Running with Scalpels

Little Surprises

2011-12-21T12:08:00.000-05:00

-I just started ENT, and I found out that I'll have Dec 24, 25 and 26 off of work!! In exchange, I work the next 19 days without a break. Still, I think I win. I get to fly home and see my family!!

-I'm slightly terrified of starting peripheral vascular surgery next month at county; but I just found out that my co-intern used to work as a phlebotomist. Translation: I don't have to do all the every-6-hours labs draws by myself!! Or at all!! YAY.

-Fencing is really REALLY atheletic. I'm sore allllll over. Ouchy. Also, see how the sword bends when it hits me? That's how I got a whole bunch of little bruises everywhere. Here are other funny thinks about this picture, (1) I think Dan is smiling/sneering way too big under his mask (2) I think Dan is planning on karate chopping me after he stabs me (3) even though his stab coutns for a point, I think that my across-body swipe would be more deadly in real life (4) doesn't it look like we are wearing grown-up onsies?

Translation

2011-11-30T16:41:00.000-05:00

64 year old female presented with nausea and vomiting . No acute events overnight, nausea or vomiting. No shortness of breath or chest pain.

Physical Exam
Alert and oreinted to person, place and time
Cardiac- Regular rate and rhythm, no murmur, rub or gallop
Lungs- Clear to asuculattion bilaterally
Abdomen- soft non tender non distended

Assessent and Plan

64 year old female with partial samll bowel obstruction.

Nasogastric tube to low intermittent suction
Nothing by mouth
Intraevenou fluid

Abbreviations

2011-11-27T12:47:00.002-05:00

Here's a fairly typical surgery progress note. Please note the complete lack of words longer than "no". We use more abbreviations than teenage girls texting. LOL.

64yoF p/w N/V. NAE ON. No N/V. No SOB, CP.

PE
AOx3
RRR no M/R/G
CTAB
S/NT/ND

A/P
64 yo F w/ pSBO.
NGT to LIS
NPO
IVF

babies!

2011-11-23T17:04:00.000-05:00

Did you know that babies could be this little? (picture stolen from internet)

That's probably one of my medium sized patients. They are so tiny it blows my mind. I put a rectal tube in one baby and after advancing it about 5cm, I decided to shoot and xray to see where it was; and it was half way up his colon! Stop being so tiny babies! I can't stand it anymore! They have tiny little hands, and sweet little noses, and they squim around when you pick them up. Tiny babies are the best. They are sort of like little aliens.

Compare that to me adolscent patients who are too cool to talk to be about their appendicitis. Dude. You'd better tell me whether or not you're having diarrhea; because we might have to cut you open.

I want to have like 6 babies. Mmmkay?

Sacred Space

2011-11-21T21:17:00.000-05:00

Just finished up my SICU month, and it seems to be that ICU's are very sacred spaces. Once there was a 8 year old girl, who was probably visiting a grandparent, who was walking up and down the halls with her iPod and singing along to some borderline inappropriate pop radio song. It was annoying to say the least, but we all sort of looked at one another and shrugeed it off; because if you are visiting someone in the ICU then you are having a very bad day. And bad days give you the right to sing off key the same song on repeat for as long as you want. It's a sacred space where all the staff knows that it's a Bad Day for anyone we see, so we're all a bit more forgiving and graceful.

I took call alone in the ICU a few times; far less than interns used to before the 16 hour work rule. My last call was really tough. It was perfectly quite from 6pm until 10:30pm; at which point one patient got very very sick very very fast. I pronounced him dead before 10am. In twelve hours, he went from sitting in bed talking to me; to struggling to breath and stating that he wouldn't want a breathing tube, he was 82 and had had enough. Then I was calling his daughter to ask her to come in and say goodbye. I held her hand as the priest gave Last Rights; and later I removed the last few things that were keeping him alive when we all agreed that it was time for him to go. I stood next to his daughter and the nurse who had been with us all night as we watched his monitor flat line; and I choke out- "Time of death 9:46am."

Part of me felt like I was invading a sacred space as I stood in that room. I was a stranger to them, having only known them for a few hours. It's a lot like the other post that I wrote awhile ago about Death; it was such a deeply personal and devastating thing for them, and I felt a bit like a fraud being a part of the moment without truly knowing them.

Sorry for all the sad thoughts. More cheerful posts to come- I'm on pediatric surgery now and my average patient age is about 1 month. So I get to hold tiny tiny babies all day. Love.

Life!

2011-11-18T21:38:00.000-05:00

Somehow I'm on call tonight in the ICU, and it's silent. We are at full capacity in terms of patients; but they are are all sleeping restfully and keeping their vitals totally stable. Weird....

So I get to update the blog!! This past month has been really wonderful. Dan and I have gone to archery classes, and are looking into a few different archery ranges around the city that we might join. It's been really fun. Also I love having totally random skills and experiences to confuse people with. How fun would it be if I just casually slid out of work someday, stating that I had to get to my archery tournament. AWESOME.

We bought a bunch of beautiful plants at a Conservatory sale a while ago, and they are mostly doing well. We had to ditch our cotton plant because we found a bunch of bug eggs on its leaves. Our big plants have been loosing some leaves; I have to clean up after them more often that if they were real pets.

North Carolina

2011-09-30T21:18:00.000-04:00

They bonded over their loved of blonde, wind-swept hair.

Cute cute cute

Finley discovered that YouTube has videos of trucks working. He was riveted.

So True.

2011-09-26T08:40:00.000-04:00

Football

2011-09-25T23:05:00.000-04:00

I've spent the last 2 hours watching about 1 hour worth of the Bears/Packers football game with Danny. He's slowing down the TiVo and rewinding every play and trying to teach me football.

Dude.

There are SOOOO many rules in football. Eligible receivers? Shotgun position? Off sides?

I've always thought that women were more detail-oriented and could remember more information than men; but now I've decided that men have just filled up their brains with football. I will forever be more forgiving of Danny forgetting to pick up milk at the grocery store, because apparently 50% of his brain is filled with the rules and statistics of sports.

We Do Not Say Thank You For This

2011-09-21T21:17:00.000-04:00

Remember Avatar? I think about one of the scenes from that movie a lot. Toward the beginning of the movie, the main woman character kills a few wolves who are attacking the main male character. He thanks her for saving him; and she harshly reprimands him with "We do not say thank you for this!! This is sad!" She's saying that any death is wrong, and it's never something that should be rejoiced in anyway.

It's hard in surgery sometimes, because the biggest and "coolest" surgeries are almost always the result of someone having a terrible terrible cancer. Today I was in a surgery for a colon cancer, that ended up being fixed to the pancreas and duodenum. So we did a combination right hemicolectomy and Whipple procedure. That probably means incredibly little to most of my readers; but the bottom line is that it was a ridiculously "cool" procedure, and the sort of thing that happens once every 10 years at a big academic hospital like ours.

I try to remember every day that we do not say thank you for death. We do not get excited about advanced cancer. When the patient is asleep, their cancer may be "neat"; but the moment that they wake up and learn what we learned during surgery- their cancer is devastating.

I bounce back and forth constantly. I told one medical student about what we were going to have to do for this patient, and I was annoyed that they didn't recognize how cool the surgery was. Another student was excited about the rarity of the surgery; and I was annoyed by his insensitivity.

Chapter Four

2011-09-18T17:54:00.001-04:00

Chapter Four.
for you reading pleasure. :-)

Chapter Three

2011-09-11T22:14:00.000-04:00

Chapter Three of the novel is done!!

And here is a highlight from each of the prior chapters, for those of you who are on the fence about hopping over to my other site and reading it....

Chapter One- "As their old TV flickered to life and the Gifting Day broadcast began; Marlene gasped, knowing immediately that something had gone terribly terribly wrong."

Chapter Two- "William! What the hell is going on?! What was that?!” she shouted again. He didn’t respond, and for the first time, Andrea became suddenly aware of the redness that was seeping through the back of his shirt."

