29 December 2010
i was also lucky enough to spend time with my little sister. can't ever seem to spend enough time with her.
there were presents at my parents' place. oh, there were presents.
the best present award probably goes to cat tank given to us by my sister beth and brother-in-law drew for our cats. that's right, a cat tank.
all-in-all, it's been a lovely break -- first one henry and i have spent at home in two years! (taiwan two years ago, philadelphia last year) even so, i'm looking forward to hitting the interview trail again in a few days for my fun-filled month of seeing the entire northeast. :)
06 December 2010
14 November 2010
05 November 2010
the first time i listened to the second track on the album - "picture window" - i bawled. if you've followed my blog the past few months, you might remember a particularly depressing entry this past summer when i discussed a patient who died while i was rotating on the gynecology-oncology service during my OB/GYN rotation. it was a very difficult experience because there was so little we could do for my patient and many others with end stage disease. as trite as it might sound, this song somehow embodies my experience and allows me to have catharsis for this rotation. i've included the lyrics below.
they checked into the hospital new year's eve
nothing to be done about that
rainbows, daffodils, she's not naive
symbolism's all crap
there's a big picture window in their room on the ward
with a view over parliament hill
but the view offers more joy than they can afford
when there's this much pain to kill
you know what hope is? hope is a bastard
hope is a liar, a cheat and a tease
hope comes near you, kick its backside
got no place in days like these
at dusk the darkness surrenders to colour
as the fireworks streak the sky
and their window gives them the prettiest picture
the useless luck makes her want to cry
then it turns to midnight, the shitty old year's spent
another mum gives her some sparkling wine
she nearly gives in to the moment
but she'll be sick in 2009
and just as she's thinking of pulling the blind
a huge rocket bursts, right in front of her eyes
the city lit up, London's given a bright crown
as she tires, and fails, to stop spirits rise
interestingly enough - consistent with the song - the rooms on the gyn-oncology floor all have gigantic picture windows. here's a view out a patient's window i snapped with my camera phone one day. thanks, nick and ben. you guys help keep a poor medical student sane.
29 October 2010
28 October 2010
today is my mother-in-law's birthday, and instead of going with a cake (they're so fattening, you know? wink, wink), why not cookies? time-honored, mouth-approved, pierce family tradition. plus i got to use the kitchen-aid mixer and take our new canon powershot SX120 IS for a drive. i only wish i could share the smells with you all.
(henry and i may have eaten a few of the "broken" ones)
all the ingredients: ready for action
eggs and butter: irresistible already
the dough formed into perfect little balls
one of the tricks to the taste: rolling in cinnamon sugar
another trick: the fork smush
the goods (and oh, it's good): the perfect snickerdoodle
21 October 2010
it had been my intention to blog much more often during my weeks in clinic. my patients were great – they taught me so much. i learned better ways to ask questions, tricks for less awkward physical examination, and even once had a 10-minute conversation about Alabama football (shout out to my husband for his help on this one). i got to know people the way you cannot in a hospital setting. i got to see repeat patients. i loved recognizing patients, meeting their family members, finding out how treatments had or had not worked. here are a few highlights i meant to tell as stories:
-removed half of a q-tip from a lady’s ear (that she waited a week to come to the doctor for)
-smoking cessation counseling: “so, ms. so-and-so, when do you plan on quitting smoking?” (without missing a beat) “when i get old, develop alzheimer’s, and forget that i do.”
-middle-aged lady, on getting her throat swabbed for strep: “i’d rather get something shoved up my vagina than down my throat if you know what i mean!” (we can only assume she was referring to a preference for a pap smear over a throat swab.)
-middle-aged gentleman, flies a lot for his job: “you know what they say about birmingham: when you die, whether you go to heaven or hell, you have to go through atlanta.”
-older lady getting her blood pressure taken, as the cuff tightened: “god bless america!!!”
