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18th June 2009

health care reform meta

Chris moves to Boston at the end of this month (I’m hoping for one more quick visit, but he’s booked solid with going away parties and moving companies). On July 1st, he’ll be working with my hero, who distills the health care reform arguments and gets down to the heart of the problem, and does so beautifully. Dr. Gawande’s latest article in the New Yorker is a must read. I’m sending a copy to my representatives, because nobody, nobody is addressing the real issues that affect medicine. I strongly disagree with Pres. Obama’s ideas of health care reform (and I’ve agreed or at least grudgingly understood why with all of his decisions so far–but I knew back in November that while I was supporting his election, it wasn’t on the platform of health care reform), but I loath every other politician’s idea as well. They aren’t in health care. They see health care from a business model, and the focus is on “saving money,” while insisting on continuing to provide care exactly how it is now.

“…We are witnessing a battle for the soul of American medicine. Somewhere in the United States at this moment, a patient with chest pain, or a tumor, or a cough is seeing a doctor. And the damning question we have to ask is whether the doctor is set up to meet the needs of the patient, first and foremost, or to maximize revenue.

“There is no insurance system that will make the two aims match perfectly. But having a system that does so much to misalign them has proved disastrous. As economists have often pointed out, we pay doctors for quantity, not quality. As they point out less often, we also pay them as individuals, rather than as members of a team working together for their patients. Both practices have made for serious problems.

“Providing health care is like building a house. The task requires experts, expensive equipment and materials, and a huge amount of cordination. Imagine that, instead of paying a contractor to pull a team together and keep them on track, you paid an electrician for every outlet he recommends, a plumber for every faucet, and a carpenter for every cabinet. Would you be surprised if you got a house with a thousand outlets, faucets, and cabinets, at three times the cost you expected, and the whole thing fell apart a couple of years later? Getting the countrys best electrician on the job (he trained at Harvard, somebody tells you) isnt going to solve this problem. Nor will changing the person who writes him the check.

“This last point is vital. Activists and policymakers spend an inordinate amount of time arguing about whether the solution to high medical costs is to have government or private insurance companies write the checks. Heres how this whole debate goes. Advocates of a public option say government financing would save the most money by having leaner administrative costs and forcing doctors and hospitals to take lower payments than they get from private insurance. Opponents say doctors would skimp, quit, or game the system, and make us wait in line for our care; they maintain that private insurers are better at policing doctors. No, the skeptics say: all insurance companies do is reject applicants who need health care and stall on paying their bills. Then we have the economists who say that the people who should pay the doctors are the ones who use them. Have consumers pay with their own dollars, make sure that they have some skin in the game, and then theyll get the care they deserve. These arguments miss the main issue. When it comes to making care better and cheaper, changing who pays the doctor will make no more difference than changing who pays the electrician. The lesson of the high-quality, low-cost communities is that someone has to be accountable for the totality of care. Otherwise, you get a system that has no brakes.”

From The Cost Conundrum, The New Yorker, June 1, 2009.

A few short months after I started residency, the neurology department switched from paying their physicians a salary that was based on experience and tenure to a “relative value unit” compensation system, meaning that patient visits or procedures were reimbursed based on a calculated fee. A basic office visit would be 2 RVU, doing injections for headaches would make it worth 10 or performing an EMG would give you 30. You had to make a certain number of RVUs in order to get a base salary, anything else you do is “gravy”. Things changed overnight. Attendings who used to lecture at noon time suddenly were squeezing in more clinic patients or doing another procedure. My program director is the only one who lectures any more. When on service (meaning they’re in charge of the patients who are admitted to the service and over the residents), attendings leave for a few hours to see clinic patients, cutting into the time that they spent teaching. My neurology clinic was a disaster. Instead of learning how to diagnose and treat migraines, seizures, Parkinson’s, etc, I had lectures on how to document my notes, so that they would generate the most income.

Contrast that to the internal medicine side, who pay their physicians a set salary. The attendings work their two weeks on service every three to six months. They staff the residents clinics and I never hear anything about how I need to see more patients or finish my notes in X amount of time so they can get all of the billing. The focus is instead on my learning: making sure that i understand thoroughly what the cholesterol panel on my diabetic should be for heart attack and stroke prevention. I just learned that that the internal medicine doctors will be getting a 15-30% pay cut next year because of the economy (and some piss poor economic decisions by higher management–but that’s a rant for another day). So far, I haven’t seen it affect the care that they are providing their patients or the education that they are providing me – a vastly different and much more preferable. I understand that unfortunately in this capitalistic* society, medicine is a business as much as anything and that I will have to face monetary decisions once I graduate, but I strongly disagree that it should be influencing my medical education or the care I provide my patients, to this degree.

Also check out his other article Getting There From Here that has a fascinating history lesson in how health care coverage and insurance evolved over the past century, as well as an examination of why idealism should not prevail in our quest for a better medical system. It’s a beauty as well.

Now if we could only get good tort reform as well…

*I support capitalism, but I don’t support endless greed (such as CEOs of private insurance companies or hospitals making billions of dollars a year), which is what our current system seems to be based on. We seem to be learning lessons very slowly.