Chapter Three "In front of everyone whose opinions he cherished, he lit the fuse on his rocket. Seconds before the rocket should have lifted off, Christopher was smacked in the head by his religiously fervent mother who had snuck up on him while he was engrossed in watching his fuse burn. "

Gifting Day

2011-09-05T22:34:00.000-04:00

I've dove head first into starting my next novel. Instead of doing the whole thing in one month like last time; this time I'm going to post a chapter a time on my blog. I'll put a link here for each new chapter that I write, so you can all read it as it develops. I think this will make me more excited about writing it, because it'll give me little bits of accomplishment and gratification as I go, instead of having to wait until the end. Also, then you don't have to pay to read it. I'll probably still throw it on Amazon when I'm done so that I can put it on my bookshelf.

I'll post a link to each chapter as I go over there---->
Chapter One and Chapter Two are already up.

Enjoy!!

The Person You Want To Be

2011-08-18T21:30:00.000-04:00

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.

Vacation

2011-08-17T13:40:00.000-04:00

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!

My First Medical Mistake

2011-08-12T16:58:00.001-04:00

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.

The Problem With Socialized Health Care

2011-08-04T22:07:00.000-04:00

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.

City Baby

2011-07-31T20:39:00.002-04:00

Danny and I had a great weekend with my good friend from med school, her husband and their 364 day old baby. It's hard to go enjoy the city without out-of-town guests to force us to do it.

So please come visit!!

A Million Thoughts

2011-07-30T19:40:00.001-04:00

I have a million thoughts that I want to write about, but pretty much no time to do it.

I want to write about my first patient who I cried with. And how much it sucks to tell someone that their tumors were unresectable. I want to tell you how emotionally exhausting it is to have four palliative patients on my service right now- who all look to the surgery team for some kind of hope but we've got nothing to do for them. How I find myself avoiding visiting them, because as soon I step into their room, I feel the full weight of their incredible emotional burden. I think of the quote alot- "Consider exhaustion a state of having given completely, rather than having been taken from". When I'm emotionally spent, its because I chose to give my energy, attention and empathy to someone who truly needed it- and remind myself not to feel abused or taken advantage of by the System or the Man. I want to tell you how emotional exhaustion has pushed me to the edge of what I can handle on a few occasions- resulting in at least one episode of hanging up on one very senior doctor who was treating me like crap when I just had no energy left to be reasonable.

I want to tell you about my patient who asked me if I went into medicine for the money. And how my first real paycheck adds up to just over $8/hr after taxes.

I want to write about how torn I feel every night when I get home- between relaxing with Danny, reading up on all the things I don't know enough about, showering, having dinner, calling my med school friends, catching up with family, doing the dishes, buying groceries.... and how I only have time for about one of those each night.

I want to share how rewarding it has been to work with my team- how they support whatever decisions I make about patient care, and go out of their way to make me feel appreciated and recognized for all the work I do on the floor while they are in the operating room.

I want to tell you about all my new ideas for my next novel, and how guilty I feel about wanting to spend a hour per night of my already cramped time for Danny and studying holed up in the office writing another silly book.

I'm grateful to have one of my good friends from med school, her husband, and their darling 1 yr old daughter as house guests this weekend. Pictures to come- I needed a nice relaxed weekend with good friends and it's been awesome so far.

Language Lessons

2011-07-22T22:45:00.001-04:00

#1- The word "poo poo" is universal. Spanish, Polish, Ukrainian, Mongolian, Russian... everybody knows poo poo.

#2- Using charade-like motions to communicate vomiting or diarrhea is never as successful as you would hope. But it sure is funny to watch.

#3- Conjugating verbs in Spanish is soooooo unnecessary. Past tense = just add "en el pasado..." (in the past....), future tense = "en el futuro..." (in the future).

#4- This is what my pocket looked like last time I was on call. Doesn't have anything to do with language, but I managed to avoid dropping any of them in the toilet accidentally, so I win.

Drawing Blood

2011-07-16T19:31:00.001-04:00

At the county hospital, the phlembotomists only draw patients blood at one certain time. If you want blood drawn at any other time, you have to do it yourself.

This morning, one of my funny old man patients refused to let phlebotomy draw his blood. So I had too, which is one of my least favorite parts of being an intern because it takes forever on some people. While I was doing it, I asked why he refused them. He said that it was because he likes me more and wanted me to draw his blood.

Dear patient, I appreciate that you like me. Please please please find a new way to show it.

Scrubs

2011-07-11T20:53:00.000-04:00

Not the stuff I wear every day- but the TV show. It's fantastic. Starting residency has made me dislike Grey's Anatomy more and more, and made me love Scrubs a TON. It's become a bit of a nightly ritual to crash on my ridiculously huge couch and watch an episode or two.

I love it.

That's all.

Day One!

2011-07-02T10:42:00.000-04:00

Yesterday was wildly successful. The county hospital that I work at had a "furlough day", so the OR's were closed on Friday. That meant that my 3rd and 5th year residents weren't in the OR and therefore they very slowly and patiently took my co-intern and myself through everything that we needed to know. All of my team is incredibly smart, nice and helpful- which is exactly why I picked this program to begin with.

I did have a few classic intern moments. I got really nervous about giving a patient Tylenol for a fever. I resisted the urge to check liver labs before giving a simple over the counter medicine. I was actually paranoid enough about sending the healthy young patient into liver failure that I checked back at the end of the day to make sure I hadn't killed them. With Tylenol.

I also had to transport a semi-stable patient from the ICU to the CT scan (all ICU patients have to have an MD with them when they move). I definitely re-lived some of the more dramatic scenes of Grey's Anatomy as the doors closed on me and my patient alone in an elevator. The nurse had sent me with a small amount of vasopressers to start "if the patient craps out again". What?! My current knowledge of vasopressers is that if someone needs them- they should be in the ICU, and far far away from an intern like me. I was not excited about starting them alone in the elevator. But everything was beyond fine, and it was probably good to get my heart rate above 120 for a few minutes.

I don't think that I really knew a lot about what it would like to be a doctor before medical school. I never really shadowed anyone, or had any family members in medicine. But even with that extreme ignorance, I think that I somehow picked a career path that fits me really really well. It's awesome to be in a position where I can actually DO stuff for people who are in the hospital. People are vulnerable and alone and scared when they are sick- and it is incredible to be able to relieve some of their anxieties and pains about their illness, and sometimes FIX them (yay surgery!).

Coffee, My Nemesis

2011-06-30T21:02:00.000-04:00

I'm supposed to like coffee. I'm supposed to use my fanny programmable coffee maker to make it fresh every morning for when I wake up at oh-my-god-this-is-sooooo-early-o'clock. I'm supposed to sip it on the bus and arrive to work feeling alive, awake, alert and enthusiastic. I'm a surgeon, for crying out loud. I should bleed coffee.

I made coffee every day for orientation and tried really hard to like it. But as I added more and more cream and sugar, and peeked inside the lid to see how much more I had to drink, it hit me- I don't like coffee. I like Diet Coke.

So as I prepare for my first day of internship, the dreaded "July 1", I plan on braving the day without this mysterious "caffeine", whose effects I am apparently immune to. I'll throw a Diet coke in my locker. Maybe I'll change my mind when its 11am and I've already been awake for 7 hours. But I'm freeing myself of the expectation that I need to be coffee fueled for this epic day. Because I don't like it. It's sort of gross.

First Impressions

2011-06-26T00:37:00.000-04:00

Two days of orientation so far, real work starts July 1. Here are my first impressions:

-Of my co-interns: Some of the most normal, down-to-earth, level-headed and easy-to-talk-to people that I've ever met (at least, in surgery).

-Of my schedule: No comment. Apparently March 17-June 23 is just not enough time to make our schedules, so they still aren't done yet. I'm a nervous nelly and REALLY want to know what I'm starting on. We were told that we'll get them on Tuesday or Wednesday next week, and also told that there is nothing that we can read or do at home to help us prepare for our first day, so we should stop worrying about it. Easier said than done.

