My basement is leaking again. Thankfully, the drain was able to keep up with the amount of water (it really pounded for a while; I thought for sure that they’d back up again). This time, however, the window sills were caulked, the outside drain took most of the water away from my back door, and the walls were dry. It was just that there was a puddle of water that continually drizzled towards the drain–coming from the bathroom. I think it’s seeping up from under the toilet (it’s water, it’s not sewage as far as I can tell). I’m worried that I’m going to need to get a plumber in here. I don’t know how; I have no days off during the week and I don’t get done until after 5 or 6 most nights. It’s times like this that I wish I had a husband or roommate so that I could let them deal with this.

Grrr.

On the bright side, it did not flood and all of my belongings are still safe.

*sigh*

After the symphony, we met up for dinner and drinks. The conversation turned away from surgery and medicine and into the impact that the failing economy was having on us. Chris joked about how when I started residency, he had pushed me to buy a house for the financial investment (it was encouraged to most of us freshly graduated medical students) and a year later, when he was in the same position, he had decided against it and how glad he was that he hadn’t bought a house.

“How much has your house lost in value?” One of the group asked me.

“I don’t know,” I demurred, “I’m not selling it for another two years at least and I figured I’d save my heart the stress test.” Besides, I reasoned, the housing market had never been as profitable in Milwaukee. Milwaukee is very much a blue-collared city and the home values and resell reflect that. Surely, it could weather the storm a little better.

The City of Milwaukee decided, however, that they would have none of this blissful ignorance, thank you very much. Since I am the one paying taxes on the property, they felt it was their duty to inform me of their recent appraisal of my property and sent me a nice official letter (in purple ink. I applaud the creative and aesthetic touch). Net Change: -4,600. Ouch.

My first thought: “Hey, that means my taxes will go down!”

The COM may have thought that they were bringing doom and gloom, but they hadn’t ever encountered the little orphan annie who resides prominently in my frontal lobe. For my raspberry bushes have sprung the first leaves of green this week and I have tiny rhubarb shoots popping through the ground and a garage door that now locks. You just can’t get better than that, even if the CoM has decided that it’s worth less this year.

I’m not doing the English dancing weekend after all. I piddled around, delayed sending in the registration, debated eternally where or not I should go until it was too late. It would have been easier if there was somebody that I was going with… or if the price had been half as much; then I’d have done it without a second thought. In the end, I decided that I could not splurge on it, and I’ll have to find another place to wear my pretty dress. I’m planning on going down to Illinois in May for a English dance so it will be displayed then.

So instead of men in cravats, I’m going to New York to visit Sam and baby Meghan. This is such a huge deal for me and evidence of how much I want to see that wild baby hair. I’m already trembling and have a pit of fear in my stomach. I don’t do tall buildings. That’s the understatement of the year. I become paralyzed under their shadow, frightened to near death that they are going to fall on me (yeah, September 11th was virtually my worst nightmare come to life). And that’s just the comparatively scrawny buildings in SLC. Needless to say, a visit to the Empire State Building/Chrysler Building/Times Square/Ground zero and even the Statue of Liberty are not on the list. Right now, I’m liking the idea of a boat tour of the city: a chance to see the important sights and bridges, but from a distance, where I can practice taking pictures of reflections in the Hudson River. I’m also looking forward to central park and seeing the skyline there.

And if all else fails, I’ll get myself a prescription for some propanolol and/or alprazolam and medicate my way through. The benefit of being a doctor.

So, question to my wise friends out there who have been to NYC: Which are the must see sights, mostly in Manhattan and that won’t frighten me to death? And from those who live there, any hidden nooks that shouldn’t be missed but are often overlooked by the tourists?

I had this awesome dream last night where I was working for President Obama. I was supposed to deliver something for him, but got caught up in this conspiracy and we were talking over this telephone that had a garden hose as the cord as it was supposed to be safer than our cell phones. As we were talking, he suddenly realized that it had been wiretapped and I was in trouble, so he stole a car from the secret service to come pick me up. We then escaped with other members of the team, who included a few people from my residency, on a ferry from Milwaukee down to Chicago. It was a pretty fancy ferry with a big chandelier and a garden with a pool. Barack (as I called him) and I discussed security policies (aka, who was after me) and how I could stay safe. As is the case with most of my dreams, the rest is rather vague. I think he left to confront of the men who was chasing me, as he had also ended on the ferry, and I was sleuthing and flirting with the pool boy (alas, Dream!Barack was as married as in real life).

