(As one of my program directors called it today. I think it makes it sounds like I’m part of this secret society or something.)

I had my semi-annual review today. I don’t know why I get so nervous every time for these. I walked in today with the biggest pit of dread taking up residence in my belly. Of course, all of my fears were drastically way out of proportion. They did not threaten to fire me or tell me that I make their program look terrible. I’m doing fine, they said. My students and interns like me, my attendings rave about working with me, and I perform at the level where I ought to be. And if they truly had problems with me, they would be bringing them up when they occurred, not springing them on me. Probably true, but I don’t think I’ll ever get over the fear entirely–it’s definitely been ingrained from years of needing external validation.

I did share some of my concerns, that I feel that I’m too fragmented switching from medicine to neurology and back every three months and that I’m missing out on lectures that I need to prepare for boards and to take better care of my patients. They both agreed, so I’ve just added a couple hours of lectures to my already full week. I also stated that I feel like I’m being compared to my straight medicine or neurology colleagues of my year, which is unfair because I really am behind since I do six months less than they do every year. I’ve only had 10 months of neurology, when my neuro colleagues have done 14-15 months. My medicine friends will be finishing this year, going on to fellowships and jobs, and I’m not even half way done with my residency. So my in-training exam results are going to be compared to the PGY2s instead, which is definitely better.

I expressed my eternal frustrations with the neurology continuity clinic, of how I’m always behind, always stressed and never feel like I’m learning anything because of it. It’s too late for me (5 more clinics!), but I really hope that they change it so we have 40-45 minutes to see a follow-up patient and staff it. Ten minutes more would make everybody’s lives so much better.

I saved my rants on my neurology program director’s selection criteria for the potential residents interviews (I’ll explain later), but believe me, I think that’s going to come up next time.

The SAR does provide me a chance to reflect on what I need to do to improve my performance and knowledge base. Even though I’ve been told that I’m doing fine, I know I need to do better. It’ll just be 2.5 years before I’m done and expected to know this stuff and I can’t afford to put it off or rely on the lectures to learn it.

Goals until my next SAR:

• Read the review articles and case reports in the NEJM once a week. (Should I get subscription to NEJM, even though I hate getting journals and end up recycling without reading most of them?)
• Read a chapter from Principles of Neurology a week
• Read a chapter from the MKSAP board review book each night
• Catch up on clinic notes (I’m 18 behind)
• Complete evaluations (I’m 5 behind)
• Improve on teaching with students. I always feel like I’m lacking time to teach. I need to have dedicated time with the students each morning.

Obviously, I have some work to do!

I could have just made an empty post with this icon and it would have summed up my day. 🙂

I took off after early morning church to Madison and spent the day with Chris and his friends. We hung out at his new apartment (which so reminds me of Suz’s apartment that she shared with her sister in SLC), fixing his water faucets that, of course, sprayed rusty water across the room, ate bagels for lunch, wandered around a little bit downtown (it’s definitely starting to get chilly!), went to the movies (Quantum of Solace), ate fried cheese curds (it’s a really good thing that I didn’t know that those existed before) and played trivial pursuit while eating dinner. My friends started falling asleep around 9 (they tend to wake up at atrocious hours like 4:30 to get to work), when I graciously took my leave then.

I don’t get to see Chris much these days. Granted, it’s much more frequently than if he had done residency anywhere else (I haven’t seen any of my classmates since graduation), but considering that we only live an hour and change away from each other and we practically spent every day together for 2 years, it’s pretty paltry. I love how we can get together and nothing has changed. I think I also get the benefit of really seeing him become a surgeon; every time I see him he is more assured and comfortable in his role. He’s planning on applying to this research program that exactly fits his plans for life and I’m so stinkin’ proud of him that I almost don’t mind that it’d be 2 years completely across the country, starting this summer. Oi.

I love his friends. His co-surgery resident (Aaron) is an absolute hoot and in many ways a mirror image of Chris; its not hard to see why they get along. His girlfriend (Gretchen) is someone that I heartily approve of and I’ve almost forgiven him for not telling me that they were dating. She’s smart, athletic, funny, and sensible (a trait that I found somewhat … lacking in his other girlfriends). Plus, she belts out musicals in the middle of a restaurant too–definitely a kindred spirit. I hope she’s around for a long time.

Man, it’s really hard going back after weekends like this.