-Of my commute: I've taken the bus everyday so far, which has been really nice. I like having a bit of transition time to sip my coffee and watch Jon Stewart between the hospital and home. I think that I will succeed in being able to read for 20-30 minutes a day on the bus, which would be WONDERFUL. I get free parking at the hospital though, so I'll probably try out driving and see which I like more. Options are good.

-Of the hospitals: Our county hospital orientation consisted of a lot of "We used to have funds to do X, Y and Z... but now the city is broke. So you'll have to draw your own blood. And transport your own patients. And cook your patients meals". OK fine, I made the last one up. The private hospital orientation was a little like Disney World, sparkly and exciting. It'll be funny to flip flop between the two environments.

-Of the gender roles: There are only 2 female surgery interns, and we get along great. When we went out last night with our whole group though, I felt like we both ended up mostly keeping "the wives" company. I'm trying to make a more concerted effort to not find myself blocked out of important conversations and relationships just because women tend to clique off together.

-Of the city: Love love love.

-Of the apartment: We had a fairly epic power struggle over whether our dining room would house a pool table or a dining room table. Somehow, we have ended up with BOTH. This is what happens when 2 stubborn people date each other. Oops.

Danny's Old Stuff

2011-06-21T23:06:00.001-04:00

A Tandy word processor! We just have to find an old printer with an equally ginormous connector cable, and then we can use it. And also find out the last thing that 8th grade Danny wrote on it.

A pamphlet from NASA in 1967

In case you can't read it- "Then if all went well, Apollo 11- in the third quarter of 1969- was to make the first actual landing." They were right on that one. But not their claim later in the book, that "After establishing a base on the moon, it will serve as the gateway to travel throughout the rest of the solar system".

Family In Chicago!!

2011-06-17T21:58:00.000-04:00

A Common Sight In Our Place

2011-06-14T13:42:00.002-04:00

Burger and Beer 5K Fun Run

2011-06-13T22:39:00.000-04:00

Operation Make-Friends and Operation Get-In-Shape are both in full swing here in Chi-town. We live above a running store, and on Monday nights they host a "Burger and Beer 5K Fun Run". Basically about 80 people meet in front of our house at 6:30pm and run either 5K or 5 Miles (I bet you can guess which group we went with), and then go to a local bar for a free beer and not free burgers. YUM.

How can you turn that down? Seriously.

We met a few really great people- and we saw someone slip inside our building after the run, only to find out that one of the people we'd been running with was our upstairs neighbor!! I like being back in the Midwest, where people are friendly and talkative, where beer is free, and where burgers served in a ridiculously huge portion size.

Until I get a paycheck, I am perfectly willing to run a 5K to get a free beer.

Living With a Boy

2011-06-09T22:52:00.000-04:00

I'm living with a boy now.

Pro's

He owns every tool. I'll say something like, "Man! I could totally fix that if I had a circular saw...." and BOOM! I have it. Or, "Huh... I wonder if I could fix that with a wire cutter...." and SHABAM! I'm cutting wires.
He carries heavy things. I'm no wimp- but unloading a 16 foot truck about a 6 hour drive was certainly a lot nicer when he constantly said things like "Don't worry, babe, I'll get all the heavy boxes." *swoon*
He is always around. I no longer have to carry around the mental list of "Things I Need To Remember To Tell Dan When I See Him", because he's always within ear shot.

Con's

He totally dominates the TV. We've had our fancy new big flat screen TV for exactly 8 hours, and I'm pretty sure he's been watching the Cubs game for at least 6 hours.

Ask me for a pro and cons list in a few months. Maybe it'll have shifted. :-P But its been really great so far. We've painted our new place, and it looks fantastic. We bought our grown-up TV today, and we're getting our grown-up couch on Saturday. I'll post pictures when everything is set up. One thing that has been so odd, is to be around one another even though we don't particularly want to be. It used to be that if we were together, it was because one of us WANTED to be with the other person enough to drive over and hang out. Now it's just the default setting that we are together. It's sort of funny to be around him all the time, and yet still feel like any time we spend together should be special and important.

Here's a few pictures from my friend Heidi's wedding that we just went to. It was the perfect way to party it up, one last time, with my med school possee. If I look red and sweaty and terrible in the second picture, it's probably because the outdoor ceremony and reception were both in 95 degree heat, and I had already been dancing quite a while at the time of the second picture. Gross and sweaty.

The Last Five Days

2011-06-03T23:22:00.000-04:00

I've been pretty busy the last five days. I graduated from medical school, went to a wedding in Colorado, packed up to move, drove to Niagara Falls, and now I'm at a wedding in Ohio. Busy busy times- but all very well worth it.

Adverse Reactions

2011-05-26T11:05:00.001-04:00

I'm 72 hours away from being an MD. I also recently wrote a novel. I thought those were 2 separate events, but I'm getting a lot strange feedback from people who think they are highly correlated.

Adverse reaction #1: On the back of my book, I wrote a pretty funny "about the author segment". Part of it implies that I came up with the plot of the novel while daydreaming during medical school lectures. Another part says that the book is best read when you are drunk (it was all written in jest). Funny, right? Well one person had already told me that I shouldn't have implied that I daydreamed during lectures, because if a patient read that then they would lose faith in me.

Adverse reaction #2: I wrote the book in a month. So there are typos. And grammatical mistakes. And misspellings. But it says, on the very first page of the book, that it was written in a month- so I tried to warn my readers beforehand. Again, someone told me that there are high expectations of any book written by someone with as much education as me, and that all of the mistakes reflect poorly on me.

I am proud that I wrote a book. I don't think my MD should hold me to any higher literary standard than you would hold anyone else with zero writing training. Now, if I had written about an appendectomy and said that it was on the left side, then I should be held accountable. But if I occasional change tense mid-sentence, cut me some slack. I wrote 90% of the book on airplanes between residency interviews, so my attention was usually in 6 different places at once.

Also, I will fully admit that I daydreamed in lectures. And if anyone wants to question whether or not I learned everything I needed to learn, I've got some stellar board scores that I'd love to show you.

I'm already looking forward to writing my next novel in November. It's going to rock.:-D

Goofy Goofy Boys

2011-05-23T16:55:00.000-04:00

These are the last three pictures on my phone- of three different boys who are too goofy for words.

99 Cent Kindle Version and Amazon Paperback Available

2011-05-17T14:43:00.000-04:00

I promise this is my last post about my book. For those who actually know me in person, I cannot make any such guarantees about yapping about it.

The Kindle version is available for $.99 on Amazon.com
So is the paperback version for $9.99 on Amazon.com

NOVEL!!!

2011-05-14T10:01:00.003-04:00

I wrote a book!! It's in my hands!!! I'm in love with it, and I'm never going anywhere without it.

Would you like to buy a copy?!?! BECAUSE YOU CAN!!!!!!! It's available for direct purchase through CreateSpace (the company that prints it) at this link https://www.createspace.com/3535974. It'll be up on Amazon in 3-5 days. It's listed at $9.99 on each site, which grants me a whooping $2.43 commission on each book sold (CHA CHING!!). I actually get a little more commission through the CreateSpace site than through Amazon, but I think that Amazon will give you free shipping if you have Amazon Prime.

The bottom line is that you should buy the book if you want it, but don't do it to help me get rich. Give me $10 if you want to give me $10. I'm counting the whole thing as a success is I make enough cash to buy a Chipotle Burrito.

I should also put out a warning to my fans who are under 18, and my fans who are genetically related to me. There's a sex scene. Chapter 31. When it starts to get steamy, just skip right ahead to the next chapter. You won't miss anything in terms of the plot, and I think we'll all be more comfortable at the next family reunion.

State of the Hutch Address

2011-05-13T12:40:00.002-04:00

Stemware racks added!

