about how wonderful he is) and thought he was amazing because he was a med student. The crush very quickly faded because he never acknowledged my presence. Never. Not even when we were in med school together and we were friends with the same people. Opinion quickly changed to “He’s a JERK!” I was pretty gloomy when I discovered that we were going to be on the same team together, but over the course of the month we at least came to a reasonable state of friendliness, to the point that I thought I’d at least get a hi.

Bah.

The sun peaks through the heavy clouds, shining through the large bay window of the neurology physicians work room. The room, as always, is bursting with people. Dr. Peltier is rounding with her team; they have just admitted a new patient who has been a diagnostic mystery–an illness that not only is causing neurologic deficits, but GI complaints as well. The team is discussing what tests should be ordered: labs for vitamin deficiencies for sure, but should they repeat the MRI and spinal tap or get an EMG? Would a biopsy serve any purpose?

Around the computers, the neuro ICU team clusters. A patient had been transferred from an outside hospital because of a head bleed. The patient is surprisingly stable with no deficits (alert, oriented, pleasantly conversant and able to move all extremities), a different picture than the transferring team had painted. The images show the real truth: a tiny little speck of intracranial blood from where the patient had hit their head–something that would resolve on its own, requiring no intervention and needed nothing more than closer observation for a few hours. The team is disappointed, not only because of the lost opportunities for procedures and action (for real head bleeds are usually the sickest patients we admit), but because now they had to write orders to transfer the patient out of the ICU–when they had just written the orders to admit.

I sit on the window seat, conversing with Dr. Lynch, the neuro ICU attending who had quickly lost interest in the CT images. He’s my favorite attending and I’ve got a bit of a hero-worship crush on him. He’s three-fourths of the reason that I’m considering a career in critical care–I admire his calm demeanor in stressful situations, the relaxed yet structured rounds, the evidence based approach the patient care, and his endless supply of random bits of knowledge. Today, the conversation diverges from discussion of a patient who had had another stroke to the origin and extraction of heparin and its antagonist protamine. It’s a fascinating history lesson on 2 drugs that I’ve used commonly and had no idea how exactly they worked. I wonder if I’ll ever have half the knowledge that he does. He teases me to remember this conversation so that in years to come, I’ll be able to pimp my residents about it.

The conversations circle around me and I look around at all my colleagues, my friends, my teachers and a feeling of peace settles over me. I gripe so much about the endless paperwork and documentation, the senseless protocols and mandates, the increasingly demanding and ungrateful patients, the ridiculous phone calls in the middle of the night, the sometimes long and exhausting hours, and so forth, that it’s nice to have these moments of confirmation. There have been times, many, many times over the past two years that I have regretted my decision to go into medicine, times when I wish that I had a time machine and could go back and warn 20-year-old me to think more seriously about pursuing a career in creative writing or genetic engineering or becoming a bum. But now, looking around the room, I realize again that this, this is the place for me, the profession for me, the life for me and I wouldn’t change a moment of it.

***

It was the medicine department graduation last night. I almost didn’t go–because of my failed camping trip last weekend, I was determined to take off last night. The thunderstorms put an end to that plan, so I dusted off my google maps and went to the ceremony instead. It was a good decision.

Several of my friends graduated last night, friends who were my senior residents when I started as an intern and who guided me in patient care. Jenn graduated, done with her 5 years of residency. I met her when I interviewed for the program two and a half years ago and she’s the reason that I chose to do the crazy combination of two residencies in one, because she was doing it and was thriving. She rallied for me, told the program to pick me, and for that I’ll be forever grateful.

The program was great and I had a blast. I stayed out late and chatted and caught up with all of my friends (and some of the conversations weren’t even about medicine as well!). Now I’ve got to decide whether or not to go to the Neurology graduation this Friday. Normally, I’d just go, but my church is having a barbeque and a dance that night and there’s a good chance a certain fellow will be there…

Chocolate cupcakes with a Hershey’s kiss in the middle AND a slice of a fresh, perfectly ripened strawberry on top makes the perfect breakfast. Yummmm.

I love the epilepsy service. We have 3 patients. I was here at 8:30 this morning. We were done with rounds by 9:30. I watched a wada procedure this morning, which was totally cool. It was as if I was watching somebody develop a stroke right in front of my eyes–and then to be able to conpletely reverse it in a matter of minutes. I’ll be admitting a patient around 1, and then I’m done for the afternoon. Sweet.