I woke up this more in a rather good mood. 😉

I wish it had lasted longer, that I could have pressed the snooze button just a few more times. Hard day. Fifteen patients that I had to see before noon. By far, the best part of the day involved taking a mid day break with one of my friends and getting hot chocolate and swooning over Franz Ferndinand, who is apparently coming to concert in a week. As a resident, there’s no such thing about having a lunch hour; if you manage to finish your work in time, you can look forward to a noon lecture. But today we played hooky, even though it put me behind and I was rushing to finishing seeing everybody.

And now off to bed again. I wonder who/what I’ll dream about tonight?

(written this afternoon. The hospital’s firewall prevented me from posting)

I realized yesterday, as I was looking at my schedule for next year, that while I’ve been feeling like I’ve been doing residency forever, I still have 10 months of internal medicine left to go. 10 months. Since I’m doing a combined residency, I have 30 months of medicine and 30 months of neurology, compared to my colleagues who do 36 months of medicine or neurology. Not only am I missing out on six months of training, but as it is, I’ve still got a third of my training left. I’ve been comparing myself pretty harshly to my fellow residents, especially the medicine residents as they are graduating in 2 months and I certainly have not felt that I’m at that point and was quite discouraged. Yesterday, I was dispondant after getting lectured by one of my friends about a disease presentation that I didn’t know anything about, but he was rattling off all of the clinical symptoms and signs and I felt like an idiot. I feel a little better now, realizing that I still have time to learn it all.

I’m on neurology consults this month (I think I mentioned that) and it’s also been an opportunity for me to appreciate how much I have learned as well. I was on this same rotation two years ago as an intern and it was one of the hardest months of that year (the other 2 being the inpatient neurology wards). I didn’t know anything. I felt like I was struggling every day to ever come up with one idea of what exactly was causing the altered mental status/weakness/seizure/what have you, much less come up with a differential diagnosis or a diagnostic and treatment plan. Now, I at least know where to go and read about it, or know the common workup for common problems and can generate some reasonable ideas about where to go next. My attending actually commented on it. It was his last day, so he was giving me feedback, and he stated that he could see the growth and knowledge maturity. I feel more optimistic that by the time these next two years are over, there may be a middling fair neurologist in me. And that’s better than what I’ve been feeling in a long time.

On a related note, I’m still struggling on the decision for a career path after graduation. Unfortunately, the decision about fellowship needs to be made relatively soon, so that I can get research projects started to beef up my slim and rather non-impressive CV, as well as trying to go to conferences so I can start networking etc. I change my mind on an hourly basis. It’s a sad state of affairs. I’ve decided to give myself until June. Someday, I’ll do a big long post about the positives and negatives about the decision. Maybe it’ll help me think through things.

**
I am quite smitten with one of my attendings. I worked with him briefly last month and had butterflies during every patient presentation. Recently, I’ve gotten to interact with him more because our teams have been consulted on the same patients. When he greets me with a half smirk and razzes me about my treatment ideas, I get swoony. You think music is the language of love? For me, it’s vestibular neuritis due to colistimethate (don’t worry, I hadn’t even heard of the drug before, either!). I’m almost seeking out consults, just so I can have those few minutes of conversation.

I’ve missed having a work crush. It’s been a long time since CuteIntern disappeared into the dark coves of the hospital and I have not had a good flirtation since then. I think, however, that all of the period dramas that I’ve been watching these past weeks have affected my mind and I’m ready to see romance from every random corner. It’ll pass, I’m sure.

**
The hospital has a repeating playlist of songs that are piped over the hospital. It includes a piano version of the theme to Titantic and it plays Every. Single. Day. Usually around 10 or 11 in the morning. I went the entire day today without hearing it… until I returned a phone call just now and got placed on hold to that song. Grrr.

**
Vienna Teng is performing in Chicago this Friday and I’m so excited. She’ll never come to Milwaukee again; poor attendance for two concerts would convince anybody not to come again, but I’m grateful that I live so close to Chicago so I still can see her.