I just got home. I left my house at 10:30 this morning and just got home. Most of the time was spent chatting with my girl friends, eating yummy noodles and sampling chocolates. Just the way a Saturday should be spent.

Now that’s how a weekend should be. 🙂

I did almost contemplate going Christmas shopping today, to beat the rush, but since everything is going to have to be shipped this year any how, I wisely talked myself out that. I am thinking seriously about a Christmas tree, though, and can’t decide whether real or fake is the way to go. I love the smell of real ones, but I don’t have a stand, or a tree apron and I’m not sure that I’m the most reliable one in terms of watering the poor thing. I had a fake tree for a couple of years in SLC and enjoyed it, but left it behind when I moved.

I also really want holly around my house. I’ve never been able to find “boughs of holly” before but figured that it was because Utah was much too desert like to support its growth. Sadly, I’ve been unable to locate any here either.

And I think I just beat my midnight bell toll. This post won’t be turning into a pumpkin after all!

I am in a really happy mood right now.

All of the patients for clinic this afternoon showed up early and since I was gone to the neurology business meeting for lunch, by the time I came back they had all been seen (or not shown up) and my attending basically waved me away. A whole afternoon off. I love this rotation!

I finally got the bookcase and water bottles out of my car. Yeah for better gas mileage! Tomorrow I’m vacuuming the entire thing out and washing the windshield. Baby’s gonna sparkle.

I got more leaves swept (gutters are still full).

Chris just called, he’s got the weekend off and I’m going to Madison on Sunday to see him! I need to find someone to teach my sunday school class (anybody itching to discuss the law of chastity to a bunch of single adults? Yeah, didn’t think so), but that should be the only glitch. I haven’t seen him for more than a few, brief hours in months, so I’m really excited about the prospect of an entire day. I’ll get to see his new apartment, eat some kind of exotic food and just catch up.

I am relishing the thought of sleeping in tomorrow.

I had pumpkin frozen custard last night, which was phenomenal. THis really is the best time of year, ever.

In just a week, Susan and her family are coming for a weekend visit. Suz and I are going to the opera! And then we’re having an early Thanksgiving/birthday celebration with lots of mashed potations and pumpkin pie.

I’m doing great with my NaBloPoMo goals, haven’t missed a day yet. How are you guys; I hope I’m not boring you all too much! (I have noticed that as my posting has increased, the blogging of many of my friends has decreased… Hmm. A scientific correlation, perhaps?). NaNoWriMo has, as expected, fallen drastically short of the mark, but I’ve really come a long way in brainstorming ideas and plots and characters so it might be something that I can continue to pursue.

And to top it all off, there’s this:

I love Doctor Who and can’t wait for Christmas. 😀

It is November 12, and I ate my last raspberry off my bush two days ago. Yesterday morning, I awoke to frost, and the poor raspberries were all frozen to the branches in various states of ripeness, perfectly preserved in their last moments of life. *sniff* If it had just stayed warm for 2 more days, I’d had enough to add to my breakfast. Tomorrow it’s up in the 50s again (but raining). I hope there will be enough of a peak in the clouds that I’ll get to clean out my gutters when I get home.

In another food related news, I had the most awesome dinner. When my friends were here last month, Laura insisted on making a Sweet Potato Curry. But it had to be the right kind of sweet potato, the “pale variety” she told me, more like a potato than a yam. Fine, fine. Sam and I scoured the grocery store, finally finding something that was labeled as a sweet potato and brought it home, where we were flatly informed that it was a yam and would not do. Sam later returned and with the help of 2 grocers who couldn’t resist helping the cute pregnant woman, found the spud, which at least here in Wisconsin is known as a “Golden Yam” (it really is a SweetPotato. So dinner was salvaged and I instantly became converted to the yummy yumminess that is the yellow pale-skinned SweetPotato. Its texture is much closer to a potato, it just has a hint of sweetness to it.

So I was digging through my cupboards this evening and stumbled on a golden sweet potato and I knew I had to make it my dinner. I heated up some minced garlic, whisked in some fat free evaporated milk with curry power, paprika and a touch of cinnamon, poured in on the griddle and then added thin slices of the yummy spud and cooked it until all of the liquid was gone and the potatoes were soft and flaky. Perfect. You all should try it some time. 🙂

(I need more food icons)

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!

