Want

I have the oddest feeling my computer is about to crap out. If it can just hold on for about, oh, 6 months after I start my residency then I can buy the good stuff.

August is almost over. I will have to thank the FM dept for *nicely* trying to convince me to not do pathology. I can't wait to do my clinical path month, I still need 1 more letter of rec. The gym has been going well, although I'm still too chicken to do spin class just yet. Thought I need to work on some cardio/strength training for a while before jumping into spin. Don't want to make a total fool of myself in front of the entire class by going into cardiac arrest.

Can we hit the "easy" button and just have match day magically appear?

August is almost over. Yay! I'm one more month closer to being done, being out of the house, and being on my second path month! Clinic has been very challenging for me, especially since I don't like clinic. There was one couple this past week that literally talked for about 20 straight minutes. After that I was so drained I just wanted to go home, shut myself into my room, and not talk to anyone. One more week, I can do it!

Speaking of clinic, seems like I've either caught some stomach bug or eaten an egg full of Salmonella. Which is why I'm unfortunately missing High Energy's reception :( I was really looking forward to it, but I feel like poo and my stomach cannot be trusted. I'm sure she and her new hubby will have a wonderful time! I'm totally pumped for her. That also means I didn't go to free clinic and now I HAVE to go next weekend to make my FM requirement.

So, did anyone realize it's going to be September in about another week? Yikes! I still have to get 2 more letters. Kinda freaking. GOT to get those done next week. Will probably miss another morning of clinic. Blah.

Hope everyone's rotations are going well.

And I run

I run so far awaaaaay.

I'm doing better after my little rant. I think people just get too wound up with stereotypes and their own personal opinions and don't see the forest for the trees. I'm sorry for anyone who was in the wake of my rage. No worries, I'm still doing pathology no doubts.

Anywhoo, clinic has been entertaining this week. My favorite was the Dilaudid druggie who ran (literally RAN) out of clinic when security was called. We just wanted him to leave, but I suppose he thought he was going to be arrested. his story as to why he's had multiple doctors write him Rx's and had them filled at multiple pharmacies was that his identical twin brother stole his identity. Priceless. I have a deep, seething hate for drug addicts. At the same time I have a pity for them as well. Mainly, we'll get you help, but I don't appreciate your crap. Give it up. I also have the power of a very confrontational personality on my side.

I'm looking forward to next month. I'll be back in the path dept. i'm not looking forward to sending my application (it's almost Sept ALREADY?!) and asking for the last few rec letters. My meeting with the dept chair went well, and he enthusiastically agreed to write me a letter. I really do love the path chair. He's an amazing teacher and so supportive. I wanted to give him a hug, but I feel that it would have made the whole meeting awkward. I'll be getting my second path letter sometime next week, and I need to find someone to get me a letter from another dept. My medicine attending hasn't answered back, but I may get one from the family medicine people. I've got 26 places on my list right now. I think I exhausted all the places where I'd be ok living for the next 4 years.

Enough of talking about things that make me want to drink.

Joined a local gym (again) today because 1. the school gym stinks and 2. school gym parking stinks worse. I didn't like the fact I had to wait until 5 pm every day in order to park by the gym. Or anywhere near the gym. I'm pretty disgruntled by the parking situation at UMC anyway. Although, I'm excited about Spin class. I've always wanted to try it, and they have one at 530 pm on weekdays. I'm definitely going to try to go tomorrow. Hopefully I'll survive! haha. I gotta get more serious about my whole new year's resolution to run a 5k this year. Maybe the Blues 5k in December?

Catch you on the flip side.