**
I realize that everybody has probably seen this video, but I couldn’t resist sharing. I love Britains Got Talent; it has a way of tugging at your heart strings. Paul Potts the first year, Andrew Johnston the second and then this year, Susan Boyle. Just lovely, I was seriously in tears.

Today was one of the most exhausting days I’ve had in a long time (boy, I’ve been spoiled). It was endless pages and endless consults (I had 5 before 1 pm and another after that), haggling with radiology to get an MRI done (if I hear one more time that’s its protocol… I understand that you don’t want a patient with metallic things getting an MRI done as those metallic things can come ripping out. However, when I tell you that this patient had a MRI done 1 week ago and survived it just fine, I think we can forgo all of the drama, okay?), managing a patient in status (poor intern had no idea what to do), answering questions about the dozen patients that I thought I could finally sign off (and got pulled back into their disease) and somehow still seeing all of the patients that we are still actively following as well. I didn’t leave until after 7:30 (and still came home to a glimmer of daylight! I love spring!). Good thing I didn’t have plans tonight (this is the reason that while I’m going down to Chicago next Friday to see Vienna Teng in concert, I’m buying tickets for the 10:00 show, rather than the 7:00 show. I may be driving home at 3 in the morning, but at least I’m mostly guaranteed to make it).

I came home to a lovely little package on my front porch though, which made the whole day better:

It’s wrinkled (muslin wrinkles like nothing else) and I didn’t wear any makeup at all today, so the big pimples that I’ve been fighting for the last week are quite prominent, (and we’ll entirely ignore the weight issue, shall we?) but I love the dress! I’m still fighting with the neckline (you can make out my divotted and scar-ridden right shoulder on the second picture), but I think if I pin it to the underslip (and maybe the bra), it should look better. Chris brought me home this gorgeous lilac silk shawl from India, which matches my dress perfectly, giving it just the perfect elegant touch.

Next is figuring out how to do my drab hair (the new haircut lost its luster pretty quickly). And finding my fancy jewelry. And then actually sending in the registration for the weekend of dance.

Today, I woke up and thought to myself that for the first time in almost three years, I like neurology again. I’ve taken care of some really interesting patients with diverse diseases; I’ve come up with diagnostics and differentials that my attending agreed with; and I had a chance to read so I was starting to feel like I understood the difference between polyradiculopathy and polyradiculoneuropathy (don’t ask). It didn’t hurt that we had maybe 1 consult a day, so I could really sit and think about my patients care.

Of course, right after I thought that, my pager went off nonstop all morning with new consults and complicated questions (as well as stupid questions), making me feel like a freshly chopped chicken and the love faded. It’s still there, dimly trying to stay alive. Who knows, if I manage to survive tomorrow and clinic, it might take up permanent lodging; that would be nice.

Other thing going on in my life:

• I have just about caught up with all of the little requirements that residency piles on me. I completed the last of my dictations (it was nine months old, but, as I discovered when I dictated it, I had never even taken care of the patient and it really wasn’t my responsibility. So I suppose that evens out). I finished all of my evaluations. I’ve stayed caught up on my clinic notes (that will probably change tomorrow). So I’ve finally been able to concentrate on something else: my house. It’s been a disaster since January when I got sick for a month and was working close to the 80 hours/week limit. But this week, I went through all of the papers that I’ve collected and recycled three entire boxes of junk mail and have collected another 3 boxes of patient information that I need to bring back to the hospital for shredding. No wonder I felt like I was drowning. I’m focusing on the progress and ignoring for now the pile of dishes, the laundry that needs to be washed and all of the sweeping. All in due time.
• My beloved mommy finished my Regency dress this weekend and mailed it on Monday. I hope to get it tomorrow. There will be pictures. 🙂
• I had a fabulous weekend, visiting Chris and his friends. We went to the symphony (incredible pianist!) and out to eat and then made crepes the next morning as we watched Sicko. Three years ago, as a fresh idealistic medical student, the documentary might have inflamed me to action. Now, after experiencing the multiple complexities of the medical system, I am become more cynical about the likelihood of success with medical reform. Doesn’t mean that I don’t support efforts to do so, but I see much more of the pros and cons of all of the proposals. Surprisingly, Chris was as conservative about the movie’s premises as I; residency has changed him as well.
• In any case, there is some pictorial documentation of the weekend at my Picasa site. It already hurts thinking how much I’m going to miss this.
• I’m getting an elliptical machine and a bench press from my friend who is also moving away (*sniff*). I’m so excited to have my own little gym. Now, the bitter cold of Milwaukee won’t be an excuse to keep me from exercising AND I won’t have to endure endless ball games. As soon as my house is in order (I’m hoping this weekend) I’ll get to retrieve it.
• It’s actually been really hard recently, thinking about all of the friends that are leaving this year. My medicine resident buddies are graduating and going on to fellowships and careers, leaving me behind for another two years.
• I am trying to get the courage to buy tickets to visit Sam and her little one in New York over Memorial weekend. In New York. I start hyperventilating at the thought (serious phobia issues here!) but I think my love for baby Meghan’s poofy hair might win out over my fears. I may not see anything more than central park and in the inside of her apartment, and I may just be one quivering jellyfish the entire trip, but it’d be worth it. Right?