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. 🙂

I arrived at work around 8:30 this morning, feeling positively guilty for sleeping in. I wandered over to the pathology department, where I’m supposed to be rotating for the next month. The secretary blinked at me. “Oh, Dr. H doesn’t usually arrive until after 10. I’ll call you when he wishes to meet with you.”

At 10, I found myself in the autopsy lab examining a brain, being asked all kinds of questions that I’m not sure I’ve studied since medical school… and certainly not in the last three months, where my focus has been on treating alcohol withdrawal, pneumonia, and acute renal failure. By 12, we were done and instructed to come back at 3–tomorrow.

*blink*

It looks like there’s about 6-8 hours a week that I’m expected to show up. The rest of it is self study. I haven’t self-studied since med school and I wasn’t very good about it then.

So, instead of studying and instead of doing the 22 clinic notes that I’m behind on and instead of writing out disability paperwork for a patient that I’m not entirely certain should be on disability, I came home and took a nap. I had a migraine from the formaldehyde fumes and it has been a very long month (I flirted very close to the over 80 hours a week limit. I’m sure I went over) and I deserved some time to myself.

Thursday I have an appointment to get my teeth cleaned, the first time in over a year. I hope to get my hair cut and get to the gym on a regular daily basis. I have a week of vacation coming up where my girlfriends are coming out for a long weekend and then my dad and grandparents are driving out to see me.

It’s shaping up to be a very good month.

I have had a fabulous weekend. It’s been so refreshing and relaxing that it almost feels like I had the entire weekend off, instead of just Saturday.

Friday, I came home post call and packed for the “girls only” camping trip. It was one of my friend’s 30th birthday, so to celebrate, we decided to go camping. Yay! I’ve been wanting to go camping all summer long but have been thwarted over and over again by forgetting tents, threatening rain and long work hours. The weather didn’t look promising, but I was naive enough to believe the forecast of “20% chance” of rain. It started raining before we were even on our way. There went those plans. Instead, we went to my friend’s mother’s house, and sat under her car port, grilling our tin-foil dinners (seriously, tin foil asparagus is the most incredible food ever), and basking in the glow of the fire pit (I’m more determined than ever to get one). Afterwards, we all came back to my house and had a sleep over; my upstairs room almost looks like an oversized tent and everybody fit perfectly. We stayed up late talking (well, they did. I crashed early. 2 hours of sleep in 40 hours does not a coherent Julia make) and in the morning consumed pancakes (cooking tip: the addition of vanilla, cinnamon and cardamon makes a fantastic pancake). I haven’t had so much fun in a really long time.

After they all left, I decided to take advantage of my one day off and went over to Home Depot to research more about garage doors. The contractor was busy with another customer, and I got impatient waiting, so just as I was about to decide to leave and just order the darn thing online, one of the other sales associates stopped me. He listened to my rambling complaints of what was wrong with my door and felt that the door and opener were not the problem, that likely I needed some lubrication and new wheels as they get worn out.

I attempted to install the wheels yesterday and I think I’ve figured out the whole problem. It’s doesn’t even seem to be worn out wheels. The tracks were entirely caked in about 6 layers of grease and grim and the bottom part has rusted and the wheels were in a similar state (I don’t think those wheels have made actually contact with the tract in years, hence, there is barely a sign of wear on them, once you remove some of the grime).

I spent all day yesterday getting as much off as I could with a combination of paper towels, knife, fingernails (they could angle the best. I chopped them all off afterwards), and finally, dish soap (didn’t work so well). There’s still at least one multiple layers, but it’s already running just a little bit smoother. I just need to find a really good grease solvent to cut through the rest of it (any ideas???), and then lub it up good with some WD-40, and I think I’m set! YAY! You have no idea how much of a relief this is, this possibility that I might not have to replace my garage door. Of course, I still might have to actually replace the tracks if the rust at the bottom is worse than my original glance-over, but my bishop’s wife has recommended an independent contractor who is reasonable, so I might be able to get that done for a quarter of what I originally predicted. SWEET.

Afterwards, I cleaned up and went over to my neurology program director’s home for dinner which was nice. Everybody brought their kids, there was more food than imaginable (we have a rather large mix of vegetarians, meat consumers, Muslims observing Ramadan, etc). And then after that, I went to my friend Laura’s birthday party. She decided that she wanted to do a sing-a-long party, so we all got together and sang “The Music Man.” Yep, you read that right. We are such nerds. I haven’t seen it since high school at least; I remember most of the lyrics.