Modern Family Mother's Day Episode

2011-05-09T22:19:00.000-04:00

I'm not a very sensitive person, and I don't get offended easily. So maybe I was just in a funny mood the other night, or ate some bad shrimp- but I found the most recent episode of Modern Family about Mother's Day sort of incredibly offensive to women.

One of the major plotlines of the episode is that one of the gay fathers, who stays at home full time with their daughter, is treated like a mother on Mother's Day, and resents the implication that he is "like a woman". He, and his partner both spend the entire episode making these really offensive comments like, "There's nothing we (gay men) hate more than being treated like women. We don't have a special time of the month, and we don't want to come your baby shower." They say it with such disgust in their voice, as though being compared to a woman is the most terrible insult you could possibly utter. And they keep harping on it the WHOLE episode. I almost expected them too look at a moldy piece of bread at some point in the episode as gasp, "That's so disgusting!! It's almost like... like... like... a woman!"

I found it all very offensive. Can you imagine if the episode was about a dark skinned Caucasian going on and on about how insulted they were that someone mistook them for an African American (implying that being African American is so utterly despicable...)? Or if someone who was straight flipped out about being treated as if they were gay? Isn't this the main reason that society has moved away from using "gay" and "retarded" as adjectives? I also hate how the episode "redeems" this plotline- by telling the insulted character that "it's ok to be compared to woman, because women are so nurturing". Apparently we're back to 1950's when our only worth is as a mother/homemaker.

Anyway, I'd love to hear other people's thought on the episode if they've had a chance to watch it. It's on HULU if you're super interested.

End of rant.

HGTV'd!!

2011-05-05T17:39:00.001-04:00

If I've learned anything during the 4th year of medical school, it's that HGTV is amazing. I'm eager to start decorating my new Chicago apartment- but I can't start buying most of the stuff that I want yet since it doesn't make sense to buy it here and then move it.

But I decided to makeover our ugly dining room hutch today, since a pretty hutch doesn't take up any more space than am ugly one.

Here's the BEFORE picture:

Did you notice the 1970's gold-leafed design on the outermost 2 glass panels? And the ugly hardware? And the overall depressing feel? It had to go.

First step was taking off the paint from the side panels. After quickly googling "How to Remove Paint From Glass", it seemed like the most universal element was just taking a razor to the glass and chipping away at the paint. That was exactly as fun as it sounds.

Next, I went to Home Depot to find pretty new hardware for the cabinets. I was greeting by this ridiculous amount of selection...

... only to be informed that the handles I was replacing were a VERY old style that didn't fit any conventional sizing. Bummer!! So none of the pretty handles would fit what I needed. So instead, a nice man told me that I could spraypaint the existing hardware for MUCH cheaper than buying new ones anyway.

My last big change was to wallpaper the back of the hutch. This is something that I've seen done on HGTV a lot on bookshelves and cabinets to add color, and I always thought it was such a cool idea. So here is the final product!! Well, almost final. I ordered some stemware racks online, which I'm going to hang on the inside of the ceiling, so that I can hang my pretty wineglasses in my pretty new hutch!!

I'm SO excited to fill it with all kinds of goodies once I get settled in Chicago. I really like that it'll provide a mix of storage for pretty things (behind the glass) and not-so-pretty things (in the fabric bins and the cabinets underneath). I also found some cheap recessed lights that I might buy to put inside. That will depend partially on how much lighting there is already in our dining room, so I'll probably hold off on that.

Here's the total cost for the project
-Ugly Hutch from Salvation Army -$40
-Can of metallic spray paint -$5
-Patterned white wallpaper- $12
-Stemware rack- $13

Total: $60. Not bad, eh?

Dance

2011-04-29T10:44:00.001-04:00

Finley did two things after this video.

First he took off his diaper, then he puked.

My Nephew Loves Bieber

2011-04-28T13:00:00.002-04:00

Cute Nephew

2011-04-27T19:34:00.002-04:00

End of 4th Year

2011-04-18T17:03:00.000-04:00

I have a difficult time explaining what its like to be in this magical period of my life- between Match Day and starting residency. I finally came up with the perfect analogy.

Remember that week in high school, senior year, after you'd taken all of your AP tests, but still had to go to school for two more weeks before summer? So you got to watch movies in every class?

That's what my life is like now. Except, instead of watching movies in a classroom, I watch them in my bed. And instead of counting down to a summer full of fun, I'm counting down toward the scariest day of my life- the day that I have to use my MD to Make Decisions (that's what it actually stands for, btw) and therefore have the sudden ability to royally screw up.

I also spend a decent amount of time finding gems like this and giggling.

Lil Brudder!!

2011-04-13T10:36:00.000-04:00

My favorite nephew has a new lil brudder!!! He's cute. My sister's blog has pictures. In honor of that lil brudder, I though I'd share my favorite picture in the whole wide world of my own lil brudders. They are cool high schoolers (almost in college!) now, who would probably murder me for showing this picture, but I don't think they read my blog, so I'm safe.

Once upon a time, these two little fellows wanted a swimming pool. Someone (Dad? Me? Overly sarcastic neighbor?) told them that they should just fill a trash can with water and pretend that it's a swimming pool. And they did. I love them.

So here's to Finley and Braden being just as rascally and adorable as my own brothers.

tiny!!

2011-04-07T14:55:00.000-04:00

Here's my newest obsession: SPACE BAGS. I'm normally not the infomercial type; but I'd seen these on TV and then found them in a store and I just couldn't resist. Danny and I are moving from two comically oversized houses to one normal sized apartment with limited storage space. So I've become very nervous about our closet space. Check out what I did to a stack of 8 throw pillows, and a stack of of 8 hoodies.

Do you feel neglected?

2011-04-06T21:11:00.000-04:00

Sorry, blog. You've been ignored for a while. Following Match Day, I sort of stopped having much to say. I matched at my favorite place. What else is there to say?

But there have been exciting happenings in my life. And luckily, I have fun pictures to go along with all of them!!

Thing #1- Chicago apartment hunt= SUCCESSFUL!! We found an AWESOME place that we are in love with. We were hoping for a place with laundry in building. Surprisingly, we were able to afford a place with laundry in unit. Shockingly, we got laundry in closet. No more laundry basket for us- laundry goes from body to washer to dryer to hanger. Love it.

Thing #2- I got a wild hare to do something wild. With my hair. Meet Ragedy Ann, as Danny calls me now.

Thing #3- I use my fancy Droid for EVERYTHING. I get free ebooks from my local library on it. I keep track of my multiple to-do lists and calendars. I cruise the web on it. I watch TV shows on it. I read journal articles on it. I play Scrabble on it. And I HATE when people assume that I'm just texting anytime that I'm sitting around looking at its magnificent screen. I'm not a 13 year old girl, thank-you-very-much, I'm a very important almost doctor. I do important stuff. So I've added a little bit of flare to my phone.

Anatomy Lab

2011-03-24T22:12:00.001-04:00

I am doing an anatomy elective to finish up fourth year, and I love it. Here's one of the odder things hidden in the basement anatomy lab.

Double Trouble

2011-03-19T18:14:00.002-04:00

Sometimes one Mac just isn't enough

Another Silly Video

2011-03-18T12:08:00.000-04:00

Found another silly video of match day.... just trying to give you guys as much of the experience as I can. BECAUSE IT WAS AWESOME.

And here's more silly pictures. There were LOTS of silly pictures.

Match Day Video- Its Like You Were There!!

2011-03-17T14:25:00.000-04:00

Here are the 5 girls opening our envelopes (and Ala's dad... he didn't match.) We all got our top choices!!

And this is a silly one when Ala thought she was taking my picture, but was actually taking a video. I'll put up pretty pictures where I seem less crazy later. The crazy ones are the most fun anyway, right?

Pre Match Day Breakfast!

2011-03-17T10:06:00.002-04:00

Strangest Door Handle

2011-03-16T11:23:00.001-04:00

Match day fortunes

2011-03-14T12:15:00.001-04:00

Here are the fortunes that Ala and I got today... I was happy with mine, she was very sad about hers. :-) PS I didn't get the dreaded noon phone call telling me that I have to scramble. I matched!!