And that’s all folks. Tune in next time for another addition of Glimpses of Julia’s Oh So Boring Life.

Mom has a lists of blogs from family members that she follows on a regular basis. I don’t think she’s quite ready to tackle blogging herself (I can set you up if you are, Mom!) but she enjoys staying involved in the lives of family who live far away. Of course, that doesn’t work very well when the blogs don’t get updated. My sister updated her blog Feb 18 (even though she had plenty exciting news to tell), my cousins the early part of March, and me, well, I haven’t updated this since March 1. So much for my goals of writing about Tolkien.

Thanks to Mom’s persistent pestering, you now all get to hear about my very busy life.

The first part of March, I actually went on vacation. As a resident, I get 4 weeks of vacation a year (which I have to plan out a year in advance. I also have to plan out my 4-days-off-a-month 3 months in advance, which makes spontaneous outings nigh unto impossible) and I haven’t had any vacation since October. I was pretty ready for some time off, believe me.
cut to be nice to your bandwidth! Click to read and see more!

The Road goes ever on and on
Down from the door where it began.
Now far ahead the Road has gone,
And I must follow, if I can,
Pursuing it with eager feet,
Until it joins some larger way
Where many path and errands meet.
And whither then? I cannot say.
~ JRR Tolkien.

I am done (mostly) with call for the next 3 months AND I’ll have weekends off as well, as I’m on a stretch where I’m doing more consult work than taking care of my own team/patients. It’s going to be a nice change of pace, aka, freaking fabulous. I’m already booking stuff for every weekend until June, let me tell you.

I’m trying very, very hard to talk myself out of signing up for this: http://www.folklorevillage.org/t2/user_file/English%202009.pdf. An entire weekend of English country dancing. Let me say that again. An entire weekend of English country dancing. Granted, the price is somewhat outrageous (okay, it’s outrageous), but… it’s an entire weekend of English country dancing!! Hopefully, people can show up just for the Saturday night dance. (Must finish, aka start, dress!)

This place also holds monthly barn dances. I’m hoping to drag a few friends out to one of these this summer. So much fun!

I have vacation starting on Friday night. I’m just about to the point where I’m counting down the hours. I need a vacation sooo badly. Even my hair seems fried to the ends (it could be because I haven’t had a haircut since October, I think). It’s been a hard winter. I’ve never really been one who has seasonal affective disorder; I usually like winter, but this one has been brutally cold and everlasting and I’m ready for some sunshine.

I have a pseudo-date-thingy on Thursday. A boy from church and I were talking months ago about finding some good ethnic food around here and he stated that we absolutely had to go out and find some. Last week, he facebooked me (funny how that’s becoming a verb) and mentioned the idea again and we confirmed plans today. It’s a pseudo-date because the guy is somewhat weird and for all I know he could be bringing the entire ward with him. He did say that he wanted this to be a monthly thing, so who knows. My expectations of the evening really consist of hoping that I’ll have lots of good stories to share when I go home. Good or bad.

