Holidays

Finally, a break. What I've accomplished so far: catch up on my sleep debt, get completely wasted and then regretted it the next morning, hang out and bowl with some out of town friends who are home for christmas, and chop off all my hair.

That's right. Here's the pics to prove it.
ok, wow, my nose looks big in this one.back/side view. It's a little longer in the front than the back.

It's growing on me. At first I was like "omg it's so cute" then a minute later i was like "shit" now I'm like "yes". haha. It's fun and I'm glad I cut the hair short because 1. It wasn't growing long fast enough 2. there was just too much hair 3. It's a little too short to fully pull back so it'll make me fix my hair in the mornings. I also went and treated myself to a couple of headbands. So far I've had a lot of positive feedback from people. I think my favorite thing is the BANGS.

So, beginning tomorrow I will commence the bake-a-thon. I'll be making those peanut butter cookies with the hershey kiss in the middle as well as the good ol' sugar cookie. Plus bread. Those will be what the good boys and girls get in their stockings for christmas from me this year. Since I didn't have time to buy presents (or go out in that traffic. Good lord, I just want to stay at home!) so I'll just be baking mine. I'm pretty pumped. I've also sent out christmas cards for the first time ever so that's a fun thing. I think next year I'm putting a santa hat on gryffin and doing one of those custom picture cards. I'm sure it's going to be hilarious.


Other than that I'll be enjoying my time away from the hospital. And omg, I forgot how nice wearing sweatpants and jeans as a main staple of clothing could be. yay for christmas holiday!!!

Speaking of yay, it's cold in the house. I've assumed this position on the couch for most of the day.
Merry Christmas!!!!

Saying Our Goodbyes

I think within the past week I've had to do some of the hardest things I've ever had to do.

I had to say goodbye to my dog of 16 years. I've gotten better about talking about it, but it still makes me tear up. If you're ever around me and see me tear up out of the blue, you know I'm thinking about my dog. She was old. And senile. She couldn't hear or see. She had peed on herself while asleep. She spent the last few nights of her life crying as if she was in pain. She had been my baby for the past 16 years. So on the first of two whole days I got off from medicine, I took her to the vet. I won't go more into it, but I never left her. I held her head in my hands and still pet her even after her heart stopped. I even cried in public. I miss her every day. I come home and don't see her. Today when I got home from the store I called for her to take her out (it was one of my routines) but then I remembered. It's so hard, but something I knew would come one day. I just hoped that she'd just never wake up one day instead of having to hold her and watch as she took her last breath. What's worse was that I wanted to scream "I changed my mind! put her back! bring her back!" but I knew I couldn't. It was final. It was done. She was gone.

In with that whole goodbye theme my life has recently taken, I also had to give back sweet precious little kitty. Mainly because Gryffin has spent most of his days trying to murder her. We found out that spraying him down with water was the only way to get him off her. So back she had to go. I'm really sad but I know it's better for her. I really did want to keep her. She was so so so sweet.

So really, the past week has really sucked for me. Not only because of my overanxious partner (granted my eval from my attending was surprisingly positive. I was just happy the word "slacker" was never mentioned) but because I've lost 2 animals in the past week. I just hope that christmas time will be pleasant. I know I need the time off just to collect myself and sleep and just be normal. Medicine really sucks. I think it actually sucks worse than surgery! Luckily my time on blue medicine will end friday at 5 pm.

Speaking of sucky hours, I need to get ready for bed. Got to be up early to pre-pre round.

Gunners and the Rules of Dating

Does anyone remember the beginning of med school, where we were warned of gunners and learned that it carries a very negative connotation? Let's review.
Gunner: A person who is competitive,overly-ambitious and substantially exceeds minimum requirements. A gunner will compromise his/her peer relationships and/or reputation among peers in order to obtain recognition and praise from his/her superiors.

My current partner tends to fit this discription. Now, I'm not saying he's an ass. He's actually really nice and I find it easy to get along with him. And I did confront him on 1. his reputation that is quickly turning toward gunner and 2. the elevator situation. He basically said that he's not "gunning" and that people can think whatever they want. Also, the elevator situation was a misunderstanding. But he thanked me for letting him know. Because honestly, I'm going to tell you once and leave it.

Some Evidence that supports the assumption of gunner:
1. he currently has 5 patients. I have 3. I offered to pick up another, and the resident told me that it would be too much, and to not do it. It was better to know 2-3 patients well than more and not so well. But I don't understand why he feels the need to have so many. Why can't we have the same number?
2. He stays behind and tells me to go home and he'll "wrap it up". Most of the time I don't care. But when the resident says "You're carrying the list" or "you're going to make a great intern" it causes me to worry that I am being outshined, even though I'm doing exactly what I was told to do. And even though I want to do path, it doesn't mean I don't want to do my job and carry my weight as well.
3. The hovering. Maybe that's more of a pet peeve thing, but the looking over the shoulder while you write notes. Or "dont' forget to put down renal consult". Or even looking through the papers I'm holding IN MY HAND to "make sure the resident note wasn't in the stack".

