So Mitt Romney, Presidential candidate extraordinare, is giving a speech tomorrow to address his Mormon faith. Which is all good and everything, except it’s going to be so serious and “all about family” and how “we’re just like everybody else”. And I gotta say, being Mormon has some quirks and perks that are just unbeatable.

10. Funeral potatoes and frog-eyed salad. At every wedding, funeral, relief society function. They make the world awesome. *ignores the other staple of lime jello with carrots*

9. Single wards. Been part of them for 10 years now. They’re like bars for hookups, only without the gross drunken come-ons, and you don’t have to do the “left hand search.”

8. Mo Tab (aka Mormon Tabernacle Choir). People flock to see them like they’re a rock band.

7. Sen. Harry Reid. The Senate Majority Leader is a democratic Mormon. How awesome is that! I wish he was running for president, then I might actually have somebody to vote for.

6. Napoleon Dynamite. Except for Borat, there ain’t a more (annoyingly) quotable movie around. Gosh!

5. Garments. Not only do I never have to worry about the butt wedgies anymore, I’ve got an extra layer of clothing to keep me warm in the frigid Midwestern winters.

4. Ken Jennings. Yes, it was annoying that he won over and over again. But you know that in your heart of hearts, you were cheering him on. Now he keeps a blog and he’s seriously nerdy and funny. And smart. Does your religion have Ken Jennings? I didn’t think so.

3. Mormon movies. No, not the recent travesties such as The Singles Ward and sequels/prequels. We’re talking the 70s and 80s Church approved videos. Especially worth checking out are the annual classics, Nora’s Christmas Gift and Mr. Kroeger’s Christmas (Jimmy Stewart’s last performance, I’ll have you know). Also highly recommended: Pioneers in Petticoats, a good moralistic commentary on immodesty that will warm your feministic-hardened heart. Lastly, I defy you to find better entertainment than Johnny Lingo and his eight cow wife.

2. President Gordon B. Hinckley. For being 96 years old, he is amazingly spry and witty. I’m such a fangirl ( did I tell you about the time I got to shake his hand?) and I wanna be old like him.

1. The horns really come in handy. As do the multiple wives.

***

I’m really get tried of shoveling snow post call. I’m already done with winter.

My annual review went well. Only one mention about my conference attendance, which I did get to defend myself about. Overall, they’re not threatening to kick me out of the program. But I gotta finish my license application or I’m going to be in serious trouble.

Call was so busy for the first part of the night. We went from 1 patient yesterday morning to 7 this morning. But I got to do two subclavian central lines last night, which was the first time I’ve done a subclavian. I find them much more terrifying than internal jugular lines because there’s lungs and a big fat artery that I risk hitting. No complications this time.

And now to bed.

Seriously, Julia, next time you bemoan having only 1 patient, recall the afternoon of December 4th when you admitted 3 patients to the ICU within a half hour. Remember me, Future Julia.

Another long call night awaits…

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!

Shoveling snow is bad enough. But shoveling snow post-call after it snowed, then rained this morning, then froze this afternoon was torture. Now my hip and shoulder are killing me.

Anybody wanna play Santa Claus and provide me a snow blower?

I’m doing a week in the NICU (neuro ICU) with my favorite attending. Yay! But we have no patients. None. There is one patient in the ICU. One, and it’s a not even a real patient, just a consult from the neurosurgery service. *sigh* While I do enjoy a lighter service and more free time (guess I’d better catch up on all of my dictations, eh?), I rather not have those times be on rotations that I really enjoy and where I really need to hone my skills. If I do decide that critical care medicine is what I want to do, which more and more seems likely, then I’d like to be competent enough at lines that I can do them without assistance. And I’d really really really like to be able to do an intubation or two. And a Swan Ganz.

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.

I’m so sorry. I forgot.

You were such an enigma of symptoms that I got caught up in working you up, and then when it took me so long to get all of the different consult teams involved, it almost became a comedy of errors when I came to see you in the morning. “Sorry, Radiology thinks we need to get this one test, Surgeon X thinks that it’s too small to biopsy, Team Y doesn’t think it’s anything serious.” I was so excited when I got the right people to see you, the right consult, the right tests. Things came together. I got the tissue and sent it off to pathology and was excited when finally, after weeks of uncertainty, I had the diagnosis.