This morning, I rounded on all of our patients. We’ve cut the number patients down a lot, which made for easy rounds so I actually was able to make it to church for the first time in three weeks. And then I came home, ready to make potato soup for our on-call pot luck tomorrow, but I’m missing several ingredients, so instead I’m heading to the grocery store bright and early, chopping the vegetables and bringing it all to work so that it can cook in the crockpot all afternoon. Yummy.

And, I’ve figured out most of the problems with my from-scratch blog. It should be up and running in a couple more days. I’m so excited for its unveiling.

This week will be busy. I’m on call tomorrow and Friday. Saturday, I’ve invited my entire church over for a party. *boggles* Not sure exactly what possessed me to agree to host a party when I’m post call and sleep-deprived but there it is. It’s going to be fun, with a firepit in the backyard with camping chairs around and white Christmas lights on the fence, music in the front room, games and instruments downstairs, more games upstairs and tons of food. Luckily, I have the day off on Thursday to clean and all of my friends are coming over Friday when I’m at work to set up, so I don’t have to do that; hopefully, all I’ll have to do on Saturday is nap, take a shower and put on clean clothes and greet the guests.

Okay, I’m off to bed. Gotta get those veggies in the morning. 🙂

Apparently, my ladder was also among the casualties of the recent heist of my garage, as I discovered this morning when I tried to find it to examine my garage door that has now started making grinding noises and loud squeaks when it closes.

The ladder was heavy, folks. 50 pounds or so. I could barely lift it. It changes this break in from a neighborhood kid going around, testing doors and lifting a camera. This appears more orchestrated than I had thought.

I’m so tired of feeling vulnerable. Now I get to add nightmares of nefarious thugs using the ladder to break in my upstairs. I already freak out every time I open my garage access door. I peer out my screens before leaving the house to make sure that the back gate isn’t open. I’m jumpy, and just two weeks ago, I felt safe.

The door’s gotta be replaced… there’s no way that it’s going to last this winter and I can’t leave things open and leave like I did before. So I’m researching doors and deciding between Lowe’s and Home Depot and will be getting it professionally installed so it’ll last a little longer.

***
There are two trees near work that have red leaves on them. It’s still August, trees! The weather last week felt like autumn had arrived. A friend and I were going to go camping today… and then it turned into summer again. Hot and humid. And supposedly rainy. It hasn’t rained a drop. So we ended up not going. I haven’t been camping yet this summer and I start inpatient wards again next week so I think I’ve missed my chance.

***
I went to a baseball game last night with the rest of the neurology department. It was so much fun. I love baseball, have since the fall of 1992 when the Toronto Blue Jays won the world series and since moving to Milwaukee have made it to a least a couple of games every year. The Brewers stadium (Miller Park) is awesome…we always get the nosebleed seats that are a hundred feet above the field, which always freak me out until I get settled. Last night’s game was the first where the roof was open. I saw with my friend Rehan and his 4 year old son who was shyer than anything… which was easily cured by the spun-suger cotton candy. We made faces at each other with our blue tongues through most of the game and were good friends by the end. Lots of pseudo-nephews and nieces has taught me well.

***
I did go by Best Buy and look at cameras today. I’m going to have to postpone my purchase of the SLR for a couple of months because of the expense of the garage door (natch). But I have decided that the D40 is the camera for me and I will be getting it to celebrate my birthday in a few months (gotta have some reason to look forward to that milestone). It’s small and featherlight, which because of my multiple shoulder surgeries is a necessity. And I think it’ll be just as portable as my last camera. It never fit well in my pocket anyhow, so the one camera will probably do me just fine.

Although I hadn’t realized that the camera doesn’t have live preview on the LCD. I’ve been so used to taking pictures using the LCD only for years that it might take a bit to get used to that again. I loved being able to angle it and getting those shots that were impossible before because I’m short.

Thanks for all of your input! It was sooo helpful and I was so excited to see that many of you had similar cameras and were taking gorgeous photos with them. It makes me feel more and more that I would not just be throwing my money away on a frivolous purchase. 🙂

I did walk out of Best Buy with a copy of Summer Magic on DVD. I couldn’t help it; it was on sale and I need a little more “femininity” in my life. It’s not available on YouTube folks, and sometimes the urge for Old Time Disney can be a little strong.