-85yr old lady (with poison oak on her ankles for the 3rd time acquired from her cat who goes outside, plays in poison oak, then flops himself all over her slippers) offering me life advice (i got a lot of life advice): “let me give you advice. don’t try to own the road. i got in a wreck last year because i’m too aggressive. stupid @#$%# GMC. my kia was totaled.”
i had an excellent teacher for most of my time at the clinic. i worked primarily with dr. l. when i signed up for the course, i had asked specifically to work with her – and i got to – but she works only tues, wed and thurs (and spends the rest of her week at home working her butt off with three young kids; her husband’s an MD, too). dr. l is great at instructing and giving feedback, but she also has a humble attitude, something incredibly hard to find in medicine. she advocated for me doing any and all procedures patients needed. i froze warts off feet, elbows, and fingers. i sent patients for x rays, urine studies, and to the lab. i did more pelvic exams/pap smears with dr. l than i did on my entire ob/gyn rotation.
on mondays and fridays when dr. l wasn’t in, i worked with some of the other doctors at the practice. most of them were great. one of them was not. dr. b was not a surgeon with a “god-complex,” nor was he a “know-it-all” resident. even so, each time i worked with him i gained a clearer picture of the type of doctor i never want to become. dr. b is an older man. he had a practice at another hospital in town that went bankrupt a few years ago, thus finding himself without a practice. instead of retiring, he took a job with this practice at UAB. it’s obvious dr. b is miserable, and that he has completely checked out. exhibit a: one morning working with him, i saw his first three patients while he meticulously placed stickers on one of those mail-in sweepstakes return envelopes to the national rifle association, complaining to his nurse that he never wins anything and makes no money compared to his colleagues in surgery and other fields.
one of the most frustrating things about dr. b is that he gives out narcotic pain medications (among other controlled substances) liberally. many of his patient encounters started something like this: “so what brought you in today?” “well, my friend/neighbor/boyfriend told me that you’re a really good doctor for controlling pain. i don’t like what my arthritis doctor put me on, and i want some lortab.” and he would give it to them. even ask the dose. and whatever other controlled substance they asked for. so much so, that the clinic created a policy that requires patients on pain meds to get them from a pain management clinic. what does dr. b do? gives the patient the note with the clinic’s policy with one hand, and the prescription for lortab with the other hand.
seeing a patient before dr. b, i talked to her about the harms of narcotic pain meds. she told me she needed them. we talked about how she could try to use less, how she could try other things long term, etc. i didn’t really think i got through to her, but maybe one day she’ll think back to the conversation we had. i was feeling ball-sy and mentioned to dr. b i had talked to her. “what difference does it make?” he laughed in my face. “that’s how people are.”
so if ever someone says to you
"life isn't fair, get used to it"
then you should say:
"well it might be
if folks like you would let it be"
-the avett brothers, the lowering
21 September 2010
and it's awesome. i knew it would be. here's why:
1. laid-back doctors who let me do a lot ("did you write the prescription? order the labs? can you just run my clinic?")
2. steady flow of adult patients (no babies! or kids!)
3. 8a-5p, baby
4. and - dum, dum, dum - i did my family medicine clerkship here! so i have intimate knowledge of the whereabouts of important things like the bathrooms, vending machines, staff microwave, younameit
in medical school where you sometimes switch to a different ward/service/specialty as often as every week, it was such a delight to be starting something where it didn't feel like my first day was my first day.
and my cheap jab above about not seeing kids in the clinic? nah, don't sweat it. they say kids say the darnedest things, but i'd be willing to fight 'em for it. here's an example from today from a delightful little woman in her late 60s. my patients say plenty to keep me rolling all day long.
"hi, ms. so-and-so, what brings you in today?"
"this awful cough" ::coughs::
"i see. well we wouldn't want that to happen. tell me more about your cough..."
