post-33hr-call

After 33 hours of the following,

-0 showers
-1 brushing of teeth
-2 meals + a granola bar
-3 hrs of "sleep" with multiple pager interruptions
-covering 4 teams' services overnight
-11 pages of DKA gluc/fluid management protocol
-innumerable cups of stale black coffee

I can officially (post-post-call-nap) say I love what I do. Even if my brain was unresponsive and dissociated for the better part of the afternoon today. Beer > dinner, then bed.

fun with acronyms

Actual buzzwords used in pedi clinic/hospital.

"precious" = something's a little off in a newborn, e.g. suspect chromosomal disorder
FLK = funny-looking kid
BFH = big f*ing head (hydrocephalus)
GLM = good-looking mom

More to come later.

hypochondriasis

A little knowledge is dangerous. I know juuuust enough to freak myself out, but not enough to do anything about it. So on Monday I went to the ER to see if I could get stitches placed for my laceration. Long boring story.

More importantly, they took my BP at 137/88. Holy shit. I was 90/60 just a year ago. No FamHx of HTN. In fact, I clocked my 60yo dad at 120/85 over Christmas. I'm freaking out now. Pheo? Aldo-secreting tumor? Graves'? Renal artery stenosis 2/2 ascending UTI? (I saw a 14yo kid last wk w/ renal artery stenosis decompensating into ESRD 2/2 multiple undiagnosed ascending UTIs. That could be me!) I lay awake in bed last night, extremely aware of my bounding PMI/pulses. Do I have a hyperactive precordium? Or LVH?

Worse, since I've been counseling every appropriately-aged girl on Gardasil, I'm convinced I already have HPV and am going to die of cervical cancer. Funnily enough, I'm also in denial and convince myself I'm too busy to make an OBG appt for my annual pap. I'm going to be the person who presents w/ a 20lb tumor b/c I was too avoidant to see a doctor sooner.

I had a hilarious story from clinic yesterday but I'll save it for a time when I'm freaking out less.

older but not wiser

1. Drink very lightly/occasionally for 2 months while studying for boards, the start of MS3, etc.
2. Sleep 4 hours post-call on previous night.
3. Forget to eat dinner that night.
4. Go out to celebrate board scores/having the weekend off.
5. Drink before going out.
6. Take shots while out.
7. Slip in someone's spilled drink and broken glass.
8. Sustain 10cm laceration on leg and don't notice until blood is dripping down leg.
9. Wake up next morning hungover, in pain, amidst blood-stained sheets, and feeling extremely stupid.
10. I am definitely too old for this.

143

Reason #143 for a weekend off work being awesome:
The cigarette-burn-sized scrape on my hand will finally have a fighting chance of healing when I don't constantly wash my hands and smear sanitizing alcohol all over them.

currently eating

Ben and Jerry's New York Super Fudge Chunk. This in and of itself is not inherently weird. It is the fact that it is 5:43am on a weekday and this is breakfast post-call. I have lost all sense of sleep/wake cycles, time, and choosing appropriate cuisine for the time of day.

kiddos!

So it's only been a week, but HOW CUTE are the babies and kiddos in clinic?? They tug on your ID badge, giggle when you palpate their soft little bellies, pull on your stethoscope, ask all kinds of funny questions... and uh, cry and scream when you do an otoscopic exam. Which, conveniently, saves me the trouble of having to use a tongue depressor to get a great look at their throats. 5 minutes later, they've forgotten all about it and they love you again. One little girl even shyly told me she thought I was beautiful. Cutest kid-with-diarrhea ever. All together now: awwwwww.

Even the parents are cute: while waiting for me to see his toddler, one dad was told in triage to give her a few sips of Gatorade every 10-15 minutes, since she would vomit anything else immediately. It was just a standard PO challenge, but at first I was wondering why he kept looking nervously at his watch during my exam... until he politely interrupted me to say it had been exactly 10 minutes and it was time for her to sip some Gatorade. It happened again 10 minutes later, at which point the the cuteness nearly made me laugh aloud. I know, it's not my kid, and I'll probably be just as neurotic one day.

Okay I'm going a little soft here. Maybe I'll change my mind when I come down with viral gastro after having seen multiple cases of it this week in clinic. Or when I get vomited and/or peed on, which thankfully hasn't happened yet. Better yet, it's good to remember that cute kids turn into awkward adolescents, what with the surly attitudes and acne and the obligatory STD/"risky behavior" talk. Puberty is not a pleasant thing; I'm hoping to grow out of it any day now.

med students

Conference begins at 8am. I walk in unruffled and calm at 7:50. Literally ALL the chairs are already taken and everyone is sitting with notes open and pen in hand. And only 2 people walk in later than I do.

WHO ARE THESE PEOPLE??

3rd day of 3rd yr

You always hear about how 3rd year can beat your spirit down. Long work hours, only to come home and have to study more; being the bottom of the totem pole (translation: being the convenient dumping ground for everyone's frustrations from the patients to the attendings to the nurses); your own self-doubt in your abilities, etc. I guess it shouldn't have surprised me that 3rd year would be not only an academic and intellectual, but also an emotional and psychological, challenge. Still... until the first beatdown happens, I think it's easy to dismiss all of the above as exaggeration.

Well... today I came home feeling utterly dumb, incompetent, and discouraged. And wonder what I'm doing in med school in the first place, though by now it's consumed 2 yrs of my life and a good amount of debt. Here's hoping it can only go uphill.

simple pleasures

Farmer's market locally grown tomatoes: deep red, plump, and amazingly flavorful with perfect unblemished smooth taut skins. Sliced and tossed with olive oil, sea salt, fresh ground pepper, and Italian herbs. Whew. Okay now.

Other simple pleasures: resetting 3 nursemaid's elbows on my first day in the pediatrics ER.