New Phone!!

2011-03-13T11:08:00.002-04:00

It was better than Christmas morning. Maybe even better than match day

Stairway To...

2011-03-11T08:02:00.001-05:00

Why do you tempt me so??

Elevator

2011-03-09T21:27:00.001-05:00

Gold star to the first person to identify what's wrong with this picture!

Sometimes I Write Stories

2011-03-08T21:58:00.000-05:00

I wrote a novel a while ago. I promise that it'll be available for sale on Kindle and Amazon soon. (Don't get too excited- so far I've given it to 3 of my friends to read, and none of them have made in more than half way through- so I think it might be awful. But that's for you to decide!)

Anyway, it my attempt to keep my small kernel of creativity alive and kicking- I've decided to try to my hand at writing short stories in science fiction. My first story is now officially available to viewing using that link over there----> or this link right here. Enjoy!

It's first critical review came from Danny tonight, "I think I get it...."

The New Poverty Line

2011-03-08T13:35:00.002-05:00

I really hope they meant annual income, not monthly income...

Choices choices

2011-03-07T22:39:00.001-05:00

Took him 5 minutes to pick a carton of milk.

This is why we don't shop together.

Pink and Purple Flower

2011-03-06T14:04:00.001-05:00

Found a pretty pink and purple flower-y thing on my run today.

This is good because (1) maybe Spring is fiiiiiinnnnnallllly coming and (2) I'm running again!

What A Loaf

2011-03-05T11:03:00.002-05:00

Why would you bring a giant loaf of bread to a bar??
He's compensating for something if you ask me.

Argyle

2011-03-04T08:54:00.001-05:00

In a desperate attempt to improve my skirt/dress wardrobe;

I have purchased my first pair of patterned tights. Thoughts?

What Teachers Make

2011-03-03T21:09:00.003-05:00

I've had lots of great teachers.
And I have lots of family and friends who are great teachers.
And so this video gives me goosebumps.

Pure Gold

2011-03-03T12:51:00.002-05:00

Chipotles new gold foil makes me uneasy. I don't deal well with

change. And, yes, I realize that this is my second burrito-based post

in less than a week.

Feelin Lucky

2011-03-02T09:39:00.003-05:00

I won this in an impromptu med student competition that my attending had.

A few million bucks would certainly be nice...

NASA

2011-03-01T13:41:00.002-05:00

Found this on a random wall in library.

Free Burritos

2011-02-28T11:33:00.004-05:00

2-for-1 burritos make the world go round.

Snowy Morning

2011-02-27T10:05:00.002-05:00

Out Out Damned Spot

2011-02-26T01:02:00.001-05:00

... you weren't there BEFORE I drained that abscess!

This is what I look like. AKA figuring out how to post from my phone

2011-02-25T14:13:00.004-05:00

A Photo A Day Keeps The Crazy Away

2011-02-25T13:27:00.000-05:00

I'm a VERY project oriented person, and I've decided to tackle a new one!! If I don't have a project, I'm going to spend the next 3 weeks (actually 20 days... but who's counting?) completely freaking out about Match Day.

So the new project: It's called "Project 365" or "365Project" or something like that depending how you google it- but the idea is to take a picture a day for a year and share it with the world.

I've put a little app on my phone that will let me snap pictures and quickly upload them onto my blog. So, for as long as it keeps me interested- you'll see some picture from my daily life every day!! Aren't you excited?!

Saving Lives

2011-02-20T08:09:00.001-05:00

When my parents call me, they sometimes ask if I've save any lives recently. Well, last night on my overnight ER shift, I can proudly say that I ~~helped~~ ~~strongly contributed~~ DID save three lives.

#1- A guy's heart stopped beating and I started CPR. Let me just tell you that doing CPR and starting CPR are two very different beasts. I've done CPR a few times, and it's not that big of a deal. But starting CPR- whew. That takes balls. You're not just replacing someone whose already been banging away on their chest, you're the one deciding- Hey, this guy's dead. I'd better start doing something about it. Not only did I start CPR for the first time, but we also got the guys' heart beat back. If you watch any medical shows on TV, you're probably thinking that it's normal to get the heart beat back; but it's not. It happens less than 5% of the time, for the type of dead that this guy was. It was my magical chest compressions that gave him the will to live, I think. :-)

#2 & #3- A husband and wife came into the ER with nausea and vomiting after eating dinner together. My resident and attending were both eager to write them off as viral gastroenteritis or food poisoning- but in my obsessive medical student way, I suggested that we test them for carbon monoxide poisoning (mostly because we had just had a lecture on it!) And guess what? They were both puking because their kitchen was cold when they were eating, so they brought their generator into the kitchen to run their space heater. Generator in closed space= carbon monoxide poisoning. SLAM DUNK. Slap some oxygen masks on those folks before they settle into a nice coma.

It's nice to feel Doctor-ly. It's nice to feel confident enough in my own knowledge and instinct that I'm able to DO THINGS that end up saving lives. I think I can do this doctor thing. In fact, I just might be pretty good at it.

...came up when I searched Google Image for "happiest"
...in my sleep deprived state, it somehow seemed the most appropriate picture

**Stupid disclaimer- as always, I changed pieces of the story to make the patients' stories unrecognizable because otherwise I'd be violating patient confidentiality. I did not, however, alter how awesome I was.

MCAT- Memorize Crap And Take

2011-02-16T20:35:00.000-05:00

Since my 4th year med school work load keeps me busy, oh, on average, 2 hours a week- I decided a little while ago that this might me a good time to get a job. Not a real job- just something to fill my time and fill my Laura's-first-grown-up-apartment-needs-to-have-adorable/expensive-furniture fund. So I'm working as a private MCAT (medical college admission test) tutor. I make $30/hr, and get to help kids study for the test that I took 4 years ago. Everybody wins.

There's not a HUGE demand in my town for tutors, so I'll be happy if I make $500 on this gig before I leave town, but that's still more money than I've ever spent on furnishing an apartment before. I already have students scheduled for $360 worth of tutoring- moderately sized flat screen TV, here I come!!

Anyway, today I was tutoring a girl, and we were reviewing the "physics" section for the test. We were going over the physics sound waves- which maybe I can relate to medical practice since (1) ultrasounds use sound waves to make images, and since (2) understanding the mechanics of sounds conduction in the human ear requires some knowledge of frequency/wavelength. But as we went through the material, we were suddenly talking about resonant frequencies and harmonics. And then about how a pipe has different harmonics if it is open on one end, or both ends. What on earth does this have to do with medicine? I've never used a pipe for anything on any of my patients. And even if I did, I don't think I'd care about its harmonic frequencies.

My conclusion, which I came to years ago when I was studying for the MCAT myself and has been reinforced through my tutoring, is that the MCAT is built purely to test your ability to memorize mundane material. Because, let's face it, most of medicine is mundane memorization. Side effect profiles, protocols and criteria, contraindications and differentials.... when I think about all the mundane information that I carry around with me in the ER, I kind of get why the MCAT is just trying to see if you can memorize weird stuff. So, sorry tutortees, you aren't going to get a ton of sympathy from me. Memorize the harmonics, and then move on with life.

Doctor, Patient, Nurse

2011-02-14T07:41:00.000-05:00

Weekend Summary

Friday- saw 3 patients in the ER with vomiting and diarrhea
Saturday-Sunday- rarely left the bathroom, grossest 2 days of my life
Monday so far- Danny has started puking

This is one of the less well-known downsides of dating a doctor- lots and lots of viruses

Short Stories and Half Marathons

2011-02-02T10:56:00.000-05:00

The novel, and the marathon, were both BIG accomplishments for me- and now that I have satisfied those goals, I'm looking forward to paring down my commitment in both areas to (1) short stories and (2) half marathons. Both still require hard work and commitment, but you get the sense of accomplishment MUCH sooner.