***
I’m not entirely sure what to make of Joe Biden as Barack Obama’s running mate. I hadn’t even realized that he had been in the primaries and haven’t heard of him before. It looks as if it is going to get ugly, though, and I had been impressed that both candidates had refused to get really ugly. The jabs about Obama being a celebrity candidate and McCain’s 7 houses (seriously??) were pretty mild compared to elections in years past. I guess that’s all going to change now.

At least it’s not John Edwards. I guess I can be thankful that he turned out to be a cheating louse just prior to the decision for running mate (sorry to those who like him. I could never support a guy for president who’s entire career was based on cerebral palsy malpractice lawsuits. But that’s the doctor in me).

My favorite personal speculation was Senator Harry Reid as running mate. I like him a lot and his acerbic tongue and I giggled at the thought of both Harry Reid and Mitt Romney as VP candidates and the chaos that would cause. The Mormons would be all up in arms, questioning if they could really continue to be a card-carrying member and vote Democrat. And the rest of the world would freak out that the Mormons were taking over and soon there would be “National Green Jello with Carrots Day” in March and no alcohol in the country. Good times. Such a missed opportunity. 🙂

***
Strictly Ballroom is still one of my favoritest movies ever. If you haven’t seen it, you should. I watched it again for the hundredth time with my friend Erika who had never seen it again. It’s one of those movies that I can watch over and over and it still cracks me up and turns me into a sappy romantic. I miss dancing…

(Notice the date… written last week and accidentally posted now.)

Chicken spagetti made with spinach and yogurt is an interesting combination. Not bad, really, but it took a couple of bites.

This started out as an attempt to make chicken tikka masala. But I’m missing ingredients for this new recipe I found (there is an appalling lack of ginger in my house), and I couldn’t let the chicken go to waste and I’m rather infatuated with cooking with yogurt recently (I think I perfected my salmon recipe), so… the above was the result.

I’m not sure that I’ll be repeating it soon.

So, my mother noted that I haven’t been updating my LJ and called in a panic on Sunday to make sure that I was alive. To alleviate those other worries about my safe-being, yes, I’m alive. I’m just bored and have little to talk about. Okay, I do have things to say: I’ve got a post brewing about the Vienna Teng concert that I went to on Tuesday which may have even been better than her first concert two years ago (her music makes me want to write in purple prose. I love it!). I’m still not a clinic person and I’m really glad that I didn’t go into orthopedic surgery (sample of the conversation today: “Is [he/she] on pills? [He/She] sounds like someone who would be on pills” – referring to antidepressant medications. And this gem to a young, but overweight patient coming in for referral “So, is this you? I mean, when we do the operation is this what I have to deal with?” UGH. Please note that this is not an attack or rant against orthopedics or surgeons in general. My favorite, most inspiring doctor in the entire world is an orthopedic doc. Because of my bone disease, I have to see them periodically as a patient, and the number of muscles and ligaments that they have to know thwarted me in med school and hasn’t gotten much better. That said, this particular orthopod was a jerk.)

My new blog s almost, almost ready for its unveiling. I’m trying to figure out the heading, and once that’s done, I need to transfer all of LJ entries over (which I keep putting off in the hopes that somebody will figure out how to import moods and current music fields. Tags would be nice too), and then it’ll be ready. I think. I can’t tell you how much effort this has been. I started working on it back in March, messed something up, deleted it, started again in May, deleted, repeated about 3 times in June and finally got the current version partially running in July… just in time for the upgrade of wordpress to 2.6. *sigh* I’ve devoted much of my spare time over the last two weeks to figuring it out. Most of my problems have been related to the fact that I know next to little about webdesign… the little I taught myself for my little website was all HTML (and sloppy HTML at that) and that has been long since forgotten. WordPress does make it easier in that most everything is run through plugins, but if something goes wrong (and it always does), then I had to dig through the code to figure out what was up. The only thing I haven’t figured out is how to expand out the default size of the comments once they’ve been posted and how to get the UserPhoto working so that it actually shows up inside the comments, rather than haphazardly across the page as it currently is wont to do. I’ve given up on that for the moment (unless of course some computer programming brainiac out there might know the answer!) and have accepted that my blog won’t look quite the way that I want it to. At least at this point.

