Once upon a time (a really long while ago), there was a poetry meme that went around and I found the most beautiful little poem entitled “ Like Anne Shirley’s House“, which, unsurprising, completely captivated me.

I’ve since become a fan of Faye George’s poetry in general, at least those that I can find online. The language is sparse but rich in imagery. Here are two that I’ve especially liked.

ONLY THE WORDS

No one cares:

not the professor
of rhetoric
bored by all
but his own experience;

not the editor
who, in at least
two languages,
has heard it all;

not even
your good friend
who does her best
to listen;

only the words–
the words that rise
from their accustomed tasks
to lead you

deliberately
through ferns
and phonemes
into the woods,

where you must dig
for roots,
fish from the deepest part
of the stream.
-Faye George

WHY THE GOOSE WENT BACK

I miss the scrape of spiked boots on the groundsel
at evening, the iron creak and slam of the door.
The stroke and pet of his hard hand gave the days
their meaning. Jack, can you understand?

In dreams I return beyond the beanstalk, fly
to my old home in the clouds.
Here it is safe, but the thought he needs me
pecks at the eye of peace.

I yearn for the oaken sound of his stride.
What you call bondage,
I would purchase with my last gold ounce.
For the smell of leather and mead, I would sell
my soul.

-Faye George

Clinic today went really, really well. Probably because I had two patients that didn’t show up, but there were other reasons. A couple of my favorite attendings who I just admire so much for their knowledge and compassion were there and staffed my patients. We discussed things quickly and thoroughly, formulated a plan, and went to discuss it with the patients. The patients liked the plans and everything went so smoothly. THe attendings didn’t insist on repeating the entire physical exam (my biggest pet peeve. I have a half hour scheduled to see these patients. There is not enough time for me to see them, examine them, you to ask me about all of the details of the physical exam and then you to do it all over again!! Trust me when I say that their sensation is intact!). Plus there was still some time for teaching, both for me and the patients, which was lovely.

Two of my patients were people that I have seen since starting residency 2.5 years ago, and even though I haven’t fixed their problems, I’ve developed a close relationship with them. I will miss them when I switch clinics. When I look over my schedule, most of my patients I really like and they’re the reason that I went into medicine in the first place. I just wish I didn’t feel so overwhelmed all the time so that I could remember that feeling more.

****
Happy Veterans Day! I do love the veterans so and I’m so grateful for the service to the country, and I really do love the opportunity to serve them now. Most of all, I’m grateful for the holiday, so that I could catch up on a few notes, as well as some sleep.

Clinic today went really, really well. Probably because I had two patients that didn’t show up, but there were other reasons. A couple of my favorite attendings who I just admire so much for their knowledge and compassion were there and staffed my patients. We discussed things quickly and thoroughly, formulated a plan, and went to discuss it with the patients. The patients liked the plans and everything went so smoothly. The attendings didn’t insist on repeating the entire physical exam (my biggest pet peeve. I have a half hour scheduled to see these patients. There is not enough time for me to see them, examine them, you to ask me about all of the details of the physical exam and then you to do it all over again!! Trust me when I say that their sensation is intact!). Plus there was still some time for teaching, both for me and the patients, which was lovely.

Two of my patients were people that I have seen since starting residency 2.5 years ago, and even though I haven’t fixed their problems, I’ve developed a close relationship with them. I will miss them when I switch clinics. When I look over my schedule, most of my patients I really like and they’re the reason that I went into medicine in the first place. I just wish I didn’t feel so overwhelmed all the time so that I could remember that feeling more.

****
Happy Veterans Day! I do love the veterans so and I’m so grateful for the service to the country, and I really do love the opportunity to serve them now. Most of all, I’m grateful for the holiday, so that I could catch up on a few notes, as well as some sleep.

Today was one of the few times I have really enjoyed clinic. As I mentioned, I’m rotating on the spinal cord unit during the morning and in the afternoon, I work in the neurology “specialty clinics.” Multiple sclerosis on Monday, general on Tuesday, dementia on Wednesday, movement on Thursday and seizure (if I’m not post-call) on Friday. The nice thing about these clinics is that there’s only one or two attendings and I can take my time on seeing the patients, because they are also seeing their patients. This afternoon, I saw one patient, a new diagnosis, and got to spend my time going over all of their symptoms, exploring the impact that the diagnosis is having on their lives, treatment, side effect, shown them the images of their brain, etc.