Bottom line: no one wants to work with him. He's gotten a bad rap amongst students. Maybe the gunners do get the better recs and maybe his eval will say "awesome hard worker, great student, knows everythign" and mine will say "average", but the fact that I haven't heard one person want to be his partner on VA is concerning. I would hate if anyone thought i was a gunner. Or even worse a slacker. I think i would honestly cry if I found out NO ONE wanted to be my partner. I would just think with the feedback i gave him he would have calmed down some. Seems like it just made him worse. In a way I'd like a resident to tell him that he needs to cool it. But i know that won't happen. I just dont' want a bad evaluation myself because I seriously feel like I'm being outdone.

Speaking of bad evaluations, how about we talk about all the things NOT to say to a girl you've recently met and/or started showing interest in, shall we?
1. Don't ask "what does it take to get into your pants" 30 min after we start texting each other. it's a quick road the the "do not respond" list.
2. don't text me with your random thoughts or to wish me a good call. As endearing as some people may find this, it annoys me. stop.
3. Don't start talking to me and immediately tell me you're into a "no strings attached f-buddy relationship" or tell me you're not into monogamy or having kids. I mean, seriously?

So yeah, that sums up the last few days. I still hate medicine, and I hate not having a day off even more. What's worse is I'll be post call the day of my test. Can't wait to see what that grade is going to be. Speaking of post call, I'm off to bed.

M3 Progress Note Blue Medicine

25 y/o WF presents to ER with bilateral self mutilation of the wrists c/o feelings of dispair and frustration s/p 2 weeks on internal medicine service with no day off. Denies CP, SOB, N/V/D, NS, F/C
ROS: + insomnia, sleeplessness, decreased appetite, weakness, headache. otherwise negative.
Vitals: Tm: 97.6 HR 85 RR 18 (because it's always 18) BP: 112/68
PE: Gen: WDWN clearly distressed with a wild look to her eye resembling a caged animal, labile mood
CV: RRR no MRG
Lungs: CTAB no WRC, good air movement
Abd: s/nt/nd NABS no HSM noted
Ext: MAEW.
Neuro: PERRL, EMOI, CN II-XII intact, reflexes 2+
musculoskeletal: no atrophy, 5/5 movements in all limbs
GU: no dysuria, hematuria, oliguria
Endocrine: no heat/cold intolerance, hyperphagia, nocturia, polyuria
Psych: labile mood noted

Plan: 1. CT head due to headache and depressed mood r/o tumor
2. EKG
3. Chemistry, CBC, CXR
4. consult vascular and plastic surgery.

Don't be surprised to see this in the UMC system anytime soon. Medicine sucks. I mean, I see how some people like it. But not me. Rounding on people 3 times a day, updating the list several times, ordering test after test, changing someone's fluids from NS to 1/2 NS, adding potassium, waiting for the CBC to come back, it's so...detailed and micromanaged. I just don't have the patience for it. And the prescriptions. I hate pharmacology. No matter the setting. And medicine is all about some, well, just that. medicine. yuck.
2 more weeks till christmas. My first day off is thursday, and I get to spend that putting my dog down because it's the only time I have. so yeah, I can do this, right? Then I'll only have 1 month of house medicine ever and then never again. Why can't I be one of those people who loves everything, instead of disliking it all?

Yeah, completely set on pathology. now to just make up my mind where I want to do residency...

Easier Said Than Done

So project new kitten isn't going so well. I was prepared for the hissing and growling from Gryffin. I wasn't prepared for catatonic kitty depression, personality changet from best friend to antisocial doesn't want anything to do with anyone, or go up to people and instead of being friendly start biting for no reason. So we're trying to see if I can help out my Fashionista friend by finding kitty a good home. We've come close twice. One couldn't because her roomate is allergic. Apparently nosebleeds are associated with kitten dander? Didn't learn about that one in immunology. And the second one, his wife basically came up with a list of excuses so he can't take her either. Both fell absolutely in love with the kitten. She is adoreable, sweet, and very VERY cute. But I have to say my first priority is Gryffin and he's just absolutely miserable. It breaks my heart. If we can't find a home we may just keep her and make her outdoor/indoor kitty.

Aside from feline household drama medicine, well medicine blows. I don't want to do that for a living. Studying the molting patterns of penguins in the south pole sounds like a better plan to me. I definitely realized I don't enjoy patients at all. I don't like the questions and the explaining or the complaining. You're in the hospital because we're trying to make you better. Not like you're going to do anything about it after you go home anyway but at least we're trying. So basically unless I somehow 1. change my mind 2. decide neuro doesn't still give me PTSD or 3. I can handle surgery on an OBGYN basis then I'm doing pathology. For realz. No questions, no medicines, no notes. My idea of a perfect job. Plus 8-5 days, at home call, and no weekends. Win. Also, I won't be responsible for calling up some stupid medical records at some office clinic just to get some voicemail recording on how the lady that does medical records is busy. I mean, I did medical records for 4 years. I always answered calls. And at least my stupid recording would have included "If you wish to fax a request, our number is blah blah blah, blah blah." Instead of me leaving some stupid voicemail for you to call me back ASAP (luckily I spared her the thought of "i'm post call and would like to go home. this number is separating me from my bed and it could end badly for you if I ever meet you in real life) just to wait 20 min for NOTHING. So I search more, get what looks like a fax number, and just send it. If you're going to have voicemail, but down pertinent things LIKE PHONE NUMBERS.