One of my favorite book growing up was "The Illustrated Man" by Ray Bradbury, which was a collection of science fiction short stories. I found my copy of it when I was going through boxes in my parent's attic, and it definitely looked well loved. So I've decided to write sci fi short stories on a semi-regular basis. My first one is almost done. And, since it'll be shorter that the novel, hopefully I can put it up here on the internet for easier sharing. Still working on editing the novel before that'll be available (I swear it takes more time to edit than to write).

I haven't been running much since the marathon, which I blame on New England weather. There has been 4-6 inches of snow on the ground continuously for the entire month of January. We just tend to get 2-3 inches every other day, and I'm terrified of running on snow/ice and ripping some tendon in my leg. Plus, it's freaking cold outside. But all excuses aside, I need to do another half marathon. There is one in May in Rhode Island that I'm thinking about doing.

Here's a funny picture from the Marathon trip, of Danny and I putting Spiderman in his place.

Rank List Dilemmas

2011-01-26T12:06:00.000-05:00

I thought that making my rank list would be about deciding what kind of program I want to go to- but it's turned into so much more than that. It's about deciding what kind of person I want to be, what kind of life I want to have, what kind of surgeon I want to be.... none of which are questions that anyone else can answer for me.

There's one type of program- we'll call it Academic Central, that is great in a hard core, down and dirty surgery kind of way. The residents are the coolest, slickest, most confident and cool-headed people I've ever met, and I want to be just like every single one of them. They work really hard, but they save people's lives every day. They come out of residency completely exhausted, but also as some of the best trained surgeons you'll ever meet. They publish lots papers and are taught by "famous" surgeons who have invented procedures and written textbooks. If I went there, I would have little/no life for 5 years- but afterward I would be on the track to becoming a world-renowned whatever-kind-of-surgeon I want.

The other type of program- we'll call in Community Galore, is much more laid back. Smaller program with a heavy emphasis on bread-and-butter surgery cases (lots of gallbladders and appendixes). They work less hours, and they see fewer super complex cases. If I want to be a general surgeon, though, do I really need to see 14 Whipple's? Probably not. And as a 4th and 5th year, you operate fairly independently which makes you actually ready to operate alone in practice after graduating. Their average number of cases is higher than Academic Central's, and yet they work about 20 hours a week LESS (that's the magical thing about home call- you stay at home at night and only come in if they need you) . I would actually have a life for 5 years (the current residents have babies, run marathons, play poker 2x per week...) and I would graduate as a well prepared general surgeon, and I could go to fellowship if I want to (but no one will be beating down my door begging me to come to their program, like they would if I was from Academic Central).

I'm sure that half of you think its a slam dunk decision in each direction- but it's really REALLY not. I don't think I'm ever going to be the world-renowned surgeon in anything, because that's not what I'm passionate about. I don't care about being "famous" or "cutting edge", I care about having patients who I can take good care of and who I can help. I'm going into surgery because I like operating and I like fixing people. The more I do that, the happier I will be.

I want to have a life outside of surgery too. I've been told repeatedly that being in academics is general at the expense of any kind of family life. I want to have friends, and see my family, and have my own family someday who I actually get to spend time with. Call me crazy but don't get me wrong- I'm not lazy. I don't have a single lazy bone in my body. When most other medical students take a nap- I write a novel and run a marathon. I'm not hoping for less time at work because I'm lazy; rather because I love all of my life so much that I want to have time for all of it. Balance. I would love to start volunteering with Danny in my free time. I'd love to become an adviser at my sorority for women interested in medicine. I want to write another novel. I want to run half marathons. I want to get married and raise good kids. I want to have a full and meaningful life, where I can point at five completely different areas of my life and say, "That satisfies me." Surgery should be one of those areas- not all five.

And yet, there is a little voice in my head that says, "You HAVE to go to the most competitive program that you can. You HAVE to always be reaching for the highest medical school, the highest program, the highest job. Otherwise, you're wasting all your hardwork and abilities." My competitive nature tends to highly value adversity and difficulty; as though something being challenging innately makes it the most desired path. True, I like challenges, but they need to have meaning.

So I'm stuck between this unrelenting drive that I have to succeed, do more, reach further; and the very real desire to be a well rounded person who is happy and balanced in every area of life. ADVICE WELCOME.

Birth Control and Folate?

2011-01-24T14:09:00.000-05:00

I was watching TV the other day, and I saw a commercial for a new birth control pill that contains folate. Folate, as they correctly state, is to help prevent certain birth defects that can happen early in pregnancy.

Hmm.

Does it strike anyone else as odd that a BIRTH CONTROL pill would include something to make your PREGNANCY healthier? It feels to me like a used car salesman who includes a free bus pass with every car sale (umm... if the car works, then you shouldn't need a bus pass). If the pill works, you shouldn't need the folate because you shouldn't be pregnant.

I get that the company is just trying to do something to make their product stand out, but why couldn't they include something that helps you with every day life (calcium, viatmin D, etc...) instead of something to help with pregnancy?

Five Year Old Doctors

2011-01-18T22:06:00.000-05:00

I just spent three days hanging out with Danny's sister's family- killing some time that I'm stuck in Chicago between interviews. Today, his 5 year old niece asked me to play doctor with her. I was obviously relegated to being the patient, but I was willing to go along with it. Here's how the interaction went:

Me: I have a cough, doctor!
Niece: OK. I will listen to your lungs. Take deep breaths.
**auscultates in 4 areas on my back chest and 2 on my front chest**
Now I'll look in your ear.
**pulls my pinna correctly as she pretended to look in**
Me: So what's wrong doctor?
Niece: You have strep throat. You have to take antibiotics. You have to take all of them, and you can't skip any, and you can't stop early. Otherwise the bacteria gets stronger.

I would put any 3rd year medical student toe-to-toe with that 5 year old, and I bet she did a better job of doing a classic pediatrics sick visit. She won lots of points for:
(1) actually listening to my lungs correctly (3rds years do 2 spots on the back and call it quits)
(2) looking in my ears correctly
(3) making a clinical diagnosis without unnecessary lab tests (any 3rd year would've ordered a strep swab)
(4) spending 80% of her words on educating me about responsible antibiotic use

Well done, little niece. I hope medical school is in your future.

Google Searches

2011-01-16T15:42:00.000-05:00

I use Google Analytics, which allows me to see all kinds of neat info about the people who visit my blog. One of the more interesting pieces of data that it collects is what search terms people have used who ended up on my site. Here are some of the stranger ones, which I will try to answer to the best of my ability.

"paying for medical school by running "

Dear Financially-Challenged Reader, Running does not pay very well, or pay at all. And medical school costs a lot. The only way that I can think of to make enough money by running to pay for med school is if you can run away from a bank very fast. Like faster than the bullets coming after you.

"astronaut dislike doctors"

Dear Spacey Reader, This makes me sad! I thought that astronauts and doctors had so much in common- we both never see our families, we are both the fantasy spouse of 1950's women, and we are also incredibly good-looking. I will make it my personal mission to never offend or injure any astronauts. Except the astronauts in my novel, who were all brutally murdered. By me. A doctor.

"what to put jello in"

Dear Confused Reader, I feel the need to suggest some of the more obvious answers- a bowl, a plate, a cup, a spoon, your mouth. But I sense that you are looking for more than that. You could put it in your hair (as synchronized swimmer's do), your co-worker's office supplies (as the cast of The Office did) or alcohol (as every college aged partier has). I hope that you found the answer on some other website, because you searched for this many months ago, and I bet your jello got pretty melty since then.

"usmle female blonde"

Dear Girly Reader, The USMLE is a computerized test which is quite fancy. Yet unlike Google Analytics, which can in fact tell me the gender and hair color of everyone who visits my site, the USMLE sadly does not have that advanced function. So take that test confident that the computer thinks you are a brunette male. Your patients, however, do know your gender and hair color, so you might want to get over your insecurities before starting clerkships.