Pity Party

I'm just going to take a minute and whine about my life. Why is it that the ONE year I'm applying for residency everyone and their mother wants to freaking do path? I mean, NO ONE did it last year. Now there's a guaranteed FOUR people doing it. WHY ME? And I'm getting pretty fed up with people telling me that I'm too not socially retarded to do path. I should do medicine. Ugh. Fine. I'll tell patients how I really feel, sit and look at you with a "you're an idiot" face and then fail to respond appropriately to any questions. Will that make everyone ELSE feel better about me doing path? ugh. And don't get me started on my residency application. My CV is as fluffed as it's going to be. No, I didn't win who's who for medical school, or get some fancy award. I'm a vanilla (literally) average run of the mill student. I'm sure the same 5 people are getting all the awards, just like it was in high school and undergrad. And I'm sorry I didn't make a 270 on Step 1. And  score still isn't good enough and puts me below average for pathology. Meaning I should apply for 30 or so programs, to make sure I can rank no less than 8 (preferably 11) programs. Which, if EVERYONE didn't decide to do path, I wouldn't be in this situation anyway.

F my life.

Can you tell my dean's meeting wasn't what I expected?

In other news, I'm still chugging along with my Family Medicine clinic rotation. It's my last week at one clinic, then i'll be switching and going to the other. I'm also in the business of trying to get rec letters. I have a meeting with the dept chair tomorrow, and I'm kinda freaking out about it (and not in the good way). I still have to decide who all I want to ask within the path and other depts. My personal statement is crap and my personal life is crap.

More importantly, I need a vacation.

Hope all is well with everyone else. About to head to preggo's shower then out with some friends for mexican. Margaritas fix everything.

And, before I leave, let me just share something with you all that never fails to leave me smiling:

KITTY ALMOST IN A BAG!

KITTY IN A CAVE!

KITTY IN A CHAIR! (about to attack)

On Fire

It's hot. Like, you walk outside and burst into flames type of hot. I think I'll pull up weather channel and apply to every program in any state where the temp is below 90 degrees. This is ridiculous. Heat index was 113 with an actual temp of 105. Seriously? ugh.

However, I finished my anatomic pathology month. Freaking loved it! I only got to see 1 autopsy, which was disappointing, and didn't get to see any limbs grossed in the lab but it was amazing. I seriously miss it. I was so sad I didn't get to go today. Instead I went to family medicine clinic. It was ok, just clinic. And not path. However, I told them if they could get me some quick stains and a microscope I'd read all paps in house. They just thought I was kidding....

This week will be full of meetings. I have my dean's letter meeting (um, still gotta do that personal statement) and a meeting with the chair of the path dept. I need to start asking people for recommendation letters, so I'm sure I'll have to miss a bit of clinic here and there. Hopefully it won't be a big deal.

I also got to see my amazing friends this past weekend. It was kinda lacking since one of the original gang is all married and living elsewhere and couldn't come :( She was there in our thoughts, however. we did stupid stuff like watch Jurassic Park and made dinner and went to the pool. It was a "boys are crap" weekend as well, as me and a friend of mine got screwed over. We didn't let that ruin our fun! And my friend M has two kittens. Tiny tiny, probably 4 weeks old! One of them even peed on me (too young to hold it for long) which caused a very long laughing fit by the 3 of us. Good times, I miss my girls! I'll be going  back and seeing them soon.

Anywhoo, everyone seems to be chugging along with rotations and such. I'm sure I'll have great stories. My story of the day was a 16 yo with chronic pain, needing lortab, who mysteriously disappeared (along with his mother) when we asked for some urine for a drug screen. At first he "couldn't pee" and when they realized he'd be given all the water he could stomach, they systematically disappeared. Ahh, life of direct patient interaction.

That's Frowned Upon

So my 2 weeks on the coast have been cool. Dr. Rub is cool and laid back. The rest of the docs are great as well. The only problem I have is I feel like I'm being held back a bit, but I've just started doing my thing and it seems cool with him. All in all I'm enjoying family medicine. The clinic is full of personalities and the running quote seems to be "that's frowned upon". They all crack me up. I've become a pro at flu swabs, flu injections, and HbA1C checks. Although it does slow me down to document all of it, but I understand how it's necessary for the program and blah blah.