I woke up to lightening and thunder this morning and torrential rain. Gotta love the Wisconsin summers. I hope that it clears enough tonight. I’m supposed to go play miniature golf and my skills are pitiful enough in dry weather–I can’t imagine how my swing will be affected by slick grounds and rain streaming down my face.

Okay, I’m off to discharge one of my 3 patients. *sigh* I’m so overworked!

(I only posted 3 journal entries the entire month of May. That’s shameful, folks. Hence the random, does-this-have-any-kind-of-point post here. 🙂 )

Hypothetical question (really, truly):

If you were trying to impress a young lad with your homemade cooking, what would you use as a side dish to complement my signature salmon recipe? (I was going to make it into a real poll, but I got lazy.)

1. Roasted Garlic Mashed Potatoes. What better way to get a man’s affection than through the staple of life? Plus, the author promises that I can expect to be worshipped and kissed for at least 38 hours.

2. Crushed Hot Potatoes. It’s got the potato factor in its favor, but it’s simple, so it doesn’t make me look too desperate.

3. Lemon Flavored Saffron Rice. I brought the saffron in Africa and carried it all the way back with me and haven’t used it yet. I love lemony saffron rice and it would really complement the fish. Plus, Cleopatra reportedly had great success with her use of saffron um, probably not the kind of success that I’m really seeking at this time :D.

4. Other! I am obviously an inexperienced Kitchen Goddess and need to be taught immediately that the perfect side dish would be:______________

Your input would be invaluable. And needed before Wednesday so that I can go shopping. Hypothetically, of course.

(As an aside: I LOVE the Pioneer Woman blog. I discovered it a couple of days ago and have spent most of the day browsing through her site. The pictures are goregous and it makes me long for the small town life that I’ve left behind; I miss those times of absolute solitude. Another part of me is overwhelmingly grateful that Kris Hullinger and I never hit it off, because whoa, I am glad that ranching is not my life.)

***
This is my last month as a second year resident, can you believe that? It just incredible how time can fly and still seem so slow. I’m not halfway done with my residency yet… that endpoint still seems a long way away. I certainly down feel ready to be released on the unsuspecting world, but I find myself chomping to get done with this all.

I’m rotating on the epilepsy monitoring unit, which is a different experience. Basically we admit people and provoke them into having seizures and I’m learning how to read EEGs, which is really like learning how to read petroglyphs done in a 3-year-old’s squiggly scrawl. I have no idea what I’m doing. The worst is that it really comes down to physics and electricity and currents and vectors, and man, that was my weakest point in all of physics. I could never understand it. I read and read this afternoon and I’m still confuzzled. But I’m excited about a new challenge, and the hours will be a little easier than a regular wards month (still have to do call, bleh)

***
I got my DEA license! And promptly had to renew a prescription for a patient, so I’m already being tracked. We won’t talk about how much money this little “privilege” cost me, but all I can say is that the little bonus that they give me at the end of the year to cover licensing and exams(while supposedly leaving enough to fund a gym membership as well), didn’t even cover half of what I’ve paid this past year for the honor of becoming a Real Doctor (like Pinocchio, but still with strings). But it’s all done now.

***
I’ve had “There are no cats in America/and the streets are filled with cheese” running through my head all day today. I have no idea where that came from, as I probably haven’t seen the movie (An American Tail, for those who are less Disney informed (and yes, yes, I know it’s not a Disney movie, work with me here)) since I was 10. Weird, especially since I did give in and buy myself a copy of Mulan since I’ve had an inexplicable urge to watch that movie for the last month, so I should be having “I’ll make a man out of you” there in my noggin instead. I did resist on buying the copy of Escape to Witch Mountain which is another one of my childhood favorites; luckily the store didn’t have The Three Lives of Thomasina or Toby Tyler –those I could not have said no to.

***
I think I’m going for the hammock in the back yard, it would fit the space better. One of these days, I’ll redo the front and make a real porch where I can install the swing. I’ve just gotta make sure that the side of my garage could handle the weight if I hook it there. I wasn’t able to find a fire pit yet either, so my backyard beautification project is on-going.

***
And I think that’s it. It’s all I can think to talk about, unless you want to hear that I have dishes to wash and clothes to fold and my hair to cut and CuteIntern friended me on Facebook (mostly shaved now. Definitely cuter) and I’ve got a date on Thursday that might almost be called a second date and there’s still about 5 clinic notes that I haven’t finished. Yeah, you definitely don’t want to hear about those tedious details about my life. 😀