Thursday, August 18, 2011

The Person You Want To Be

Sometimes I'm struck by how happy I am with my life.

Last night, Danny and I sat on our back porch all evening talking, drinking, and playing pool with our neighbors who we love.

This evening, we rode our bikes to the lake, which is only 10 minutes away, and just hung out enjoying the view.

It's fun to feel like you are the person who you hoped you'd always be.

Wednesday, August 17, 2011


This is my first of four vacation weeks.  At first, I was a little bummed that my first vacation week was only 6 weeks after starting internship, but I was certainly ready for it when it came around.  I think that these 6 weeks were more draining that I'd realized. 

So here's all the excitement that has defined my vacation
-I get to do laundry and dishes.  Yes,  I GET to do it.  My sweetie has been taking care of me and doing all the housework; but I really do enjoy feeling like I'm pulling my fair share around here. 

-I sleep until 9am.  I suppose that doesn't seem very late; but it's a solid 4-5 hours later than I'm used to.

-I started my second novel.  Yes, that's right, I'm doing it again.  This one will be sex-scene-less so that my brothers and grandparents can read it.    I've already written >4,000 words, which means its 8% finished.  I'm having a blast playing around with a different writing style.  My last novel was all written in first person, which gave me the chance to develop each character's voice and hear their thoughts.  This one is narrated in third person, which is a different style.  It gives me more liberty to describe scenes in great detail, which I like.  My last novel, I had a great sense of who my characters were, and I let the story grow out of that.  This time it's opposite- I have a great plotline laid out, and I'm letting my characters grow and develop as it goes.  I'm still figuring out what makes them tick.

-I'm catching up on reading my ridiculously large surgical textbook. Surgery residents have a big test every January to make sure that we are learning what we should, and I need to make some significant progress in my textbook to stay on reading schedule.  I've been rotating reading the textbook for an hour, and then working my novel for an hour.  With occasional naps.

-Going back to the novel thing, because that's what I'm most excited about, I'm still planning on finishing by the end of November, so that I can feel a part of NaNoWriMo.  But since I work solidly double what most people work (80 hr/wk v. 40hr/wk) I figured that justified a head start.  It's like using the woman's tee in golf;  this is the MD's version of NaNoWriMo.

-The weather has been gorgeous outside, so most of my novel writing has taken place on our back desk.  YAY!

Friday, August 12, 2011

My First Medical Mistake

I made my first real medical mistake this week.  I've made plenty of mistakes over the past month, but every other one was caught before it hurt anybody.   On my second day of residency, I wrote a patient for aspirin 81gm, instead of 81mg.  Anyone whose ever typed more than 2 sentences on a computer keyboard knows how easy it is to hit two keys in the wrong order.  A oddly entertaining pharmacist called me about 10 minutes later, welcomed me to residency, and then told me to try again. 


But this time no one caught my mistake.  I gave someone the wrong time for their colonoscopy on their hospital discharge summary.  I mixed up the times for their clinic appointment and colonoscopy, so they showed up at 1pm for a 7am colonoscopy.  Missing an appointment usually wouldn't be a big deal; but missing a colonoscopy appt means that this guy went through an entire bowel prep (aka crapping for a whole day) for nothing, and he was someone who already had trouble getting to and from the bathroom without help due to other medical issues.  

I got a call from a very nice GI fellow informing me that patient was completely livid at having been given the wrong time and therefore having bowel prepped for nothing.  They informed me that the patient was demanding to speak with the physician who made this mistake.  I got the GI fellow to convince the patient to talk with me over the phone instead of in person, because I knew that tho ings would not go well if I was yelled at in person.  He got on the phone and I offered him the most sincere and heartfelt apology of my life, which my co-intern who was sitting next to me confirmed sounded truly genuine.  The patient diffused pretty quickly once I took full responsibility for the error, but I still felt like complete crap.  I had 100% been the cause of his discomfort and trouble. 

I'll be honest, as I tried to get back to working on notes for my other patients, I started to tear up thinking about that poor guy having diarrhea all day.  My co-intern said the exact right thing that I needed to hear to very through that moment, "He was always complaining of constipation anyway, so a good clean out probably did him so good."

I'm sure I will look back and laugh at getting upset over something so small.  I'm sure I will have much bigger mistakes to deal with in the future.  But this one bugged me quite a bit. The end.

Thursday, August 4, 2011

The Problem With Socialized Health Care

One of my co-interns went on a well justified rant today about the problem with socialized medicine.   At the county hospital, all the doc's are salaried.  I'd like to think that most of them still work hard and do what's best for their patients, but there are always exceptions.

In one particular department, where most specialists would be raking in the dough by billing for specialized procedures, the contrast is striking.  At a private hospital, these would be the docs drooling over every possible procedure and making obscene salaries because of it.  But at County, you have to beg and plea to get them to do anything at all.  They are only in house from 10am to 3pm (with a few hours for lunch), and will not EVER come in outside those hours for anything less than a catastrophic emergency.  They don't get paid per procedure, so they aim to do as little work each day as possible.  And will gladly admit it.

But that misses the whole other side of socialized medicine.   It overlooks the patient with no insurance who is getting a life saving Whipple tomorrow for an otherwise incurable pancreatic cancer.  And the undocumented illegal immigrant who has has been wholly cared for in his last days of life with the upmost dignity and respect without question, relieving his family from some of the related anxiety and fear that otherwise accompanied his passing.  And the patient who missed her OR date because she couldn't afford the bus fare to get to the hospital; and we gladly rescheduled her without berating her behind her back for ruining our carefully constructed OR schedule. 

Yes, salaried doctors might get lazy.   Yes, unionized nurses might not work as hard.  But God help me if I ever have to tell a patient that I can't operate because he can't pay.  I'd rather fight tooth and nail against an inefficient and frustrating system, than reject those most of need of my services.