Melanoma. Finally, I could call in that last consult to hematology/oncology and start you on the right treatments. Until I realized. Metastatic melanoma. Stage IV. There were no treatments that could cure you. You, young and healthy, you are going to die and I can’t do anything to change that.

I’m sorry. I’m sorry that I couldn’t tell you that you are going to die. I’m sorry that I couldn’t tell you that there isn’t a cure. I know that I failed you as your doctor by being less than honest, by leaving that task to the cancer doctors. I couldn’t do it, because I had already sat in the team room and cried and there was no way that I could maintain composure if I had been the one to say the words. I’m sorry, because suddenly this was personal and all I can think of is the two little kids you’ll leave behind and the fact that with your limited days, you had to spend too many of them in the hospital, waiting for us to do the detective work and I had been so flippant and rushed in my morning assessment that I forgot that we are human and frail. Maybe that’s the hardest part of all.

My patient told me that [they] were going to die. I had come up to see them as they were having some difficulties and not getting better with the treatments that I had ordered over the phone. Patient looked anxious and uncomfortable, but vitals signs were stable and were certainly nothing to worry about. I ordered some tests and stayed there, while we started some treatments, reassuring that everything was okay and to just calm down. And I watched, horrified, as eyes rolled back into the head and the lungs stopped taking in breaths. Within seconds, the pulse was gone as well.

This is the second time that a patient has died in front of me and it felt like deja vu (really starting to dread the 5-6 o’clock hour). I felt only slightly more competent this time, listening for breath sounds, feeling for a pulse, directing the chest compressions. The medical ICU team was there within minutes and took over directing the code. I won’t go into any more details as to what happened next, because this is flirting close enough to HIPAA noncompliance, but as always, it’s really causing me to doubt me as a physician. I want to do critical care, but I just feel like a fish out of water in these situations. I know that it’s lack of experience, but there’s a big part of me that instantly defers when others arrive on the scene, and that’s wrong. I should be taking charge. I should know enough that I’m making decisions instantaneously–that why we learn the algorithms so it becomes second nature. And of course, there’s that part of me eating me up inside, wondering what I should have done sooner, faster. I chalked up the complaints to anxiety, when there was something seriously wrong. Am I that bad on my assessments? Even looking back, I still think that that I would have acted in same if I did it over again and that’s not good.

I was going to write more about my date tonight, but I got three hours of sleep this afternoon and I am utterly exhausted. The short version: I had a great time, I like the guy (as in, I haven’t found anything yet that is overwhelmingly a turnoff, otherwise, I’m still being cautious), deer hunting is loads of fun, and he gives pretty good hugs. 🙂 Look for more tomorrow.

That, I think, was the hardest call I’ve ever had. A list:
~~ 5 floor consults, one who was pretty ill and got transferred to the ICU right after I saw her.
~~2 (and 1/2 – I punted to medicine on the third) ER consults that I discharged home).
~~4 ICU admissions, two of whom arrived at the same time and were both quite ill.
~~10 calls from outside patients– my favorites were the 2 am call because patient had had gas and some slight diarrhea for 24 hours (which was improving!) because “something wasn’t right” and the 4 am call from a patient who had taken a bath and noticed a new, non-ithcing, not inflamed, not warm slight rash and just wanted to know what it was…!!!!).
~~1 floor admission (thankfully NOT to stroke).
~~1 patient who crumped so suddenly that it was all that I could do to keep them alive overnight. That was a four hour ordeal of calling my fellow, three different attendings and trauma surgery and general surgery and just praying that I could figure something to do.

Luckily there wasn’t an acute stroke or I really would have been screwed. But I managed, even with my lazy louse of a senior resident who got something like 6 hours of sleep (and I got 10 minutes with my head on the desk), who just managed to succeed in pissing of those I was doing consults for. I finished my notes at 7:00, ran around and put them in charts, signed out the consults that needed to be seen, prerounded on the ICU patients (which took all of ten minutes, since I had been glued to their side all night long), wrote my notes, rounded with my attending (he’s my favorite, but oh, he gets so painfully distracted when I’m just itching to leave!), called radiology to beg for an MRI, talked to anesthesiology to get the patient intubated so we could get said MRI, wrote transfer orders, and finally walked out the door, where I turned the air conditioner on in my car so I wouldn’t fall asleep driving home. And now I’m home and utterly exhausted and will be sleeping for the next 12 + hours.