Honestly, hasn't nature found a new way to employ natural selection? Now the dumb people are just breeding together causing a new super breed of moron.

Easier said than done, I suppose.

Upside Down

My Fashionista friend brought over a very cute black and white kitten for me today. I took her straight to the bathroom for her "safety room" so she can get adjusted and get a vet visit in. Gryffin went from "hey what's going on" to "HEY! WHAT THE HELL.IS.GOING.ON". Needless to say, he went from a confused/curious to pissed. Very quickly. He bit me when I picked him up (he never does that-shows you the degree of angry he is currently occupying) which is usually his favorite thing ever. Right now he's on the other couch glaring at me. He's spent the majority of the day outside the bathroom staring down the door. When I'm in the bathroom playing/bonding with kitten (to be later named. I think she's a girl so suggestions welcome!) he sits outside and occasionally growls. It's actually really funny to me. What was even funnier was when my parents got home. the kitten heard my dad and started growling herself. Priceless!

So I'm doing the introductions slowly. I can't really put them in the same room until vet on Tuesday (kitten appears to have tapeworms. Don't want Gryffin getting it). So hopefully he'll get used to the idea/smells by then. Kitten seems to be doing just fine. She's a little skiddish, but took to the litter pan immediately (yay!) and to her food bowl. She doesn't like toys too much-she prefers fingers. And she's gotten close to meeting the squirt bottle as she likes to attack and bite legs.

So that's the newest and most exciting thing. Thanksgiving went well in a very crowded way. I got to talk to my cousin's brother in law for a while. We talked on healthcare and the justification of the FDA. It was good, I didn't get overstimulated with all the company. Now I'm just really enjoying my break before 3 straight weeks of house medicine. Not entirely looking forward to it. I'm apprehensive about my partner. I woudln't be surprised if I end up going in early monday morning because he won't want to use the "our break officially ends at 8 am" cop-out. Ugh.

I'll have to post pics as soon as I get them. I'm sure the cat drama will be occupying my time for the next few days. Poor Gryffin-I realize his world has been turned upside down. As well as my official declaration that yes, yes I am now the cat lady.

Weighing In

Just FYI: it's really hard to type on a computer when your cat refuses to get out of your lap.

So...finished up psych. It wasn't that bad really. I was scared at first, then got used to it. By the end I was tired of feelings, but for a while I could have seen myself doing it if I didn't already have a fancy toward path. I'll still have to think about it. I know that it's noncompetitive and there's a massive need. So two good things toward getting into a residency far, far away.

On to medicine next. I'm not completely pumped mainly because I remember how much a 3 month rotation sucks. Because after about 2 months nothing seems too exciting. Especially if you don't like it. The rotation is all split up due to the holidays so my long needed vacation should spread it out better than the 3 straight months of surgery I had to endure.

In recent news, we've been voted the fattest state. Again. It never ceases to amaze me how people act all surprised. And it's not because I believe we're all fat and lazy marrying our cousins and not wearing shoes. It's because honestly people-look around and see the facts.
1. We're one of the poorest states. High calorie density foods are the cheapest and most convenient. So it makes sense that a family on a budget is more likely to buy a bag of chips for $2 than a single sweet potato for $1.99 (estimated costs of course)
2. We're rural. Seriously think how long it takes to go to your house to the grocery store. In the car. 5-10 min? 10-20? Think if you had to walk that. We're not like a lot of the "healthier" states that rely on walking/biking as a major way of transportation.
3. Has anyone seen sidewalks? Yeah, me either. Even if one wanted to walk (I live about a 10 min walk from Kroger), I'd get killed in traffic. Lack of sidewalks+people who drive like a driver's license is a prize in the cracker jack box=no walking.
4. It's hot. Really hot. Walking out the door to your car elicits profuse sweating. Now try walking 30 min somewhere in about 200% humidity and 101 degree temps. Yeah, not so much.

So add all that together and what do you have? Obesity. Lots of it. Not to say that it's possible to stay healthy and maintain a level of appropriate activity. But for the most part a lot of people that live here can't/won't do that. Sometimes they just don't care because it's culture of frying food and eating too much "meat on your bones" and a general acceptance of big body image as a good thing. That's just all my opinion.

Anyway, instead of studying for my psych board I'm updating my much neglected blog. I guess a lot of it has to do with the fact that I haven't had much to say over the past month or so. I figured out how to avoid Borderline questions and can tell the difference between narcolepsy and schizophrenia prodrome (unlike an attending on 7W). And now I'm dreading Medicine and ACLS (did I mention the BLS review course today was crap and she could tell I was in a hurry even though the dummy was apparently DEAD?). I'm ready to get to 4th year and eventually get to do what I love every day. Already halfway through, I can make it, right?

Oh, and don't even talk to me about STEP 2. I'm sure I need to sign up for the test soon. BLAH.