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27th December 2008

Marking the passage

As of midnight tonight, I will (finally) be half way done with residency. I hope that eventually it’ll start feeling like I’m on the downside slope, but right now, it just feels like an eternity. Two and a half more years.

How am I ringing in the celebration? By taking some Nyquil and going to bed. I woke up this evening (post call) with a sore throat and aching ears. I do miss the days when I could tak a sick day and just sleep myself better. Alas, we round at 7 tomorrow, which means waking up at 5 and little rest for the weary…

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21st December 2008

*sob*

Winter and I are not friends this year. Not only did I spend hours on Friday shoveling my car out and snowblowing my paths, it then snows another five inches and has blown for the past 24 hours to the point I can’t see any of the sidewalks anymore. I have to be up at 6 tomorrow to give myself time to shovel again before work.

Susan posted about the ball and all of the fun that she had on her blog. Isn’t she beautiful? I’m still very wistful at the lost opportunity.

My weekend wasn’t that bad. Erica came over yesterday, we did some last minute shopping at Target, got some yummy noodles and then sat down to watch the 5 hour version of Pride and Prejudice (swoon). I wrote out some of my Christmas cards (they’ll probably be mailed on Tuesday, so won’t be arriving until after Christmas) and then tried to piece together the pattern I had bought for the dress. Since it was a last minute decision, I had bought the pattern online as an instant downloaded pdf, which I then printed out to tape together. It was a nightmare getting everything straight and aligned and in the end, not only did I discover that the last row had gotten off alignment, I had only printed off the pattern for skirt– I still had the entire bodice pattern to tape together. At this point, we finished the movie and ran to Walmart to buy the commercialized version. Much easier to deal with.

I’ve since washed the fabric and poured over the instructions. Tomorrow (after work) I hope to start on the bodice toile: cut out the pieces for the bodice lining and fit it to the right size. It’s going to be hard doing it without an assistant to pin but I haven’t found anybody here who had a mother who insisted that they learn to sew as I had (I appreciate it, Mom).

I’m glad that I switched patterns, by the way. The original pattern sized up by 2 sizes from what I normally wear; it was quite distressing. The new pattern is more accurate.

I’ve been really getting into sewing and quilting blogs recently. Two of my favorites are actually surgeons: Suture for a Living and The Stitching Surgeon. Both of theirs tend to showcase their creations rather than providing tips or patterns, but it certainly has hit that little creative bug that has been dormant since high school.

And now I’m off to bed. 6 is going to be coming very very early.

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19th December 2008

disappointment

It snowed approximately 12-14 inches here, I think, based on the amount of snow that I had to trudge through when I came home post call. The roads around my house had not been plowed (although my alley had. Bless private businesses!) and I got stuck about three times before someone came behind me in a jeep and pushed me out. I then went and parked on the main street, waded back through the snow and cleared out my garage and sidewalks. By then (2.5 hours later), more cars had been through, packing it tighter, and I was able to slide my car into my garage. I’m not sure that I could get out at this point.

I was supposed to drive to Illinois tonight. Even with all of the set backs from my furnace disaster, I sitll looked forward to the weekend of sewing and dancing; Susan had recruited a seamstress friend to help with making the bodice of the dress, thus guaranteeing that it’d be done in a day and I had visions of lingering touches and smoldering eyes. I kept those dreams alive as I fervently rounded and staffed my patients this morning. And then I arrived home and confronted the wintry mess from which the hospital walls had protected me and read that not only was there still a winter storm warning out, it was extending throughout the weekend, creating blizzard conditions and icy roads. So we canceled our plans; I’m completely bummed.

I’m still going to try making the dress tomorrow. Maybe I’ll have a new dress for church on Sunday. I’ve got plenty to keep me busy: set up my antenna for digital TV, update my blog to 2.7 so I can finally release it to the public, laundry (always laundry), clinic notes and evaluations, five hours of Pride and Prejudice to watch (if I can’t dance, I’m at least going to get into the spirit), etc.

Right now, though, I’m so exhausted and depressed, I think I’m making it an early night.

(posted the next day, because I fell asleep.)

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17th December 2008

Brrr

Having one’s furnance stop working is a great way to distract one from Regency dresses.

Waiting for the tech to call me back. It’s 48 degrees inside now. Temp is 11 outside. I’m lucky there’s not a wind tonight.

ETA: Have heat now. Gears of the motor had stopped working and the whole unit had to be replaced.

I have to be to work around 6:30 tomorrow. (It’s 12:13 now). And I’m on call. Working for 30 hours straight on less than 6 hours of sleep: absolute torture.

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16th December 2008

Oh, I love a ball!