Good night!

Please somebody remind me why I’m doing neurology.

I had thought my experiences last December were due to my wonderful resident. Now, I’m realizing that the attending probably contributed to it as well, as he has certainly made these last few days less than tolerable. He yelled at everybody yesterday, which I missed because of clinic (never have I been so grateful for clinic), so we all arrived extra early to have the precious notes finished just the way he liked them, only to find myself the target today. I gave up counting the snide remarks because I was pretty much fighting back tears for most of rounds.

I have a patient to staff who I refused to admit the other night on call, who actually did have a stroke. It’s been eating me for the last two days, when I discovered the confirmatory scan, and tomorrow I get to present why I didn’t feel like I should admit an obviously ill patient (however, in retrospect, I still maintain that I was right in my decision, I just don’t know if I’m going to be able to defend it).

I’m clinging to the nice moments, of meeting up with Sonja and Satya, who reminded me that they loved working with me (and oh, I miss them and the MICU and the laughter and call nights…) and I’m not a horrible doctor (just a rather horrible neurologist). Running into Aaron who greeted me with a large, toothy grin that warmed me to the bottom of my toes and made it seem like November again.

The crush is fading. Maybe sleep deprivation. Maybe because I look/am ridiculous and Stephanie Meyer books aside, nobody finds the klutzy behavior cute (I’ve dropped my knife, my fork, all of my papers, my pager, tripped on my own feet, knocked over a tray trying to squeeze by someone, all in front of him. I’m really not usually this bad). Maybe the fact we’re all so battered that we’ve lost any fun loving spirit and we’re all grouchy and ugly to each other. Right now, I don’t even care.

I decided to make a list. I don’t know why.

– Crush news (which right now, is ever so much more interesting than patients and their neuroanatomy): He has a freckle on his right ear lobe, and a faint, thin scar down his right middle finger. His hair curls across his forehead (it’s such a good thing that these many many years have trained restraint!) and he’s had his beard for as long as he’s been a resident here (as evidenced by his name badge) which manages to hide a very small dimple and I can’t find adjectives to describe his blue eyes. And he has really bad breath post call. Oh, and he owes me big time for doing his discharge summary for him. Am I wonderful or what?

– I had a wonderful weekend. Saturday night, when I woke up from the post call coma, I went to the symphony with one of the neurosurgery residents. Mahler. My dad used to love Mahler, but until Sat. night, I never understood why. I’m now addicted. Absolutely lovely.

– Sunday I went to watch conference at my bishop’s house, which is always a spiritually uplifting time. Pres. Hinckley is still looking amazing for his 95+ years. One of the guys there hugged me and reminded me that it was exactly one year since we had met. I had forgotten. I thought that was sweet.

– It was the first day off that Chris and I have had off together in 2 months, so I drove up to Madison and spent the afternoon and evening with him, fixing his bike, eating Vietnamese food, and digging through all of his music collection. I came home with 300+ new songs and all of his pictures from Ireland and Scotland. Scotland was incredibly gorgeous from his pics… I guess I’d better add that back to the list of Must-Go places.

– Chris broke up with his girlfriend. And didn’t tell me until I pressed. Okay, I think I overlooked a big dropped hint earlier in the evening, when we were putting together pictures for a framed collage, but still. *sigh* Anyway, we had a great talk sitting on a park bench overlooking the lake. I told him about the many dating woes of the past two months. He thinks I’m missing clues (I think that no reciprocation and avoidance of conversation afterwards speaks volumes). He’s thinking about taking up Match.com dating, which I can’t wait to see how that goes. 🙂

– I’m still really bad at music guessing games. Apparently I need to listen to more Phish and Eagle Eyed Cherry(ies?).

-He beat me on the word games as well. The Word of the Day emails are not helping.

-I’m not on call again until Saturday. !!!

–The Seeker has gotten terrible reviews and didn’t do so well at the box office. Maybe that will stop any sequels.

-Still can’t figure out exactly what you do on Facebook, but at least it lacks the ads and spam of Myspace. Am trying to collect friends like mad over there. Perhaps I will make a trophy wall with all of my friends. I guess I need to add more photos, or so a little bird told me.