But, Julia, why the switch, I hear some of your asking (I’m psychic, did I tell you?). There’s a variety of reasons (I like lists):

– One, I’ve got a lot of friends and family who read this journal and don’t have a LJ themselves, and I don’t think any of them enjoy replying as an “anonymous.”

– Two, I have been rather disgruntled by the change in management styles and the addition of advertisement across all of the pages, and while I completely and totally understand that this is a for-profit business and they can do whatever they want, that doesn’t mean that I have to support it with my money.

– Three, I’ve been paying for my own web domain for over 4 years now. I probably won’t ever finish my LOTR Inklings project, but the thought of giving it up breaks my heart. So this is a little bit of a compromise and allows me some relief of the guilt of money wasted.

– Four, WordPress has some nifty, nifty functions, like a picture gallery plugin that’s even prettier than Flickr and customizable sidebar widgets.

– Five, I don’t know if you all are aware, but there’s been some backlash and criticism to physician blogging, thanks to a couple of articles in the LA Times, the NY times, and JAMA. I’m such a lurker and rarely update my other medical blog, so I’m not showing up on anybody’s radar, but I like the idea of being able to more closely control who is seeing what I write. And while LJ has this great feature of being able to friendslock an entry, that doesn’t change problem #1. WP allows me to register readers.

– Six. I can’t recall what the sixth reason is. It probably doesn’t matter.

I’m not leaving LJ, no worries. All of my entries will be cross-posted to both, the entries here will just be much more censored and locked down. And I’ll still be active in reading my friends’ LJ, although comments are still expected to be sparse.

The problem with wordpress is that it is a blog. LJ is great because it’s a journal, my journal. I can write down everything, regardless if it has a purpose. But a blog conveys that posts have themes and reasons, and I’m not sure that I like that. I’ve tried writing a couple of pure medical blogs and failed miserably. We’ll see.

I might go camping tomorrow. Yay! That is, if I manage not to get called in for back-up call and I get out of clinic on time.

And I don’t want to go to clinic in the morning.

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…

I’m starting to wonder if I’m clinically depressed. Funny, me as a doctor, not knowing whether I should diagnose myself.

I went to a dinner tonight for women in med school and sat on a panel, listening to the other residents give advice such as: “it’s easy to exercise in residency, you just have to make it a priority,” “dating and socializing in residency is essential, you just have to make it a priority,” and “you can easily be married, have kids, spend quality time with family, you just have to make it a priority.” I think I was the only one who was rolling eyes, I do not think that word means what you think it means.

Then it was advice on interviewing and selecting programs. Most of the panel suggested that trying to interview for two different specialties was “not wise” and it made you appear indecisive. I chimed in about how I had applied for three different specialties (medicine, neurology and med/neuro) and how it didn’t hurt me. Then there was the advice of what to ask the programs. One woman stated that she asked the residents if they were happy “and if there was a pause, she thought again about the program.” At this point, another resident looked over at me and started snickering because I had been ranting about my awful day of painfully long rounding wards, my whole slew of whiny, crazy patients, the difficulties of being a scut intern again and how much I hated dictating, etc. etc. So I piped up again, and stated that all residents have bad days and if they state with a Pollyanna smile of how overjoyed they were, they were lying (okay, I didn’t say it that strongly).

I’m having a rough time right now. I’m a little bit sleep deprived because I’m not sleeping well. I’m frustrated at work, because the majority of our patient lists have nothing wrong with them, besides what’s going on in their heads and are thwarting my every effort to get them home or to rehab or to wherever. My attending collects patients, so we can dawdle at every bedside. I’ve been arguing blatantly with my attending so we can make some progress. We round FOREVER. I’m going to be with this same attending for the next 10 days (kill me, please). The ER staff is driving me nuts with their inability to perform even a simple neuro exam. I’m tired of admitting patients every single day. There has been some nice moments, like today when I spent over a half an hour, explaining a procedure to a patient and her husband, really getting the chance to explain the risks and benefits and answer all of their questions. I like that. I just wish that I could convince somebody to rediagnose her and figure out what’s really going on, because I hate that I’m not doing anything to make her get better.