I’m in such a tizzy. If you’ll remember, in my last entry, I mentioned that I am going to a Christmas ball. With English country dancing like this:

I’ve been very excited since I heard about the possiblity of a ball, but I had mostly reined it in. Until Susan posted on her blog about how excited she was and how she was thinking about trying to shop for a new dress for the occasion, which of course set me off looking for regency gown patterns all afternoon while I waited for ABGs and EKGs for my sort-of-sick-but-not-really patient. And I found a darling pattern that doesn’t seem like too much trouble if we keep things simple. Short sleeves. No overdress or stays or chemise this time.

Susan’s going to try to recruit some of her friends to help her out down there. If they can, then hopefully she’ll work on her dress this week. I’ll buy material tomorrow for mine, cut it out here and we’ll sew it when I arrive on Friday/Saturday (I’m unfortunately on call Thursday night, so won’t be able to work on it. Unless I drag along my sewing machine, which will just taunt the powers that be to send me every crashing patient in the state. No thanks). We’ve had to sacrifice the opera to make it work, but if I have a ball gown to make up for it? Totally worth it.

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14th December 2008

Reason for the season

I’m spending Christmas here in Milwaukee this year. I’ve got Christmas day off, but have to work Christmas Eve and am on call the next day, so travel was out of the question and having family come out here is ridiculous. So I’m having my own celebrations. This weekend, I’m driving down to Illinois to see Susan and her family; Suz and I are not only going to see the Metropolitan Opera, we’re going to a English Country Christmas Ball, where we’re going to learn how to dance like a Jane Austen character. Susan states that there were a few cute, single gentleman at the previous dance, so I am very eagerly awaiting the festivities. *SQUEE* So much fun. I may have to break out the satin gloves.

On Christmas, another friend, who is also geographically family-less, is planning to come over for a mini Christmas celebration with present opening and a yummy breakfast. I haven’t decided what yet, but pumpkin pie is somehow going to be involved. The afternoon will either be spent at one of the nursing homes with people who haven’t family (I see so many of them in the hospital; they break my heart) or serving somewhere; I feel somewhat anxious in the need to be there for someone who is also lonely this Christmas. There is so much need in the world but I’m trying to do the pitifully little that I can. I’m listening to the Christmas devotional and have been so touched by Pres. Monson’s talk:

The message from Jesus has been the same. As we follow in His steps today, as we emulate his example, we will have opportunities to bless the lives of others. Jesus invites us to give of ourselves. “Behold the Lord requireth the heart and an open mind.” Our opportunities are indeed limitless, but they are perishable. There are hearts to gladden, there are kind words to say, there are gifts to be given, there are deeds to be done, there are souls to be saved. Is there someone for whom you should provide service this Christmas? Is there one who awaits your visit? … During this season, hearts that are confined reach out and long for a Christmas visit…

There is yet time this year to extend a helping hand, a loving heart, and a willing spirit. In other words, to follow the example set by our Savior and to serve as he would have us serve.

I think the anticipation of the coming weeks is going to be my saving grace. I’m beyond burnt out. I worked 11 hours today; I went to work early so that I could get done in time for church, because it was the Christmas program and ending up not leaving until after five p.m. I feel like I’m living the subtitle of Doctor Strangelove: “How I learned to stop worrying and love the bomb.” Hysteria is shortly to follow, I’m certain.

My holiday cards have been delayed until later this week, so if you’d like to get on the bandwagon, there’s still time. Email me with your address. πŸ™‚

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13th December 2008

holiday cheer

I took over 150 pictures of the ward Christmas part tonight. Probably 120 of them are crap, but it was fun playing around with the flash and ISO and driving other people nuts. I just love it so much.

It’s raining right now. Earlier today, I had to wear an extra sweater because it was so cold. Supposedly it’s suppose to get warm up to 50 tomorrow and then down below freezing the next day. Makw up your mind, Wisconsin weather!

I have to be to work at 6ish tomorrow morning so I can be done and be to church on time as it’s the Christmas program. My microwave heat bag has just finished getting warm and I’m ready for bed. πŸ™‚ I do love these cozy winter nights.

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12th December 2008

thousand words

From flowers

To my anonymous friend, a thousand thanks! The box labeled the bouquet as “Winter Cheer” and it certainly did that. I don’t think this smile has left my face all evening. What a wonderful surprise! I think I was even more touched to realize that the gift was because somebody had read my entry from a couple of weeks ago and decided to help make a wish come true. You all are amazing and I am so grateful to have such loving, wonderful people in my life.

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11th December 2008

time machine

One of the pharmacists that works in our unit is leaving and her going away party was tonight. I was having a hard time motivating myself to go: too cold outside, it’s been a long week and going to bed early again sounded like a fantastic idea. Plus, Milwaukee being light-years behind the rest of the civilized world has yet to enact a smoking pan in restaurants and pubs (Madison has a smoking ban. You would think that it’d be pretty easy to make it state wide) and I don’t inhaling cigarette fumes, nor do I enjoy smelling like an ashtray afterward. But friendship and the promise of Swing Dancing Thursday Nights lured me out of my cocoon.