Oh, and Trouble’s back in town. Apparently his version of “never to return” meant gone for 4 months and then back for a month, then gone for another month and then back for 2 weeks and then, never to return. He’s as much as a flirt as ever, which, since the other flirt in the ward got a girlfriend has been in short supply. Did I tell you that March is going to be fabulous? Somehow, though, I don’t think I’m going to be convincing him that a weekend of English country dancing is just want he needs. But that doesn’t mean I’m not going to try!

Lastly, on a complete change of topic: every year, since the LOTR fandom sank quietly into oblivion after the movies (it’s okay by me, I like the quiet fandoms just fine, thank you), various groups sponsored a “Back to Middle-Earth Month” in March. I’ve never participated, but I’ve really been missing LOTR. It’s been probably 2 years or more since I’ve seen the movies, longer since I’ve read the books. My poor little discussion group has long since been overgrown with briars and thorns. My website sits unfinished; I felt so guilty about paying the hosting fees every year, but couldn’t convince myself to let it go. I’ve now transferred my blog over there, so it’s not wasted space any longer (it’ll be officially introduced to the public soon), but I’d love to redo the section of the discussions properly.

More importantly, I made some really good friends on my discussion group, that I’ve missed a lot. I’ve missed talking about LOTR, the in-depth analysis of Tolkien and his works. We had a great deal of fun, for over 2 years, until medical school consumed me.

Anyway. For B2ME month, I’m re-reading LOTR and will be posting some of my favorite quotes or thoughts or maybe drabbles throughout the month. For old-times sake.

You can’t change much on the team computers downstairs. I.T. has deactivated the ability to right click and has even removed “File” drop down menu to prevent viruses and other nefarious activity. The only thing you can do is change the background. All month, I’ve been subjected to “Dukes of Hazard,” some Justin TImberlake SNL skit, and Urkle (sp?).

No longer. Thanks to me and my “decorating” skills this afternoon, the computers have been wallpapered with Doctor Who.

There. That’s better.

I should be trying to go back to sleep. But my mind is reeling, preventing my tired eyes from staying closed.

I just lost a patient. The term is “pronounced dead”, which always seems so ironic. There’s no death until I say so. If I didn’t, is that non-beating heart still alive?

I’m a different person than I was as a naive medical student, where I had not seen or experienced death and cried for hours over the death of my fist patient. It’s a rare week when I don’t have a “code 4” proclaimed on somebody, and usually, we’re not too successful in bringing them back. Or if we do bring them back, they persist in vegetative states, their brains deprived of the oxygen, and I wish that we would not even tried, but that, that is not living.

Today was different. I can’t offer many details, because of HIPAA rules, but this patient was young. It’s the old people, the ones that we break fragile bones doing compressions, those with long histories of coronary artery disease, those are the ones who die from codes, not patients who had come in for completely unrelated reasons. We had had such hope for this patient, things seemed to go well and we had these moments of success before it quickly turned bad again.

My intern is devastated as he spent a sleepless vigil at the patient’s bedside, and it’s his patient, not some random person on a sign-out sheet, but the patient he’s been managing for the past week. My med student is numb and already back asleep.

I used to cry over my patients. I don’t do that any more. I told the family “I’m sorry, we couldn’t bring {patient} back” and watched the tears and sobs start, and I only got a prick in the back of my eyes. I don’t think I’ve grown hardened over the years. I’m a huge advocate of a “good death,” a death that minimizes suffering and prolongation of the process. I call the patient by name when I pronounce them, and I tell them goodbye as I leave the room; I know they can’t hear me, but I hope that their spirit knows that I tried, that God knows that I tried.

There’s going to be an autopsy. Maybe then, I’ll get some answers and some peace that there really wasn’t anything more that I could have done.

Anybody out there know any good tutorials on how to figure out aperture, shutter speed, f-stops and ISO? So far, I’ve read Ken Rockwell’s tutorials on how to set up the Nikon D40 and how to use the different menus, which was very helpful, and Pioneer Woman’s tutorials, but I think I need a step-by-step explanation. What I’d really like to do is take a class through the college, but I have neither the time nor the money for that. So online it is.

I got some lovely pictures during my weekend with Susan:

but I’d like to learn how to blur the background more. And take better pictures of flying model airplanes.

Beuller? Beuller?