"long hair medical student clerkships"

Dear Super Girly Reader, I'm glad to see that you passed the USMLE and have now made it onto clerkships. I'm also glad to see that you still enjoy googling mad-lib style combinations of (1) your physical attributes and (2) parts of medical school. You don't have to let your long hair stand in your way, but be wary of a few common pitfalls for long-haired docs: rectal exams, vaginal exams, homeless people exams, and any-kind-of-abscess-exams. Just please don't show up on my site again after googling "how to stop chewing your hair".

Marathon Slideshow, aka Pure Awesomeness

2011-01-12T20:06:00.002-05:00

I've always believed that John Williams music makes everything seem more important, historic and glorious. This slideshow is no exception. Get your tissue boxes ready, ladies and gentlemen, because this slideshow is about to blow your mind.

(Apologies for some of the low res/watermarked pictures. I'm not willing to pay $99 per person to get the full size images)

Disney Marathon

2011-01-10T19:54:00.000-05:00

Well, maybe it was a little harder than that. But either way, it was WONDERFUL. I felt good up until mile 22-ish, but even after that I felt ok (just very very tired). Seeing all the Disney parks and characters was a blast. My dad, brother-in-law and I all finished strong. My sister jumped out a little early, since she was running for two (ie- she's super pregnant). It's a little embarrassing that her 6-month-pregnant pace is not too different from my normal pace. O well! Here are some pictures!!

Twitter

2011-01-06T19:46:00.000-05:00

I joined twitter! You can see what I've tweeted (twitted?) so far over there===>

I'll be honest- I joined Twitter out of extreme boredom. I don't do well with sitting around with nothing to do, which is all I've done this week. So yesterday I decided to join Twitter. I think it'll be fun, because there are lots of little things that happen in my life that it's fun to take pictures of and share with you. A full blog post seems sort of intimidating to write, and I never get around to doing it most the time. Hopefully I'll be better at twitting (tweeting?).

And now you have another reason to visit my blog often! Even if there's not a new post, there are probably new tweets!

I'm On A Bus!

2011-01-02T17:23:00.001-05:00

After a long "vacation", Danny and I have collapsed for the final leg of our long trip home: THE BUS.

"Why are you on a bus?!" you may ask, since you are my BFF and you know that I've been in Chicago and Oklahoma this past week (both of which are non-bussing distance from New England). WELL- let me tell you.

This morning we had a flight from Chicago Midway to Providence RI at 8:30am. Pop quiz for any whose ever flown: What time should we arrive at the airport? If you answered 7:30am, then you are as smart/stupid as we were. We even arrived 30 minutes BEFORE THAT, at 7am, because we are rockstars. We walked into the airport, only to find that 20,000 people (number provided by my imagination) were already in line to check bags at Southwest. No biggie, we think, and jump in line to check our bags too. The line wraps around the ENTIRE airport TWICE. No joke. We stood in line for 2 hours. My math-saavy friends can tell you that those numbers mean that we checked in our bags 30 minutes after the plane took off.

Our only option of getting out of Chicago today (which- interesting piece of trivia alert- is the second busiest travel day of the year, trumped only by the Sunday after Thanksgiving) was to trade our defunct tickets to Providence for tickets to Boston. Don't ask me why there were seats available to Boston but not to Providence- the last time I checked, Boston had significantly more citizens.

Since we flew OUT of Providence, that is where our cars are. Which leaves us here, on a bus. The only redeeming part of the experience is that the bus has WiFi. Thus my sudden desire to blog from a bus despite my equally strong desire to nap.

Other things happened on my vacation too, all of which are more interesting and fun than my bus experience. But it's my blog, and I'll whine if I want to.

The Internet Just Blew My Mind

2010-12-23T17:10:00.000-05:00

Do you have any idea how cool the world that we live in is?

I mean, REALLY. REALLY HOW COOL IT IS.

I'm finally getting around to putting the finishing touches on my novel, and I have discovered that the internet is AMAZING.

CreateSpace is an online publishing company that I can submit my electronic text to, and they will send me a copy for free. That's pretty cool. BUT! They will also put it on Amazon.com for me, and anyone in the world can buy it. That's right. Soon, you'll be able to type my name into Amazon and a real-live hard-copy bonafide copy of my book could show up on your doorstep. I bet you didn't think you knew any of the authors on Amazon- but you are officially wrong.

But, what if you are one of those awesome people who doesn't touch real books anymore, because you own a fancy Kindle? Or perhaps an iPad where you read your Kindle books? Have no fear! Amazon has a program that allows anyone to upload a book onto their Kindle market and sell it as a Kindle book!

Remember when getting published meant that someone had to read your book and think it was worthy of being printed?? Ha. I remember when Pluto was a planet, too. Those days are long gone.

The world will soon be a little brighter, because my ill-researched and poorly written novel is about to take both Kindle and Amazon by storm. Watch out world. The field of science fiction is about to take a major blow.

I'll put some links on here once they are available. Unfortunately, the reason that I can make the novel available on so many platforms for free (on my end), is because they are going to charge you for it (on your end). I think I can make it as cheap as $0.99 on Kindle, and $4.99 + shipping/handling on Amazon. Those are the minimum prices set by the publisher- and they even give me a percentage of the price as a 'royalty'. I think I'll get $0.33 per Kindle sale, and $0.51 per hard copy sale. I might quit my day job.

Top Ten Tips For Writing a Novel

2010-12-22T12:26:00.001-05:00

10. If your plot is dragging, kill a character. It's incredible hard to write a boring death scene. Probably impossible. Unless the character was actually "bored to death", but I think that even that would be interesting to write about.

9. Start with a sufficient number of characters so that #10 doesn't prematurely end your story

8. Think of novel writing as "The Original Sims". The reason that Sims is popular is that its fun to have control over a group of characters and make them do outlandish things. Novel writing should be fun for the same reason.

7. Give up on bad ideas quickly. For some weird reason, I really wanted someone to win the lottery in my novel. It just didn't fit anywhere, and I spent too much time trying to work it in.

6. Write about whatever you want. Chances are if you are enjoying typing it, then someone is going to enjoy reading it. For example, I spend about 5 pages describing an appendectomy in space. It was SO fun to write, and it's probably the best written scene in the whole book. If it's not fun to write, it won't be fun to read.

5. Have a terrible opening sentence. It's only uphill from there. Mine was, "Hello?" You don't want to set expectations too high at the beginning or else your readers are going to have, ya know, high expectations.

4. Don't apologize for the decisions you make. I am very bad a writing relationships between men and women (love is sappy and for wieners); but I'm very good an building relationships between men, or between woman (developing friends and enemies is fascinating!!). So I put 5 men in space, and 5 women on Earth, and they really don't interact with the other group. Call me sexist- but a woman in space would've cause MAJOR issues that I'm just no prepared to deal with.

3. Don't name characters who aren't important. I hate when books have too many characters, and I hate when I don't know which ones are important enough to pay attention to. If someone's not important in my book, they don't get a name. For example, "the NASA director" appears a lot in the book, but he's not worth remembering, so he doesn't get a name. You're welcome, readers.

2. Don't say that you have 10 tips if you can only think of 9.

1. Have an awesome closing paragraph.
SPOILER ALERT: Here'e my last paragraph-

I wonder if anyone remembers that we're here. Do history books mention in passing that 2 people were left on Mars after NASA collapsed? Do kids with telescopes know that there’s an old couple living on that little speck of light that they see? Maybe someday a new ship will land. Maybe new astronauts will brave the terrain in search of life. Maybe they will find us, an old couple with a world of our own in this rickety little base camp. We will be there to greet them with flowers from our garden.

20 Miles of Inspiration

2010-12-19T20:17:00.000-05:00

I just ran 20 miles. See the video below for a thorough description of how I feel right now.