For once I didn’t feel pressured to rush through the history and physical, knowing as I interviewed one patient that the next two patients had arrived already and I was 20 minutes behind and I still had to staff the patient and the attending see the patient and then put in orders, explain again what the plan is, go through the side effects/how to take the new medications, remind again what the plan is, and point them to the front door. Is it any wonder that I sometimes overlook something on the physical exam or don’t ask if their great-aunt twice removed had seizures as a kid? Today, I got to focus on the subtleties and for once, really understood the pathophysiology of what the patient was presenting with.

I’ve been frustrated whenever I’m on the neurology side because I feel so far behind every one else; that I can’t seem to grasp the knowledge base that I need so badly so I can adequately take care of my patients. I’m mortified on a weekly basis when my attending asks me for my differential diagnosis and I can’t come up with it; and I realize that it’s because that above is how I learn, and I don’t get the chance to do that.

I’m off to bed. I’ve been so exhausted recently and it’s my own Tuesday morning clinic tomorrow, which means back to the nightmare. Only 7 more clinics.

Because I’m too tired to coherently write about my weekend:

For those who remember the old 28th ward, there’s a new Facebook group:
Friends of the U of U 28th Ward (Yet another incentive for you to join Facebook, Laura!). It’s a small group, but I’ve already reconnected with a few friends that I haven’t seen in years.

For the Plethora and any nerdy Star Wars fans:

The a cappella group, Moosebutter who perform the original song that this kid is lipsynching, were college friends. This was definitely my favorite of theirs.

And for the young at heart:

I can’t wait!

Then one day (like a week ago), he packed his bags and moved across the country, never to return. All he left were fleeting memories of meaningless flirtations and a bookcase and 25 two-liter soda bottles filled with water in the backseat of her car, which were still there (a week later) because she was too lazy to actually carrying them into the house.

And thus ended the story of Trouble and Julia, the great love saga that, as always, fizzled before any sparks were produced.

It was a rather unbusy night. One new admission, 2 ER consults that my intern saw and I discussed with her. The ICU patients were well behaved, only had slight blood pressure issues that were easy to address. I even managed to read a book and sneak in a web chat with the Plethora for our book club to talk about it. Second book club that I’ve been to this week–I really love our non-structured discussions (and diversions) rather than the painful process of answering “discussion” questions at the end of the book.

Despite that, I only got about 3 hours of very fratured sleep. But I get to go home around 7 or 8, rather than 12 or 1, and that makes me very very happy. That is if the other residents would show up so I could tell them the non-events that happened overnight.

I left my house yesterday with the weather in the high 60s, without a jacket. It’s supposed to be in the low 40s today and rainy/sleety. I had been waiting to rake my leaves until the maple in my backyard finally relinqueshed its load; now I’ll get to rake up soggy wet leaves this weekend. Joy.

Alrighty, everybody finally showed up and now I can go home. Good night!

It was a rather unbusy night. One new admission, 2 ER consults that my intern saw and I discussed with her. The ICU patients were well behaved, only had slight blood pressure issues that were easy to address. I even managed to read a book and sneak in a web chat with the Plethora for our book club to talk about it. Second book club that I’ve been to this week–I really love our non-structured discussions (and diversions) rather than the painful process of answering “discussion” questions at the end of the book.

Despite that, I only got about 3 hours of very fratured sleep. But I get to go home around 7 or 8, rather than 12 or 1, and that makes me very very happy. That is if the other residents would show up so I could tell them the non-events that happened overnight.

I left my house yesterday with the weather in the high 60s, without a jacket. It’s supposed to be in the low 40s today and rainy/sleety. I had been waiting to rake my leaves until the maple in my backyard finally relinqueshed its load; now I’ll get to rake up soggy wet leaves this weekend. Joy.

Alrighty, everybody finally showed up and now I can go home. Good night!

This evening (in between patient calls which have been infrequent and staffing patients with my intern, also blissfully infrequent) I read Randy Pausch’s book, “The Last Lecture.” It made me cry. It made me think. It may be the catalyst to get me over this lingering funk and figure out what I want out of my life. Everybody should go out and buy it, and as a big believer in supporting libraries, that’s saying something.

There are times when I really question if I’ve got the required brain cells to be a doctor.

I was able to get into my friend’s house. Because the key really was on the key ring, I just managed not to see it, despite trying everything for over a half hour and then asking another friend to come over and try as well today. We tried the back door, walked around to the front, I handed her the keys and she miraculously found the right one. Yep.

Cats are fine. Water bowls were changed, litter box scoped. I’m so overwhelmingly relieved; I can stop worrying that her cats are going to die on my care.