I haven't done as much as I had wanted down here, especially since it's been channeling Seattle and raining at least once a day, if not 5-7 times. I still need to drive down the beach, get some sand between my toes, and perhaps make it out to one of the barrier islands. I'm not sure if I'll make it to the New Orleans Aquarium or the Mobile battleship, but maybe I can. I'll be home this weekend to say bye to my mom before she leaves for Italy so that takes out some possible trip time. If not, I can always come down and visit my friend and do some of the things I may just not get around to. However, I did get to eat my crab legs so I'm all set for now. hah.

Warning: if you are a fan of Obama or his health care policy, quit reading.
*start rant*
So with the little free time we get in clinic, I've been talking with my preceptor about the future of medicine. "Free" Healthcare. Let me ask you something: when has anything in this country been free? The only two things in America that are free is speech and will. I'm tired of this notion that magically we won't have insurance premiums and copays. Do you know what all the other countries do to pay for "free" healthcare? They raise taxes. THAT is how they get the money to fund healthcare. Use whatever brain cells you have bouncing around in your head, rub them together, and make the connection. Bitching about $4 a gallon gas? How about when it goes up to $8 a gallon. Oh, and angry that 40% of your paycheck goes to taxes? Try 60%. OH! BUT HEALTHCARE IS FREE!
Health care is not a right. Just like I don't have the right to walk into a store and demand free Prada. This country was built upon the notion of an open market with competition and democracy to fuel development. Whenever monopolies occured, they were quick to step in and open the market back up to prevent such things. Same for healthcare. Monopolies of insurance companies have caused the price of healthcare to skyrocket, paired along with the uninsured receiving healthcare (if you say that's what the healthcare reform will fix I'll automatically set your IQ score to 10) without paying for it, and the sue happy lawyers creating a new entity known as defensive medicine. I'd really like to see how much of a yearly hospital budget is spent ordering tests just to rule IN a disease. Also, how many times have I (and my insurance company) been billed two or three times for the exact same test? That is just the hospital trying to make up for the fact that the crackhead walked into the OR and got treatment and then walked back out without paying a dime. Medicine is a business. Plain and simple.
So, if I have all these strong opinions then where is my bright idea to fix healthcare?
1. reign in the insurance companies. Open insurance across state lines. This will drive the cost down by sole competition. If an insurance company in Alabama is better than Louisiana, then buy the Alabama insurance. Health insurance as it stands is a monopoly of 2-3 lone companies. Places like Alabama have a monopoly owned by Blue Cross and Blue shield. Open it up so the insurance companies will be fighting for YOUR business instead of the other way around
2. Stop the lawsuits. We have something called the Medical licensing board. If a patient things that a doctor was unfit to treat their loved one, the bring it before the board. Instead of suing the doctor and driving upmalpractice insurance which causes higher costs for treating a patient, take it to the board. if the doctor really is at fault for negligence then his/her license will be revoked. And that physician will never be able to treat anyone else again. But I guess money is more important than seeing that the physician never harms anyone else again. If anything, mandatory tort reform (which, for the Obama supporters that continued to read despite warning, Obama DOES NOT support. he thinks you should be sued for every penny you're worth. which sometimes is a negative vaule seeing how many physicians are still in debt from medical school). Consequently, capping or stopping lawsuits will eliminate a lot of the defensive medicine. which includes extra costs for hiring the sheer manpower needed to file and process paperwork (which will only get worse if nationalized healthcare occurs)
3. No more free rides. Sure, if someone is in a car accident then bring them into the ER. The people who come to the ER when their problems can be solved by a primary care physician should be turned away. Because the $2o0 bill you're going to rack up and then end up leaving without paying is more expensive than the $75 charge by a PCP to tell you to take some zyrtec. And this bullshit of bringing a kid to the ER at 3 am for an earache that has been present for the last 2 days (and hasn't gone to a pediatrician yet) needs to stop. Step 1: take away kid Step 2: escort parent out of the ER. This alone could drive down the costs, ER crowding, and hospitals driving up costs to cover for those they don't get reimbursed.
Ok...that doesn't cover all my ideas, but just some that i"ve been having the past few days. Basically, it's like me walking into a lawyer's office and telling them they're doing everything wrong and THIS is how it should be done. Oh, and try to tell a lawyer that they don't need to charge for their time and they'll just receive a flat salary per year then get out of that office without being punched in the face. What we have are a bunch of lawyers and politicians deciding how Medicine should be handled and executed. Ones who tell us the process of diagnosis and treatment without EVER suffering through one gross anatomy lab or a sleepless night surrounded by pharmacology flashcards. These are the people America is trusting to take care of healthcare? Not doctors, but politicians. I guess the next time you have a runny nose just call up your local state representative.
Just think, America.
*end rant*