-I’m reading New Moon right now, as I finished Twilight a few weeks ago on call (man, I miss the ICU call). Liked Twilight, although spent a majority of the book irritated at the heroine and her love interest. I’m really looking forward to reading this, after mulling over valancy_s‘s recent posts about why we go for vampires.

-Congrats to Michelle and Kelly! Maybe, hopefully, I’ll be able to see this little one before he/she’s 40 (are you going home for Christmas?)

-I love Matchbox Twenty. This new album is just gorgeous as always.

– You all are watching Friday Night Lights, right? You’d better be. Best show on TV right now. I’m watching it online, so what’s your excuse?

-Clinic tomorrow. Only 3 patients. Maybe I’ll actually finish on time (and possibly get my notes done, that would be amazing).

It’s going to be a long month two long months. Rounds today lasted 6 hours. 6 hours to see 8 patients. No discharges. I didn’t get notes in the chart until 5 pm. I didn’t even have my morning orders written until 5 pm. Oh, and did I mention that I know nothing about my patients…why they’re there, what kind of strokes they had, what kind of interventions, and what kind of work-up they had had. No clue. I looked like an incompetent moron (the intern who’s gorgeous, btw, asked me if I was post-call. He was, and didn’t act it at all), which got worse when my attending started pimping me on differential diagnoses of syndromes that I’ve never heard of. I’ve got families demanding updates on when their loved one is going to be discharged (no clue, sorry), juggling showdowns between dueling services (the neurosurg attending’s opinion of me is even lower, but I don’t care as long as he does something surgery-like), and trying to find social workers and case managers to see if I can’t get somebody home tomorrow. It made for a very, very long day.

But my attending does one of the best neuro exams I’ve ever seen and he’s unbelievably brilliant (and is starting to change my opinion that neuro docs don’t know much about general medicine) and wow, I wanna be just like him.

I’m on call tomorrow, where the chances of me even getting 5 minutes of sleep are pretty slim.

Oh, and I really need a better reflex hammer.

*sets alarm for 5 am*
*crawls into bed*

Schedule for tomorrow:

6:30 alarm clock will go off
6:30.05 snoozer will be depressed
repeat every 9 minutes for next hour
7:30 awaken in a panic
7:35 shower in a panic
7:50 dress in a panic
7:59 shove papers aside in a panic looking for scheduling ticket
8:10 leave house ten minutes later than planned on, hope testing location is easy to find
8:30 arrive at testing center after missing a turn, not being able to find building and driving around in a panic
8:35 hand over cell phone, backpack, all papers
8:40 listen to instructions about how to click buttons on a computer and to keep my identification number with me at all times.
9:00 start multiple choice questions. 7 blocks. 50 questions per block. 60 minutes per block. I’ll be done with each section with approximately 10 minutes left. This amount will increase with each section.
11:20 Ten minute bathroom/water break
12:30ish Lunch break
4:30 Finish with test. Have major migraine. Neck stiff. Brain beyond dumb. Can’t tell you how I did. May have passed. May have not. Don’t really care anymore.
5:00 at home. Will splurge and call my friends, who I haven’t spoken to in at least a month. Hope I don’t cry.
And Saturday, I get to wake up and do the whole day over again! Yay!

No magical ball or fortune-telling here. Just exhausting, repetitive experience. It’ll be four blessed years before I have to go through this (officially–I’ll be taking “in-training exams” that are oh-so-similar twice a year for the next four years, but thankfully, those don’t count for anything), and that’s what’s keeping me going.

Wish me luck?

So, my little hometown apparently has two escaped convicts on the lam. Murder convicts at that. Luckily, it appears they have left town and were spotted 40 miles away, so I can stop freaking out about my parents’ safety. It’s a town of about 250 people, where nobody locks their house or car and we live out away from town–not the best combination with unsavory people around. The sheriff’s department is receiving a lot of flack about the escape (and they should receive some criticism about safety concerns as this is not the first escape and to the department of corrections who should have never put such dangerous criminals out in a county jail to begin with), but I’m really getting tired of reading all of the news articles, editorials and comments from people who really have no idea how small towns work and how truly small my little hometown is.