Mothers in Medicine, another blog that I read, occasionally has “theme days, where everybody writes on certain experiences. Today’s happened to be on “mentoring”, which I found to be apros, as I reconnected with one of the attendings that I most admire today. She was my attending back when I was an intern and I really loved her style of teaching and examining the patients efficiently. And then I found out that she had papered some of the articles that originally looked at resident work hours and had campaigned for reform, which is a favorite topic of mine as well.

She’s starting a new research project, one that I find intriguing and afer I had signed up to participate, I linged afterwards to talk to her. Long story short, she has some other research topics that I’m really interested in, including a pilot study that she wants to start this summer. I’ve needed to find a research project to get involved in, to boost up my resume if I decide that I want to do fellowship as well as be eligible for graduation, and I had been having problems finding a project that I was interested in. I’m very excited. I’ll be meeting with her later this month to work out details. It’ll mean that my life will be even busier, but if it gets my name in a journal, it should be worth it.

She’s also been my inspiration because she didn’t date at all in med school and residency and is now married (to a non-medicine guy, imagine that!) with two beautiful children and has been an example of how a balance life of career and motherhood can work.

Pumpkin pie on a post-call day = excellent post-call day, even though nothing else exciting happened. I had some sleep last night, we only admitted 5 patients, but I still came home utterly exhausted and slept for hours. I had some interesting post-call dreams, where I dreamed that I was dreaming something that I had dreamed before. I woke up with a headache over trying to figure out what was real and what wasn’t.

Tomorrow entails doing dishes, folding laundry and introducing a friend to the loveliness that is Colin Firth in a cravat. It is my mission in life to bring Pride and Prejudice to the lives of all those around me. Forget medicine, this is my real calling!

Link of the day: The Happiness Project. I discovered this blog several weeks ago and really enjoy the practical advice. I’ve been using her resolution charts to creating some change in my life.

I’m no good at secrets. Keeping secrets, oh I’m good at that. There’s no HIPAA compliance issues with me. But my own secrets always seem to fall flat on execution.

The last time I went home (or was it the time before?), I tried to surprise people with my arrival. Liz, of course, had to be told that I was coming so she could pick me up, but then Laura found out so I didn’t get to see her shocked face when I showed up on her doorstep demanding a place to sleep, and since nobody else knew I was coming, everybody had made plans and I barely got to see anybody. Very disappointing. Not this time. I’m announcing it from rooftops.

I’m going to be in SLC on March 6 and flying to Phoenix on the 12th for a few days before I head back home again. And I want to see people and party as only we 30-year-olds-with-kids-and/or-careers can do. Monday afternoon/night looks like the best night for me. It’s the perfect idea for FHE anyway: to spend time with the Plethora family. Laura will have just given birth, so I can’t commandeer her home as usual. Anybody else want to host?

It is nice to have something to look forward to. I’m not looking forward to the $15 a leg checked luggage fee and I have to say, while the price of gasoline has gone down, the price for plane tickets certainly hasn’t.

I am almost, almost ready to go back to real life. I could have done with another day or two (or week) off, but this was enough to recharge my batteries and dust some of the fatigue and bitterness off my shoulders.

I got semi-lost coming home, as I was on my cell-phone pretty much the entire way and thought I had missed a turn in a construction zone (I didn’t, it was just not marked), so I spent an extra hour driving through the moon-lit fields of rural Wisconsin. I was the only car on the road and at times it felt like I was the only human in existence. It was a lovely detour. I forget how much my soul craves the solitude sometimes.

I’m on call tomorrow… I suppose I should be getting some sleep now, eh?

Thousand words right here.

From Visit with Susan

I’ve taken over 210 pictures in the last day. Mostly of the baby, who moves very fast and doesn’t trust me (I rather startled her this morning when she walked into the bedroom and found me instead of her mother), so there are a lot of blurred, blank stares. I promise that she does smile very becomingly at her parents who dote on her. There should be no question in this child’s mind of how loved she is. I’m going to try to experiment with family photos (and maybe repeat “engagement photos” with Suz and I. It’s been 7 years now, we’re due for another set) tomorrow. I can’t wait!