There was no dancing. Instead, there was another private party that another hospital was throwing, who took over the stage and closed the kitchen so I couldn’t eat the potato skins I was so looking forward to, and worse, started singing karoke. The women were wearing either skimpy clothing that I froze just thinking about or these bright jewel-colored dresses that came to the knees and were belted above the waist. Straight out of the 80s. I think Claire Huxtable wore an identical dress in several different episodes of the Cosby show. If these are coming back in style, I don’t want to know.

And now I’m really sleepy. Luckily, my attending doesn’t want to round until 9:30, so I’m sleeping in. It almost makes up for the 7 o’clock rounding earlier this week.

Night all.

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10th December 2008

exhausted

I’m so tired, physically, emotionally, that as soon as I finish typing this, I’m going to bed.

I’m hoping that the extra sleep will make tomorrow go by a little easier. I got extremely emotional about a patient and the unreasonable stubbornness and stupid surgical pride of his attending today and just about lost it. I’m just frustrated because the family members have expressed their wishes and the patient’s wishes, but because the attending differs, well, then. The attending’s ego will be bruised for a days, but it’s the family who will have to live with the consequences and it infuriates me.

I’m not sure if critical care is for me. And for entirely different reasons than when I first started this month.

***

My christmas cards are going out this weekend, so if you want one, send me your address at jcd1013@gmail.com or reply to this post.

***

Also, I think I left my half-eaten burrito on the back of my car. Poor little burrito…

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9th December 2008

butterfly

I don’t hug my patients.

I shake hands, hold hands, touch shoulders, caress knees, hand over kleenex. But I rarely hug, which is unusual for me, as I love to hug. I swear, I have “HUG ME” tattooed across my forehead, which is especially discerned by all the boys that I wish to date. One hug from me, and I’ve suddenly become the sister. But it is a level of intimacy that I just don’t cross with patients, just as I never call them by their first names either.

Today, there was a patient on my clinic schedule who I had been dreading to see. A few months ago, I gave her a diagnosis that is one of those nebulous, “is it really real” diseases, a diagnosis that requires more emotional and psychiatric rather than neurologic treatment. She was very unhappy at that time, but agreed to the treatment plan that my attending and I outlined. I hadn’t hear anything more from her since then. When I saw her on my schedule, I braced myself for a very long clinic with lots of counselling and tears.

You can imagine my surprise and delight when I walked in the room and met a transformation. She had followed up on the treatment plan, gotten the assistance and help that she needed and she had not had any further symptoms since she saw me. She was virtually a new woman, with a smile that lit her face and I could not keep the same from my face.

When she left, she asked if she could hug me. We hugged tightly before she left.

I felt healed by the encouner, a little pessimism washed away. It was a good day.

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8th December 2008

elephants in the room

From white elephant FHE

I love white elephant gift parties. I gave away a stuffed whale and got this loot instead. The sword came in handy when Jared stole the Bop! magazine from me. It had pictures of Hanson in it! *pout*

Imagine my delight when I discovered that not only did I get a sword, but a DVD of Bonanza and postcards of painted cow statues! Wow!

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7th December 2008

O tannebaum!

I bought a Christmas tree!! It’s fake and cheap and sparse on the full, fluffy branches, but hey, Charlie Brown loved his little tree and I’m rather fond of mine. I gave in to my inner desires and bought all purple and silver ornaments. With the ornaments up, it doesn’t look too bare. My friend Erika came over tonight; we assembled the tree and arranged ornaments and topped the evening off with hot apple cider.

It also gave me a chance to play around a bit with my camera. Still learning (Erika performed in her church today and I brought my camera and took fuzzy photo after fuzzy photo. It was only afterward that I discovered that the lens was in manual focus mode), but I’m so overwhelmingly in love with the pictures that I’m getting already.

From Christmas

(Click for the other pictures of my tree)

Rounding at seven tomorrow morning, which means I have to have my patients seen by then. So I guess it’s goodnight!

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6th December 2008

clueless socialite

After moping today for being left out of activities and gatherings, I realized this evening that not only had I forgotten about the formal masquerade ball tonight (some of my friends were really excited about it; I’ve already attempted to get all of the guys involved to dance before and was much more realistic), I completely and totally spaced my friend’s Christmas party on Tuesday. I did nothing that night, just went to bed early. I feel absolutely horrible.