I’m lonely. I do have my friends from church, but I only get to see the once a week… if I’m lucky enough to make it to church. I haven’t talked to my best friend from med school–the guy I saw every day for nearly two years, the guy I talked to every week for our last two years of med school and my intern year–for more than 10 minutes for 4 months. I haven’t seen him in 4 months. I have no idea what’s going on with him. And let’s not even mention the last time I talked to Liz or Sam. The visit to see Susan and her beautiful family seems so long ago now. I think that this disconnect is what’s bothering me the most; I need to pick up the phone and just call… but I haven’t been able to. In this funk, all of my insecurities have been wrecking havoc to my brain…. they haven’t call me, obviously, they don’t care as much as you thought they did.

I was going to mope more, but I need sleep. The next post is going to be happy. I swear. Even if I have to go digging for pictures of baby polar bears again, it’ll be happy.

I’m disabling comments. I don’t want anybody to feel obliged to try to cheer me up; this is what they call catharsis. I think.

In a Past Life…

You Were: A Redhead Warrior. Where You Lived: Central Africa. How You Died: Consumption.

I like this meme. It only asks one question. I can do those. 🙂

(The song was a random iTunes choice as well)

I went out to dinner with my friend Erika, who is having a much worse time (and for more legitimate issues) than I, which helped getting me out of my funk. We had Indian food, which I swear, makes everything better. I, of course, had the chicken tikka masala, which is the perfect comfort food, creamy and savory. Afterwards, we came back and watched Enchanted which was almost enough to get me out of my cynical mood. I am supremely jealous of Amy Adams’ long, gorgeous, vibrant red hair. *frowns at hair that’s becoming more strawberry blond every day* I loved all of her dresses, except for her ball gown, which was a lovely shade of purple, but the bodice was all kinds of ugh.

I then finished my day by watching Doctor Who that featured another gorgeous red head (I didn’t like Donna’s hair the past episode, the bangs and style made her face seem square; today’s was perfect), and she was wearing a toga in that same shade of purple! I loved this episode. cut for mild spoilers

Hi family members!

Welcome to my blog! I think some of you have been reading this for a while now (and not commenting), but if not, glad to have you around. I’ve kept an online journal for the past 4 years, so if you are interested, there’s plenty of old archives to waste your time reading.

I am curious, of who exactly is reading my journal. So, family, friends, countrymen singe men, wanna just click on that little link that says “free your tongue” and tell me who you are. Consider this your guestbook. 🙂

You know you have really really good friends when they call you up to say that they want to see you on your day off…and they are coming over with cleaning supplies and expect to be put to work.

My kitchen, bathroom and living room looks fabulous. Still have laundry to do, but will have fresh scrubs to wear tomorrow.

*loves*

So glad that this month is over. It has been difficult and frustrating in many ways that I could have never predicted. I liked my interns individually but we never became a team, and I really struggled with how to improve things. I was in change of 15-20 patients every day, we rarely seemed to make any progress in discharges, and I think I set the record for the number of patients transferred to the unit (12). I was rarely done and home before 7 pm…when my interns usually left by 5, I was still there making sure everything had gotten done.

Tomorrow will be met with a new set of challenges: new interns and students, new hopsital, new system, new rules, (and I get to start by being on call! Yay!) but I’m glad to get a fresh start on things. Plus, all of the other residents keep teasing me with promises of work days ending by 3 pm, and that sounds unbelievably alluring.

Night all.

I woke up late for this morning. I was so exhausted after my shoveling efforts that when I finally went to bed (Erika invited me over for dinner and to decorate her Christmas tree. We watched Pride and Prejudice (the 1995 version of course) and ate really really good food. Worth being extra tired), I slept through both of my alarm clocks and woke up at 7:30. I should have been to work at 7. Big, big oops. I threw clothes on and threw myself out the door. WIth teeth unbrushed and hair that had not been washed for two days (remember, I was post call yesterday). Ugh. I managed to snag one of the cheap disposable toothbrushes provided for the patients (I don’t know why more of our patients don’t leave AMA after we give them those toothbrushes! My gums hurt so badly!) so I didn’t overwhelm those in close vicinity. But I still felt gross.