I'm pretty pumped about the Grey's premiere tomorrow night. I'm glad that the lady I'm staying with is also a Grey's fan so I can catch the episode.

Two letters-I can't wait for our date
Laura-your updates thrill me to no end. And that pic of you as a child giving the camera the classic "go to hell look" makes me laugh.

So I'll post more on my wonderful experience with my preceptor after a full week, but I just have to say one thing on why I already love the clinic.

they use a microscope to look at urine samples. Yes. They spin them down, put them on a real slide, and use a real microscope. Let's just say that I got really REALLY excited about this. So even if Family Medicine turns out not being my thing, I can rest assured I'll still get to use a microscope.

Hoorah!

On the Road Again

So, for the record, everything on my Dell has been replaced. New harddrive, new keyboard, new screen, and now new motherboard. I hate dell. I'm getting a mac the next time this thing craps out.

I'm leaving sunday for my last 4 weeks of family medicine. I'm so completely pumped. I'll be near the coast and my friend from college, I've got a list of stuff I want to do, and best of all I get to move out for a month! the only down side is that I'll have to move back in.

Family medicine has actually been really fun. I'm still trying to decide if I'm good with people or not. I think this next month will be excellent to see that. If I can do a clinic environment day in and day out. I'm excited to find out!

Well, hopefully I'll have some good stories of some of my adventures. I'm planning a trip to Ship Island, NO aquarium, and the battleship in Mobile. i'm sad to leave Baptist but excited to go somewhere different for a change.

Until next time!

Discharge to Jesus

So, Family Med isn't bad at all! I didn't think I would hate it, but I didn't think I'd like it as much as I do. I don't even mind studying! I've been reading and taking notes without being told. It's scary! Maybe there's something to this "primary care" business. I think the best part of all is that I wake up in the mornings and don't have the urge to slit my wrists.

Although I think I still got too giddy over the atrial myxoma we had on our service.

So, Tuesday night my computer had some issues. Major issues. Motherboard died issues. So now I'm going to have to wait another 5 weeks to fix it. I didn't make it over to UMC in time to turn it into the laptop depot so they could fix it. Plus I'm going out of town for a month so I wouldn't be able to pick it up anyway. So I guess I'm going to just have to go without until I can get back to university. Luckily my father has now rigged up interwebs to his computer so that I can use the desktop. It makes me realize that I will always need a laptop. I miss watching movies in bed. So right now my laptop is hanging out in my trunk in case I can make it to UMC before 4pm.

I didn't realize that I'll be dealing with those "end of life" issues as soon as I have. There is this little old lady that I've been working with since I started. She has acute mental change and now has started falling apart. The NG tube is giving her a nose sore. She won't wake up or respond, but she will start saying "ow!" when you touch her legs or feet (DVT paired with now gangrene of the toes due to lack of blood). Her family insists that she's up and talking and laughing and it just happens that whenever anyone that's not family comes into the room she's unresponsive. I mean, the lady is in her late 90's. It's time to just let go. We've gotten hospice on board and hopefully she'll be able to have some peace.

We've actually been having several of our patients on the "discharge to Jesus" list. Meaning that they're not going to make it out of the hospital alive. It's amazing that I hardly ever saw that on Surgery, but get hit smack in the face with it on Family. I like it though, since I'm probably going to go into the geriatrics direction if I decide on a primary care like Fam med or medicine (although from the M4 it seems as if I won't get along with the personality types that are found in medicine. but we'll see).

Hope everyone has a safe and wonderful Labor Day.