*grumbles*

In other news. I have the day off tomorrow. What I really, really want to do is get in my car and go driving up into one of the nearby lakes, have a picnic lunch and take pictures of the gorgeous fall leaves. Instead, I will be cooped inside studying, because I take Step 3 on Friday and Saturday (2 days of 8 hour testing! YAY!) and since studying during my ICU month wasn’t nearly as productive as I had hoped, I will be doing some major cramming. I’ve found it very difficult to study on my own–for the past how many years, I’ve had a partner, and even if we did most of our studying separately, at least you knew there was equal suffering and if you had a question, then you could bounce it off and come up with the answer. I’m horribly distracted when I’m by myself (I watched the entire first season of Friday Night Lights in the last week. Not good. For my studies, that is. The show is awesome and I’m addicted and I promise, it’s not really about football and I’ll stop now). Also, I haven’t found a good study place–I found a coffee house just around the corner that showed promise–until I saw that it closes at 4 pm!! I miss my Beehive Teahouse or Coco’s Cafe (yeah, I’m a little homesick right now).

All I need to do is pass, because retaking this thing would be nightmarish.

I return to the neurology department on Sunday. Which I’m not exactly looking forward to. I really had a great month this month (even if I didn’t get the number of procedures that I wanted: 3 central lines, 1 that was a failure, 2 arterial lines and I missed both of those. No intubations. Bugger. Oh, and not one real code. Still useless at ACLS.) and any change isn’t going to be as good. I’ve been away from neurology for so long, that I really don’t feel like a part of the department–I’ve been left out of social invitations, I haven’t been able to go to the business meetings, etc. Plus with all of the drama recently over call schedules, well, I don’t want to get sucked back into all of the (pointless) drama.

2008 marks the 100th anniversary of the publication of Anne of Green Gables. 100 years, can you believe it? Wow. Prince Edward Island, in continuing their traditions of pandering to the tourists, is celebrating the occasion with year long festivities. There’s a big part of me, that pesky, sentimental tourist (I do realize that I’m a hypocrite, but not so much that I can embrace the idea of “meeting” Anne and Diana in the streets), that really, really wants to be in PEI for the festivities

Of course, equally verbal in the inner dialogue is the frugal, money-panicked me who is trying to calculate airfare, lodging and transportation costs and wondering how I can possibly save up the money plus get the snow blower that I so need to make this winter more bearable.

Choices, choices.

Anybody inclined to tag along?

***
Today was my day off; 16 days without any time off is a very, very long time to survive. I was getting a wee bit punchy by the end. I only accomplished one thing today… I slept in until 11, which was exactly what I wanted to do. 🙂 I got up in time to prepare my lesson for church (on marriage, which everybody groaned when I mentioned the topic, but I think I pulled it off well–got a few laughs and some good discussion until the end where it veered off into pointless tangents), went to church and then have spent the rest of the afternoon and evening on the couch, doing absolutely nothing. It’s been great. Unfortunately, I’m on call tomorrow, so the reprieve was very short. Hopefully, this call will go a little nicer than the last, and I can actually get a few minutes or even better a couple of hours of sleep. Last one, I came home so exhausted that I went straight to bed and woke up around 3 in the morning. Hence the reason for no posts recently.

I take Step 3 of my boards in 12 days. I’m starting to get nervous now, because I really have had little time to study. And I still can’t tell my dermatologic diseases apart. All of this schooling and training and I still don’t know half of what I really ought to know.

I hate the neurology department. I am so close to just walking up to them and just quitting, because it’s been a long time since I enjoyed myself and I’m sick and tired of the laziness of the senior residents. The only part of neurology that I like is the neurocritical care and I can do just plan critical care from the medicine side and be done almost 3 years earlier.

“If a senior is delegated intern work from another junior resident because of a lack of their in-efficiency or work-ethic then perhaps we should re-evaluate who we are accepting into our program.”

Bastards.

My iTunes is in a sappy mood. Frank Sinatra, Dean Martin, Phantom of the Opera, Vienna Teng, Eva Cassidy, Josh Groban all have rotated on in the last hour. Hmm. I don’t know what it’s trying to tell me.

All I know is that I’ve been reading about some of the discussion in reducing resident work hours from 80 hours to 72, and limiting it to 24 hours straight, rather than 30. Half the posts are about how all it does is train physicians to be sloppy and less dedicated and less educated. And that’s enough to make me cry. There’s a nice post here about Labor Day and resident physicians. England is going to a 48 hour week for its residents. 48 hours. I can’t even imagine.