Luckily, we had 1 patient that we had admitted overnight, and didn’t round until after 9. After I discharged home that one guy, I slipped away and took a shower in the residents’ call rooms, and felt so much better. But seriously, having time to take a shower on an ICU rotation?!? Something is extremely wrong with that scenario! I got all but 1 of my 15 dictations done, though, so that’s also good. I have my semiannual review tomorrow with my program directors, so at least I’ve minimized the chastisement on that. We’ll see about the clinic notes and lecture attendance!

Of course, I’m on call again tomorrow. Of the 11 Tuesdays since I got on the neuro rotations in October, I’ve been on call for 8 of them. Never mind that there are at least 6 other juniors taking call each month. Don’t know whether I should bring this up at my interview tomorrow, as it is ultimately the chief resident’s responsibility to make the schedule, but this is definitely a good portion of why I’ve been less than happy on neuro.

On the bright side, I have the next 6 weekends off! That’s something to look forward to!

Life has been super busy and super boring. I think it’s all because super cute intern has moved on to greener pastures and I’m mourning. 🙁 While it may not have been true love, it was definitely TrueLust and made the entire month survivable and entertaining. The intern who replaced him is a girl and therefore not interesting.

CuteIntern’s facebook profile reads this: “Custom has made dancing sometimes necessary for a young man; therefore mind it while you learn it, that you may learn to do it well, and not be ridiculous, though in a ridiculous act.” Soulmates. Srsly. (Or not).

In more news, I have not talked to DateBoy since said date. I’m thinking about calling DateBoy and inviting him to my house for Thanksgiving dinner, which may be the most forward thing I’ve ever done. Or not, because I keep changing my mind.

I’ve put on weight this month because of all of the stress. And the easily available candy at the nurses station. I haven’t worked out in a month. So much for the plan to be down ten pounds for Christmas, so I could finally, finally have a vacation without my mother mentioning how unhealthy I look.

I’ve had some very difficult patients that I’ve had to deal with that have sucked compassion out of me. I’ve realized that I hate treating migraines. But to make up for it, I’ve had 3 of the loveliest patients, including two who have made a romantic out of me again, because they (and their spouses) have proved that true love really exists.

My next day off is Thanksgiving, which happens to be my birthday. I haven’t had a day off since the 28th of last month. I get four days off in a row to make up for it. I’m not sure I’m going to be able to come back.

I’ve been on call every Tuesday except one since the last week in September. Tuesday is clinic day, which means I have to see all of my patients before 8. Since I really shouldn’t be in before 7 (therefore, having enough time to go to noon conference the next day and not break the ACGME 30 hour rules), it makes the morning incredibly hectic. What makes them even more fun: all of those Tuesdays, except for one, my team has been post call. So I have to hurry through clinic (where I always get behind), race through lunch, so that I can go upstairs and admit the 3 ER patients, learn about the NICU transfers, follow up on the stuff that the other intern wasn’t able to complete, write my own patient notes that I didn’t get to do in the morning, discharge the half dozen patients of the intern’s (because my patients are all rocks which I collect) and then start getting pages every 30 seconds on 3 different pagers. Yeah, I loathe Tuesdays. Only a year left of clinic!

The best part: I’m still on call every Tuesday until the middle of December. And every weekend except Thanksgiving.

I’m still trying to remember why I loved neurology. I think I need to see David Renner when I go home so that I can be reminded. It’s probably pathetic that when prospective interns come and interview here, I end up gushing about Utah more than the program here.

Susan and Bobby and Allison are coming for Thanksgiving. I’ll be cooking something delicious, I hope. Should I ask DateBoy or is that really weird? I think I need more furniture if I do.

I spent the evening reading old Gilmore Girls fanfiction. Mostly general stuff, featuring townies, and it made me realize once again what a brilliant, wonderful show it once was.

I’m going to the opera next week with two of my girlfriends, Kristen and Erika. The Merry Widow. I was very excited when I first heard about it, because from the radio ads, it sounded like it was the translation that I fell in love with in high school. Alas, my sleuthing has proven that it is not so (although I think it’ll be better than the San Francisco version), but I’m still ecstatic about it. I’m dressing up. I can’t wait.

I’m also having a painting party involving my living room next week as well right before the opera. Need to clean the place before before then, I think. And I need to buy paint. And moth balls.

I’m totally addicted to this blog and have wasted away more of my evening reading her archives and laughing so hard I almost started vomiting.

I’m going to be 29 in 2 weeks. And I think that’s enough to stop any more random musings.