11 September 2010
when i was 21, i was in my senior year of college. i went to a local restaurant in the city with some friends for a champagne brunch. we were carded, of course. but when the waiter looked at my license and looked at me, he frowned and said he needed to take my card to his manager. mind you, my friends had out-of-state licenses, in-state licenses, you-name-it. here i was with my in-state as-legitimate-as-you-get-license, getting the twice-over from some waiter likely because of my age.
i could go on and on. apparently i look younger than i am.
but - over the past year, something changed. around january, i stopped getting carded at restaurants. it was mysterious really. i would order my drink, look down to my purse to fumble for my license, and the waitress would have already disappeared. i have been chalking it up to the chronic state of sleep deprivation and stress of third year, especially since just prior to january i had my surgery rotation.
and then it happened. we got our pictures taken for our residency application, and i picked them up yesterday. i looked nice, i thought, and then, out of nowhere: "hey, who is that grown-up?!" apparently somewhere along the way it is the goal of medical school to attempt to make you look like you are old enough to take care of so-and-so's dying mom. hey medical school? goal accomplished. ...or maybe medical school has just flown by so fast the last time i looked in the mirror was my early twenties? in any case, here's the evidence.
yours truly, all grown-up:
30 August 2010
shape shifter have you discovered a change?
why does the soul hallucinate?
i've got control, i shift my shape
your eyes, they swell like a riot, deranged
tomorrow you're laughing like a child again
why does the soul hallucinate?
i've got control, i shift my shape
if flesh and bone do not contain
the mirrors don't reflect my face
psycho, you killer, you cancer, my friend
why don't you give me an answer for when
when you'll let it go
when you'll let it go
when you'll let it go
shape shifter, local natives
29 August 2010
i actually ended up enjoying OB more than i thought. it's definitely one of those specialties (like trauma surgery) where you acquire awesome stories to tell at dinner parties (y'know, one day when you have time to go to dinner parties and friends who throw them). in retrospect, i am actually thankful for my newfound ability to wield a speculum, acquire and interpret a wet prep of vaginal discharge, and manage every aspect of a pregnancy. and i will say that when i got to deliver my first baby, it was - without a doubt - one of the most rewarding and beautiful things i have done in my short medical career.
and now i am one week into my four-week block of studying for 2nd round of boards and preparing my residency application. that's right, my RESIDENCY APPLICATION. after a lot of strife this past week, my application is mostly complete and ready to be sent to 20 (yes, twenty) residency programs on sept 1 when they start accepting them. it is completely befuddling to me that in less than 8 months, i will actually be an MD. simultaneously exciting and terrifying. sort of like a roller coaster, although maybe that's a bad analogy considering that i vomit every time i get on one.
after i take the USMLE step 2 CK exam on september 17, i fully plan to venture back into the world of pleasure reading. i have a stack of books i've been acquiring over the past few years in medical school (which in their own right have been acquiring about a 1/4" of dust). a few among them: inside the outbreaks, by mark pendergrast - a historical/ investigative report about the epidemology intelligence service at the CDC, aka my dream job; every patient tells a story, by lisa sanders - the writer who helped inspire the series House, MD; a few titles by my favorite author ian mcewan, saturday (from my dear from amanda) and the innocent; and my stroke of insight, by jill bolte taylor - a neuroscientist who had a stroke and wrote her story.
ahhhhh, 4th year. hurry up and be awesome! for now, though, i'm happy to bask in the glory of OB/GYN being over -- and the fact that i won't have to look at another vagina for a very long time.
01 August 2010
i won't look very far
cause you'll be there
with open arms
to lift me up again
28 July 2010
14 July 2010
21 June 2010
16 June 2010
31 May 2010
30 May 2010
20 May 2010
i got this feeling they they're gonna come back for more
see i was thinking that i lost my mind
but it's been getting to me all this time
and it don't stop dragging me down
silently reflection turns my world to stone
patiently correction leaves us all alone
and sometimes i'm travelling
but tonight this engine's failing
i still hear the children playing
dead beat dancers come to us and stay
cause i don't care where you've been
and i don't care what you've seen
we're the ones who still believe
and we're looking for a page
in that lifeless book of hope
where a dream might help you cope
where the bushes and the bombs