More blogs:
http://fatdoctor.org/2007/09/03/doctors-labor-day/
http://www.hourswatch.org/
http://pandabearmd.com/blog/2007/08/23/in-which-your-uncle-panda-rips-off-the-lid-rolls-it-in-a-tube-and-places-it-politely-where-the-sun-doesnt-shine/

My program is quite good about getting us out within the 30 hours. I usually am out in 29 hours. And I usually only feel exhausted and overworked when I’m on call and unable to claim more than 15 minutes of sleep with my head on the table. Those are the hard nights and it depends on the rotation of how frequent they are. My last two calls have been unbelievably sweet. No new admissions. I went to bed by 11 pm and didn’t leave my room until after 6 am. Saturday night, I didn’t get a single page all night, until 4:30 am. But I sleep with a light on and I wake up every 20 minutes or so, worried that I am missing something. I still go home in the morning absolutely exhausted.

I worked today. In the hospital by 7:30, didn’t finsih until after 3. And it was a holiday, but I didn’t get paid extra. I don’t get time and half. My paycheck states that I work 46 hours a week, isn’t that nice.

*sigh* Sorry for the negativity. I came home from the hospital after spending over an hour trying to get a foley catheter into a man with prostate cancer, with a bad migraine and my smoke detector beeping every 3 minutes because the battery was dying. So I’ve never gotten rid of the headache. And sometimes, it really depresses me that this is what my life is like and it won’t ever get better.

I’ve got a date tomorrow night. I’m a dating machine, I guess. Either that or a masochist. Different guy, one that I find conversation with to be somewhat stilted and painful, really. But he was the medical student on the neuro wards and my friends were raving about how great he was (which he is a very nice guy) and they all seemed to enjoy talking to him, so I decided to give him another chance.

We’re going to a baseball game. I apparently don’t learn my lesson. Luckily, it’s with about 40 other people, so there will be a chance to engage others, if we decide there’s nothing to talk about and the game goes into extra innings.

And I’ve got clinic tomorrow morning and have to round on my patients before rounds. Oh, and did I mention that it’ll be another 14 days before my next day off (16 days total)?

Okay, iTunes is now playing Enrique Inglesis’ “Hero”. It is definitely time to go to bed.

It’s rather comforting to know that I spent enough time doing call last year, that even after not doing it for two months, it all comes back. Of course, still haven’t had to run a code *knocks fervantly on wood…except I need the experience…so maybe I should be wanting it*

Have I mentioned recently how much I love the ICU? Seriously, this is going to be one tough month (I already inherited one of the sickest patients on our service), but oh, it’s going to be good. Procedures (I may get to intubate!), very knowledgable nurses, and an unbelievably fabulous team. Two of my favorite residents from last year are on the team and now we’re collegues, rather than resident/intern, so it’s even more fun. Right now, Sonja and I are watching House. If only things were like a tv show.

Orkin came by and evaluated my house, did I mention that? Two small holes, no evidence of mice inside the house, and certainly no enough for me to justify the expense of having them come every two months. So I cancelled the service. I have to patch the holes myself, and there’s been a mouse spotted, running across my back door, so the sooner that gets done, the sooner I’ll be able to rest in peace. I’m just glad that I was overreacting. 🙂

When my family came and visited, I introduced my sister to Doctor Who. She watched the whole first season while she was here and then, I, being the wonderful sister that I am, lent her the second season. She finished it, loved it appropriately and mailed it to me last Tuesday. Priority. It’s now A WEEK LATER and I still don’t have it.

!!!!

I’m about to start a search party. With torches and flyers. Who’s with me? My poor DVDs. Luckily, she insured them, but, oh my babies! *sniff* I’m going through withdrawals! I tried to watch my X-Files DVDs last night to make up for the loss, but I’m on the early part of season 4 and the episode was Home, which I have to fastforward anyhow because it’s too disturbing (I’d skip it entirely, but it has some of the best Mulder/Scully snark of the entire season) and it just didn’t make me feel light hearted and schmoopy. And I’m in the mood for some DW schmoopiness. Either that or dance movies. I got a hankering to do a Strictly Ballroom/Shall We Dansu/Shall We Dance (should I add in Havana Nights, Liz?) marathon. I’m not entirely sure what’s wrong with me.