Jesus Is A Liberal Democrat

2010-12-17T18:37:00.003-05:00

The Colbert Report

Mon - Thurs 11:30pm / 10:30c

Jesus Is a Liberal Democrat

www.colbertnation.com

Colbert Report Full Episodes

Political Humor & Satire Blog

March to Keep Fear Alive

If you don't have 4 minutes to watch the whole thing, you can just watch the last 20 seconds (3:55-4:15)- he sums it up pretty well.

Baby, It's Warm Outside!

2010-12-10T23:12:00.000-05:00

Running a marathon in January was a really stupid idea. BECAUSE DECEMBER IS FREAKING FREEZING IN NEW ENGLAND. I ran 9 miles on a treadmill a few days ago because it was too dang cold to do it outside. Do you know what's fun about being on a treadmill for 90 minutes? Nothing. Nothing is fun about it.

BUT!! Praise the Lord and pass the ammunition- check out the forecast for Sunday in Rhode Island.

51 DEGREES!! WAHOOOOOO!! This will significantly improve my chances of completing 18 miles. Hopefully the 90% chance of precipitation will be in the form of Gu Chomps and Gatorade. Nevermind, that sounds sticky.

Santa!! At Midway!!

2010-12-09T20:41:00.000-05:00

Walking through Midway, on our way to our fancy residency interviews, Ala and I couldn't pass up the opportunity to chat with Santa about our Christmas lists. And Southwest gave us each $20 our next flight for doing it.

It was a Christmas miracle!!

Death Takes Up Too Much Space

2010-12-06T15:54:00.004-05:00

I'm spending the next 2 weeks In the surgical intensive care unit, since my interview schedule is a little slow in December. My first day back on a surgical service since August, and I'm already waiting for a patient to die. The death has been a long process. A long morning. A family meeting, then withdrawing care, then a morphine drip. Maybe it's because I'm fresh off of my novel writing adventure, but I'm feeling very poetic about Death today. Here goes nothing:

Death takes up a lot of space. It demands a perimeter around it, where Life is not allowed. No laughing here. No smiling. No talking about what you'll make for dinner. How much space do you need, Death? 10 feet? 15 feet? The whole hospital floor? How far away do I need to keep my Life, to avoid offending your perimeter? Certainly I must leave your room- where the silent monitors growl at me. Certainly I cannot stay in the waiting room- where the family wearing black stares me down. I'll take my Life down to the cafeteria, I suppose, to avoid your looming glare.

I'd like to check my email. Is that ok, Death? I'll promise not to smile. Even if I see a picture of my nephew, I'll be as stone-faced as a wall. Your expanding perimeter soon takes out the nurses station too. Can I still have donut, with all its cheerful sprinkles? No? Fine.

Ballooning outward, stretching your limbs like a tired cat, you reach down every hallway whispering, "Run away, Life. Right now, all this is mine." Life reluctantly obilges, shrinking into the corners and closets, knowing that this too shall pass. Death will pass over us and soon leave us alone, we reassure one another. Life will resume its rhythm and dance, knowing that it was a small price to pay to keep Death satisfied. We'll shirk to the corners every time you enter, Our Friend Death, as long as you keep ignoring us in favor of sicker souls.

Slowly you fade away, shrinking back into your secret hiding place some place in the bowels of the hospital, where you can watch us furiously scurry to stave you off. Oh, if we could find you, and smoke you out like a rabid raccoon. Alas, you hide too well and we are left dreading your next return, hoping it won't be in our very own house. There's no room for you in my house, Death. I'll fill it up with Life and Laughter, build a perimeter of my own to stand at its border with my wand raised to you crying, "See, Death? I take up space too! "

Building Up and Tearing Down

2010-12-02T12:30:00.001-05:00

I have spent the past month or so focusing on 3 major activities: writing my novel, getting ready and attending interviews, and running.

The novel writing adventure was all about spewing words onto a page, as many as I could in a day, regardless of their importance or value. I succeeded in finishing my novel in time (which means I get a free paperback copy of it as my prize! Wahoo!)- but now I have to take on the task of editing my novel. I can already think of five or six paragraphs, off the top of my head, that I know are complete crap and should probably be deleted. But it breaks my heart to do it- I poured a lot of time and energy into those piles of meaningless words that don't really contribute to the plot line. At the time, I really felt like that rambling monologue about a sandwich would be helpful....

The interviewing adventure had been a whirlwind. Since September, I've been eagerly collecting interview offers and meticulously adding them and all their associated travel plans to my calendar. But soon, I had 23 interviews offers, but I knew that I should only really attend 12-15 (according to every sane person I've talked to). So now I've begun the sad process of canceling them. I get overly sentimental about the programs that I'm giving up. I KNOW which ones need to be canceled, but when I go to do it, I suddenly feel like I'm closing the door to a possible future that I could possibly have if I kept the interview. It's emotionally draining to talk myself out of all the imaginary lives that I'm envisioned for each of the programs.

The running adventure- well, that's not slowing down at all. I'm still very much building up that area of my life (my long run this weekend will be 18 miles. UGH.) It'll be torn down soon, too, though. I'm sure that a month after my marathon, I will feel like I spent an extraordinary amount of time working toward something that was over so quickly, and all I have to show is a medal and a story.

Sorry this post became so whiny. Here's my new favorite picture in the whole world to cheer you up. Aren't we the best-looking couple you've ever seen? I certainly think so.

Another Novel Except

2010-11-26T23:47:00.001-05:00

I had joked, before the mission, about prophylactically taking out everyone’s appendix. I want emphasize that I said it was a JOKE, because it would be completely ridiculous to submit otherwise healthy men to the risk of surgery that they didn’t need, solely for the benefit of potentially avoiding the rare and unlikely scenario of having to do emergency surgery in space. The NASA doctors didn’t grasp the humor or irony though, saying that if prophylactic surgery was my recommendation then they would make it happen. I mused at their overly cautious approach, and decided to see how far I could push them. I suggested that we should probably take out the men’s gallbladders too, lest one of those start to act up in space. They agreed wholeheartedly. Finally, I proposed cutting off everyone’s testicles too, to avoid emergency surgery in the (extremely!) rare circumstance of testicular torsion. They nodded along, and said that it sounded reasonable. At that point, I began to stop enjoying my little game and fearing what kind of men I was really talking to.

An Improptu T(of)urkey Trot

2010-11-25T12:38:00.000-05:00

About 2 miles into my 8 mile run this morning, I ran (literally RAN) into a group of about 100 people who were about to start a Turkey Trot 5K. As I approached where they were inconvientently standing on my running path, the gun fired and they all took off. What the heck, I thought, I'm always up for an impromptu 5k with 100 of my new stranger-friends. Unfortunately, I still had 3 miles to run when everyone else finished.

I hope that everyone's Thanksgiving is full of pleasant surprises like mine was!! Enjoy your turkey, and take the opportunity to try some tofurkey if you have a vegetarian friend who is willing to share (it's so good- I wouldn't blame them if they don't want to share!!)

Novel Excerpt

2010-11-22T12:22:00.003-05:00

I'm hard at work on my novel, and realized that I haven't shared any excerpts yet with my faithful blog audience. So here's one. Enjoy!

What struck me first was how quiet his room was. There were doctors, surgeons and nurses in the room, but there was no urgency, no rushing around, no screaming out orders, nothing was STAT!, nothing at all was happening. Jonah was too quiet also. He looked peaceful, laying on the white sheets with his eyes closed. The monitors ticked away at the calm rhythm of his heart, beep beep beep beep beep. My eyes moved from his serene face... down his body.... until I saw a dramatic change in his white sheets at the level of his thighs. The sheets turned to a dark red, filled with his blood. Blood dripped from the edges of the oversaturated sheets onto the tile floor, where a nurse calmly mopped it up as it fell. There was something else wrong with the sheets too. I looked more closely. Just below the change from white to red, the sheets suddenly fell flat against the table. It looked so peculiar that it took me a minute to put together what it all meant.

Jonah’s legs were gone.