I did get to see a few hours of sun this afternoon, finishing work a couple hours earlier (it’s hard not to get cranky when you woke up at 6 with the thought of getting done early and your fellow announces at noon as you’re putting the finishing touches on the sign out sheet that your patient needs a central line (he didn’t) and he expected you to do it) and took the opportunity to play around with my camera a little bit. The problem with getting a new camera in December is that there isn’t a lot of varied scenery to shoot. Snow. And more snow. I still haven’t done much more beyond the automatic settings, but that will come. Some pictures will be forth coming. πŸ™‚

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5th December 2008


room


(Mom couldn’t remember what blanket she had sent me to keep me warm. Hence, the inaugural photo of my beautiful new camera. Love it already.)

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4th December 2008

engage with grace

Being a resident and supervising interns is hard work. I don’t think I’ve ever worked with such a clingy intern before. Intern paged me every 15-20 minutes until around 1 in the morning and it was all that I could do not to get snippy on the phone. Because if I had done that, and something serious were to happen to one of her patients, then she would have hesitated calling me. It’s a difficult balance between too much autonomy and too much supervision. She was completely resistant to my efforts to give her more autonomy (and talking with my friend who is her resident every day, it wasn’t just last night), but it’s something that I need to work on.

I’m tired and have to be up early tomorrow. My snowblower is missing a bolt and the little spout that directs the snow now flops and I end upblow the same bit of snow over and over again. We’re interviewing candidates for next year and we take them out to dinner so I didn’t get a chance to go by home depot before so I’ll have to go bright and early so I can come back and clear the sidewalk before I go to work. Ugh.

In the meantime, I’m sharing this:

Since I’m in the critical care unit, I see many patients who are coming in with devastating injuries. These families, already dealing with the tragedy and pain of an injured loved one, are now having to make difficult medical decisions and so often, they are making these decisions without knowing what the wishes of their loved one are. Those with the most peace have had the discussion, they are comfortable in knowing that they are doing what their loved one who do if they could speak.

Engage with grace is a website that is trying to help with this problem. Here’s some of the statistics they provided:

  • 73% of Americans would prefer to die at home1, but anywhere between 20-50% of Americans die in hospital settings.2
  • More than 80% of Californians say their loved ones know exactly or have a good idea of what their wishes would be if they were in a persistent coma, but only 50% say they’ve talked to them about their preferences.3
  • Eight out of ten people say it is very or somewhat important to write down EOL wishes, but only 36% actually have written instructions.4

After my first months on the NICU, I completed the paperwork for a durable power of attorney (which actually needs to be redone, since I didn’t have it witnessed properly) and sat down with my parents to have the talk about my wishes. My friends who are also residents have said that they have “the talk” every couple of years, so that wishes are understood.

I encourage everybody, regardless of age, regardless of health to have a conversation with the person that you would want to make your medical decisions if you couldn’t.

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3rd December 2008

walked up hill both ways in the snow

I swear that when I was an intern, I was able to make the decision to treat a urine infection without requiring the assistance of my senior. Or when my senior said “I’m going to be doing a procedure and won’t be available except fo emergencies for the next 30 minutes, in the meantime, here’s what to do for so-and-so patient” I didn’t page 5 minutes later asking what to do on so-and-so. Intern is going to be the death of me.

It’s been a long day. It’s going to be a long night.

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2nd December 2008

100 Things

Felt like wasting time. I have to go to bed now, because I’m on call yet again tomorrow, and am still feeling sleep deprived and we’re rounding early. (As an aside, it is supposed to snow all day tomorrow, meaning I have to dig myself out again post-call before I can sleep. And more head traumas as people slide on slick roads which translates to more 4 am consults from neurosurgery when they decide that they don’t want to operate after all with means less sleep. Am somewhat bitter at Mother Nature who is not doing a great job of nurturing right now.)

1. Started your own blog (I have several right now. Most are just mirrors of my original livejournal, but I do have my own that will be revealed officially to the public as soon as WP 2.7 is released and working properly).
2. Slept under the stars (Several times)
3. Played in a band (I jammed with my 8th grade guitar class but I don’t think we ever made a band)
4. Visited Hawaii
5. Watched a meteor shower
Read more

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1st December 2008

death warmed over

I think I hate post-calls days more after each one. Busy day yesterday, I finished with all of my work around midnight and then had to wait to talk to a family about next plans of action and didn’t actually get to bed until around 2. I had a couple hours of fragmented sleep, but then was awoken at 4 for a consult and that was it: just enough to trigger a migraine, making me sick the remainder of the morning. I actually was so sick and so tired I went downstairs and slept in the call room for an hour before slogging home. There, thankfully, wasn’t much snow but it was enough that the snow plow has blocked me from entering my garage and the wind has picked up creating large snow drifts. So I’m parked out front and I’m going to bed. I’ll deal with the snow later.

BTW, I think all attendings should be flogged if they engage in petty pimping sessions when you’re post call. Exactly what is my tired, overworked brain supposed to be learning in that situation??

Goodnight all.

ETA: Some people write “drunk entries”, I write “post-call” entries. I think the misspellings are the same in both. Oi. πŸ™‚

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