****

It’s my last week on the “easy rotations,” my last weekend free for 3 months. I’m looking forward to next month, I’ll be in the medical ICU, but it will be Q4 call and they will be very busy calls and very long hours, so it’ll be back to the grind. I just got an email with the 18 page orientation document. 18 pages of “Thou Shall Not’s” which is just succeeding in making me irate. Nothing like treating a bunch of professional physicians as junior high schools, where we’re threatened with “disciplinary action” if we miss a conference.

Oh and to add to the fun, I’ll be taking Step 3 the day after I finish the rotation. The day after. When I tried to register for it this month, they were completely booked, I even looked as far as Urbana Ill and nothing. So, all of my free time this next month will be spent craming. Even more fun! Oh, and I’m still doing the whole application thing for my license. Yeah, I’m feeling a little overwhelmed.

I’m off to the gym, as my attendance will be sharply decreasing next month. I was doing great, down another pound, until this morning, when I stepped onto the scale and it put me back to my starting weight. The scale has been banished forthwith.

ETA: So as I step out of my house to go to the gym, I catch a flicker of movement. Tiny movement. Of a mouse scampering into the foliage right next to my house. And of course, right next to the sidewalk to my garage. I already battled a huge moth in the shower today (in the shower!!) and lost, so I’ve been a little edgy most of today. So I ran down my sidewalk to my car, having these horribly fantasies that the mice are invading my house–I haven’t seen any evidence of them inside, and I’ve had enough mouse problems in the past that I know what to look for… but, I don’t know how that moth got inside either.

Continuing. I get back from working out, open up my garage door, and there, on my sidewalk, is a huge, dead squirrel. The size of a toy dog. Dead. I don’t know if it got poisoned or missed a limb, but it’s dead. Right outside my garage. I let out a shrink, slammed the door and am now parked out front and sitting on the couch shuddering.

I don’t know what I’m going to do. I can’t touch rodents. I can’t. Live, dead, it doesn’t matter. Irrational, I know, but I’m afraid that they’re going to jump at me. I guess I’m going to have to be girly and see if my next door neighbor can help me out. Either that or one of the church guys. And I think I’m going to have to get a visit from the Orkin man, because I am not having a mouse infestion this winter. Anybody have any experience with a pest controller, as in a price range?

ETA #2 And it’s supposed to down pour tonight. Which means I’ll have soggy squirrel to deal with in the morning. Oh, and my trash is being emptied in the morning, which would be an ideal time to get rid of the thing. If I could just force myself to get rid of it! *cries*

Finally getting to do some procedures (after 3 months in various ICUs, it’s about freakin’ time!!). I got my first arterial line on the first poke… and have missed all three since then. But then… my fellow has missed on those ones as well, so I don’t feel so bad. I slid the needle right into the internal jugular with gorgeous flow back on the central line placement today, and only required a little bit of assistance to get all of the wires, scapels, and catheters in. No major bleeding and NO pneumothorax, a double plus. Hopefully, the ICU will start picking up a little more and I’ll have more procedures to do. I hope to get proficient enough that I can actually move to the teaching part of the “see one, do one, teach one” model. I’m excited.

I woke up this morning to my pager going off around 6:45, telling me that I had 2 patients to see this morning. As they were patients I was already familiar with, I paged my SMS and rolled over and fell back to sleep, intending to get up in time so I could be to work about an hour later. Of course, I overslept a little and was heading out the door right at 8 o’clock, when my pager started going off. Stat admission. Patient intubated. Patient coding… and I’m at least 15 minutes away. Luckily the cards resident was there and covered me while I raced into work, but my day was rather flustered.

Attending and I are getting along better, although I still don’t know how to read him. Right now, I’m trying to figure out how to keep my other SMS from breaking down entirely, as she’s convinced that he hates her and it makes her more flustered than she ever is when she’s presenting the same stuff to me. Being a resident in some ways is so much more difficult than being a intern, which I knew it was going to be so, but I thought more in terms of “I have to know more”, not so much of “I have to know more, and teach, and manage every patient, and direct a team, and tell attendings how to treat others and fix problems, and run codes, and…” I miss being an intern. I probably won’t be saying that come October when I’m the junior resident on Neurology again. 🙂

Think I’m making it an early night. I’ve been living on six or so hours for the last week and it’s starting to wear me down. Not good.