(Sorry if I lost your comments. I was transferring all of my entries to my other blog, which for some reason copied everything 3 times, and then I clicked delete on the wrong entry. Argh)

posted in On doctoring | 2 Comments

10th April 2009

pretty stick

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.

posted in Friends, Rejuvenating the Soul, Resident Life, Social Life | 5 Comments

7th February 2009

Photographic evidence

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?

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19th December 2008

disappointment

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

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

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

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

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

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11th December 2008

time machine

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

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

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

Night all.

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2nd December 2008

100 Things

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

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

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28th November 2008

Protected: Christmas cards

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24th November 2008

Catching the bouquet

Some friends of mine got married a month or so ago. Lindsay (the bride) is a romantic and planned the wedding to have a Jane Austen theme. All of the guests were seated at places named after Jane Austen locations: Bath, Mansfield Park, Lyme (which was actually where we were seated), Northanger Abbey, and of course, Pemberley, the table where the bridal party sat. There were horse-drawn carriage rides and silhouette portraits and of course, dancing (although not English line dancing to my disappointment). The gentlemen from my church in attendance were, as I should have expected, dolts and lacking any sort of a romantic sentiment:

Me, teasingly: How long do you presume to reside in Lyme, Mr. B? Are you here for the season? Will I have the opportunity to make the acquaintance of your sisters?

Mr B: What are you talking about, woman? I can’t understand anything you’re saying.

Excited about the prospect of dancing and a formal wedding reception, I had dressed up for the evening, wearing my bridesmaid’s dress from Sam’s wedding with the long flowing skirt that I love so much. Lindsay and Tracy (the groom) were good on their word, there was dancing. Live, big band dancing playing Glenn Miller and Louis Armstrong. And I couldn’t get anyone to dance with me. I finally did manage to drag out every one of the boys from my church out there to the dance floor, away from the food where they lingered and insisted that they escort me off the floor (I’ll save my appalled rant on the lack of common decency and manners later) and had a fabulous time anyway. I caught the bouquet, did I mention that? The pictures make it look like I had staked out the front row position, when in reality, I had just come in from the side. The bride threw the bouquet over the chandelier where it hit the ceiling, bounced off another girl’s chest and landed in my arms.

I thought I had recognized the photographer as the guy who had done the pictures for Liz’s wedding. What do you know, he was a friend of the bride’s sister. I started whistling “It’s a small world” and my friend Sarah remarked that she recognized the guy who followed him around with the flash as the photographer for her friend’s wedding once upon a time.

In any case, the wedding photos were posted online today. There weren’t any pictures of me dancing and I don’t like the pictures of me catching the bouquet (I look manic), but there is a sweet one of the groom and me.

Click for pictures

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19th November 2008

S.A.R.

(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!

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17th November 2008

a few of my favorite things

I’m exhausted. I crawled home in bumper-to-bumper traffic amidst what weather.comm called a “flurry” and I called a blizzard (shortlived, true, but pretty intense driving for a while). I’ve already napped on my couch here these last couple of hours; I think I’m making it a early night. Hopefully it doesn’t snow too much tonight, I really don’t want to start shoveling already.

In exchange for a real post, I’m sharing my favorite doctor blog link:

http://www.freshmd.com

I discovered her blog a few months ago and just love it. She’s a family medicine doctor in a small town in western British Columbia, taking care of an immigrant population (mostly the Karen from Cambodia) and has beautiful posts on the doctor-patient relationship. She also takes the most amazing pictures of her family and the area that they live in, which I find so relaxing that I have to remind myself that, no, I can’t pick up my bags and go move there, because I haven’t been invited. And who would have thought that it would have been a physician blog that got me lusting over making a quilt like this cathedral quilt?

Her blog may be part of the reason that I’m reconsidering my desire to do critical care, because I’m not sure that the hustle-bustle is what I really want. The idea of finding a smaller community with a smaller hospital that I can work in is becoming more appealing.

Hope you enjoy!

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16th November 2008

:)

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.

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7th August 2008

cooking adventures

(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.

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7th June 2008

dude, this small world stuff ain’t funny

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

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

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

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

Bah.

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15th November 2006

Protected: Christmas cards*

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24th October 2005

Protected: Friends of Becka, unite!

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14th October 2004

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11th May 2004

It’s the same pose. The same hand pose as Rory and Jess’s first kiss as a couple. The same freaking one!!! I think that’s what’s burning me the most, even more than the sickening “My Dean” comment and the suggestions that they’re sleeping together. With DEAN.

I don’t think I’m even watching the finale, not to mention next year. Not even the sweet Java Junkie fluff could tempt me. And I want their ratings to go DOWN. Bastards. The whole bunch of them.

It’s going to be a while before I remember how much I really did love this episode.

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    • End of the year reflections January 1, 2022
      TV shows watched: The Great British Bakeoff, Shadow and Bone, Bridgerton, Avatar: The Last Airbender, Ted Lasso, Long Way Round, Long Way Down, Long Way Up, Star Trek Discovery, The Mandalorian (season 1), Wandavision, The Falcon and the Winter Soldier, Loki (am I missing any?) Movies watched: Tick, Tick … Boom, Single All the Way, […]