The day’s events included waking up to a breakfast of crepes, playing with the baby, going to eat at a Thai restaurant, where the mild green curry was definitely not mild, visiting every single Asian market in the area (4) looking for masaman curry paste (every store had a different fish odor), napping, eating homemade vindaloo curry and chocolate chip cookies, and going to the model airplane show, where I got even more blurry pictures (see the above masterpiece). Maybe I’ve a future in abstract art? There is a surprising number of middle-aged men who are into model airplanes, I was hoping for a slightly younger crowd. Had fantasies of meeting eyes across the controls and I’d become a airplane junkie, traveling the model airplane circuit in support of my special someone (kidding, just kidding).

Now, Suz and I are sitting next to each other on the couch, each blogging about our day. 🙂 For my part, it’s been just about perfect. Even the weather warmed up into the high 50s (luckily, since I accidentally left my winter coat at home) and has been gorgeous. Can I stay here forever, please?

Plans for this weekend:

• visiting the library
• going grocery shopping
• watching episodes of LOST
• getting Alice (the babe) to warm up to me (it’s been a few months since I last saw her, but maybe she’ll remember me?)
• taking pictures of the babe (first chance to really play with my camera. Could I ask for a better subject than a two-year old’s grin?)
• sewing my regency dress
• cooking and consuming delicious food
• E-fest amateur electric plane festival!! (a pylon race! helicopter crashes! combat! night-flying!)
• staying up way too late talking and opening up my heart
• remembering exactly why Susan has been my bosom friend for so many years (almost 12 years)

This was exactly what the doctor ordered. 🙂

I wonder if there will ever be a time when I feel confident in my abilities to take care of clinic patients. Hospital patients, even though they are sicker and more complex, don’t bother me (too much. Don’t worry, there’s no an ounce of cockiness in me. Except that I know more neurology here at the private hospital. But that’s not hard). I have the labs, the xrays, the ancillary support and the time to figure out what’s going on. When a patient is admitted to me, I can concentrate on that problem and the one or two other medical problems to go along with it and everything else, I can, if not ignore, document and not worry about it. I have pharmacists to consult, time to look up articles, time when I can go back and ask the questions I didn’t get to the first time. I’m very efficient at it; I can see a new patient and have a good idea of what’s going on within 20 minutes.

It seems like an entirely different world in clinic, where I have a limited amount of time to get the patient’s entire history and yet pressure to produce answers right away. Symptoms that have been going on for years, I have to address and I’m expected to have a solution right then. I have no labs, no supporting procedures that I can order and have done by the next day. I feel like a fool because I haven’t done pelvic and breast exams, prostate and rectal exams, except for very specific cases, since I was a medical student. I don’t know the subtlities in how to treat erectile dysfunction or allergic rhinitis, because those patients don’t get admitted to the hospital.

My classmates don’t seem to struggle with this. I’ve never “belonged” in the clinic world and I feel it more and more acutely every week. I’m enjoying the medicine clinics much more than the neurology clinic, but I think that’s just because I’m new. Every week, I’m so drained and discouraged afterwards.

I keep waiting for that someday when it’s supposed to get easier.

I haven’t quite known exactly what my mood has been recently. Having all of the free time has not exactly been conducive to actual productivity. I’m so worn out and tired and somewhat depressed (despondent, I think would be more apt) that I haven’t done much for the past couple of days, but laundry and watching YouTube movies (Groundhog’s Day on Feb 2, course, North & South yesterday, and Jane Eyre today). I did get my antenna and digital converter set up, but that’s hardly an achievement as I have a Christmas tree still up and scattered stuff everywhere and dishes in the sink. I’m frustrated, a deep soul restlessness type of feeling, which is hard to define and harder to shake.

Chris got his fellowship position. The ending to his personal statement must have been better than I thought (or else they overlooked that due to the rest of his impressive resume, which, since I also helped him put together looks pretty good) and he’ll be going to Boston in June. For 2 years. I’ll be done with residency by the time he gets back. So much for having my friend nearby. I’m an emotional schizophrenic, wavering between ecstatic happiness (Boston! I’ve never been to Boston (in the fall)! Atul Gawade! We did it!) and moroseness. Usually the happiness wins out; tonight…

There is sunshine ahead. A weekend with Susan and her babe in two days (really just one long call day). A week of vacation  to Utah and Arizone in a month (I’ll be looking for tickets tomorrow). Presents from India. Glorious rays of sunshine. I just need to shake of the chill and clinging fog.