I’m utterly exhausted this week and have been somewhat moody and cranky. I almost started crying tonight in the custard shop because of difficulties ordering a pumpkin shake, that’s how ridiculous this is. I really don’t know why I’m so emotionally fragile, but this episode with the cats, combined with the verbal “question and answer” session that I had on Monday with my program director, which did not go well, has just brought my mood down.

But I’m going to bed now, so hopefully, a little sleep will make things better.

I have to go feed my friend’s 10 cats this evening. And clean out their litter box.

….

Oi. Why exactly did I volunteer for this?

Any ideas for making the smell of litter boxes a little less toxic on the nose? I’ve got a pretty strong gag reflex and would rather not add the smell of my stomach contents to the mix.

ETA: The key doesn’t work. I can’t get it to turn in the doorknob or the deadbolt. She’s either given me the wrong key or I’m a moron. I think it’s the former, but I’ll have to see if I can recruit a friend to try it out themselves. I feel awful. If I can’t get it open, I’ll probably have to call a locksmith or something.

I’ve been falling asleep all day long today. Just can not keep my eyes open. I’m not sure why. I did get about 7 hours of sleep last night… and 11 the night before (I LOVE sleeping in). My eyes have been itching all day long, and I think this new prescription for contacts is off, as everything out of my left eye is blurry, so that might be contributing. Oh, yeah, and that daylight savings thing too.

I’m working in the spinal cord unit at the VA right now. Six patients. Rounds consist of walking around and looking at pressure sore wounds, which have definitely surpassed the definition of “sore”. They are usually large, open and somewhat smelly. I’ve never ever liked wounds/skin infections. But as it is something that I will see over and over as a doctor, especially now that Medicare in its infinite wisdom decided that pressure sore were “never events” and won’t pay for the hospitalization if one develops during the stay, I guess I’d better get used to checking, probing, and wrapping these buggers.

In any case, in the afternoons, I have neurology clinic. Today was MS (multiple sclerosis). 2 of the patients cancelled so my attending told me to go do something and he’d call me when the last patient showed up. So I took myself out into the gorgeous 74 degree sunshine and had a nap on the grass. 🙂 Just a lovely break to the day. Likely won’t ever happen again.

And I’m still tired. I’m about to go and put myself to bed. But I really need to go to the gym (another November goal. I swear, I’m treating November like it was January 1st).

Nano word count: 355. Yep. This is going so well.

Lastly, because I love it:

One day more!

So I signed up for Nanowrimo (National Novel Writing Month, for those not in the know, that happens every November. The goal is to write 50,000 words in that month). And I’ve written a total of (*checks*) 355 words. Yeah, I can see that this is going to go well. I did finally strike upon an idea a few days ago, and have gotten a prologue, but not much more than that. I have a feeling that this month is going to be spent doing more research and writing outlines than actual writing, but we’ll see. I’m not giving up yet!

I also signed up for NaBloPoMo as well, so you all are probably going to get very sick of me! What can I say, all of the cool kids are doing it, and I hate getting left out.

Alas, it is 4 minutes to midnight, I have to be up early to do “wound rounds” tomorrow on the spinal care unit (exactly how it sounds, folks), so I’ll have to share all of my stories at another time. Luckily I’ll have 28 more days to do so this month!

For 10 years now, I’ve been a fan of the X-Files. I even accidently called one of my friends “Mulder” in the middle of a conversation once, that’s how deeply the infatuation of the show ran. As a redhead doctor-to-be and later on an actual doctor, well, I related a lot to the character of Dana Scully.

But until now, I had never dressed up as Scully for Halloween. What a waste of naturally red hair!

To complete the costume, I had my hair cut ( a little shorter than what I wanted but oh well, at least it grows) and toted a cell phone (unfortunately not old-school), a flashlight and the badge, which I made myself with the super-helpful assistance of a Office Max copy-center employee. I could not find a plastic gun, unfortunately, and as I thought up the idea late Oct 30, I did not have a Mulder either. If I had realized the number of guys who showed up at the party minus a costume, including way-too-good-looking-for-his-and-my-good-and-thank-heavens-he’s-moving Trouble Boy, I’d have recruited harder. 🙂

About ten years ago, I started using an electric toothbrush. I haven’t had a cavity since. This is my story (hehe).

I haven’t been to the dentist for the last 2 (if I’m really honest with myself, it’s probably closer to 3) years. Inability to predict my availability plus an overwhelming dread (I have sensitive gums; poking them makes them hurt more) contributed to my procrastination, but I knew that I could put it off for no longer. Good dental health contributes to overall good health, and I’d like to keep my teeth well into my 90s. I may lose my red hair by the time I turn 35 (*cries*), but I refuse to lose my teeth as well. So this morning, blessed by a day free, I visited the dentist.

I had hardened plaque along my lower gums and some inflammation of my gums, secondary to the tartar as well as the popcorn kernel that got stuck from 2 weeks back (happens every time. You would think that I would learn better). But no cavities and the majority of my teeth did not require extensive scraping and cleaning. YAY!

On my call days, I often have to go more than 30 hours without brushing my teeth–it ensures that my patients wake up when I lean over them to listen to their hearts (kidding)–because I’ve been rushing from one place to another and literally did not have a three minute break. Sad, but true. Thanks to my electric toothbrush, it hasn’t had any meaningful damage on my pearly whites.

There you go, my testimonial to the power of the electric toothbrush. Personally, I’m a Braun holder with Oral B brush user. I don’t like the heads that had the “gum massage”; they ripped apart my gums, but other than that, I’ve been satisfied.

BTW, I’m also a fan of the ultrasonic technique for cleaning teeth. So much better than the old method with a metal scraper than invariably slipped and made my gums bleed. Going to the dentist was almost pleasant today.

(The following advertisement was not endorsed by Braun, Oral B, or any other dentistry affiliate. Rather it is the opinion of a rather odd girl who’s enthused about her clean and shiny, cavity-free smile)

Who couldn’t be here this week: a taste of Milwaukee in the fall.

More pictures can be seen here

Have I mentioned recently how much I love this city? And having a camera again? And autumn? And time off work? Bliss, I tell you, life is bliss.

Happy Birthday, Karin!

Hope your day was devoid of annoying customers and homework and instead filled with chocolate. 🙂

Love, your sis

(The song was a random iTunes choice. Apt as always).

The list of things I need to do before Thursday at 3:

1. Wash clothes. I think I have 3 more batches to go.
2. Sweep and mop bathroom
3. Dishes. Lots of dishes
4. Arrange and organize all of the papers that I dragged into the living room to organize and arrange, oh 4 days ago
5. Clean my office/den. I can see carpet now!
6. Change sheets.
7. Wash sheets.
8. Buy bed.
9. Sweep and mop kitchen.
10. Replace chair/table sliders
11. Grocery shop.
12. Clean out my fridge so that the pregnant can actually hang out in my kitchen.
13. Look up other activities for weekend.
14. More and more autopsies.

So why exactly am I wasting time writing it all down rather than doing it?

The only thing worse than getting a flu shot, where my poor deltoid muscle develops a knot for days afterwards, is getting the flu. And boy, have I had the flu. Never again.

Not to mention that if I didn’t get the shot, my compassion and my professionalism would have been called into question:

“Remember getting your flu vaccine is important not only for your personal and family’s health, as someone at high risk because of your occupation, but also is important to your patients because of the risk of transmission from you to them, and as a matter of professionalism and courtesy to your colleagues who would have to cover for you if you are out sick because of the flu.” ~ Program Director.

Will do, sir.

BTW, the flu vaccine is now recommended to everybody, especially those with live with elderly people, or those with kids. The deltoid tenderness really isn’t that bad, I’m just a wimp. Promise. 🙂

Once, I danced. Mondays and Wednesday mornings. Thursdays at the Naval Science building. Saturdays at the Murray Arts Center. Beginning ballroom. Latin. Swing. My favorite was the Tango, the sultry dance where the movements came from the hips, the directions from the heart. I never was very good, my moves were too clunky and I never had enough trust in my partners to ever let go of control completely, but during the tango, I could close my eyes and pretend, for just a few minutes that I was a sexy, graceful dancer in the smoky streets of Argentina.

Yesterday, listening to the Milwaukee Symphony Orchestra perform the Bandoneón Concerto, I felt transported back to those days. The hum of the bandoneon (a modified accordion) blended with the violin and cello and occasional oboe and infused in my veins. My heart beat the time.

Today, I drove my friend to our bishop’s house for conference. He lamented that medical school had drained him from being an interesting person, that once he could socialize, converse on a variety of topics, entertain those around him, and now, he was an introvert, a shell of his former self. It’s true, I sympathized, running through the conversations that I had had with the various other medical students and residents that day. “Hi, how are you, what rotation are you on? Who are you working with? Getting any sleep? Had the day off today?” We ran through the conversations like robots, only venturing out on occasions to talk about something else. We had become absorbed into the culture of medicine that we have lost our personalities. I’ve managed to retain a little of my previous life, a play, a concert, a party here and there and thought until last night that I hadn’t done so poorly.

But, once, I danced.