On a roll, a jelly roll...

Events in the past week (at least the ones worth mentioning):

A la toilet
Dropped my pager in the lou. Splish splash and no more beep beep. Wish I could say I was broken up... but I've never been a good liar. I got a new one today, same number, new hardware. But the respite was nice. I do feel that I have completed a rite of passage in this toilet baptism of the pager. I can't believe I carried one for the last three years and this was the first time it drowned. Probably won't be the last, but, for the sake of all things sanitary, I hope it is.

Ancient Patient
Saw a 101-year-old woman in clinic yesterday. I was impressed with how great she looked (could have passed for 70). She responded to me: "The worst part is that I still have my mind" and she laughed at her joke. Great lady. I cut a massive SK off of her head. And (segue) I do love slicing, dicing, extracting and expressing. Like, a lot. Today I went nuts with a comeodone extractor (fancy tool for popping pimples) on this 17 year old kid. Poor thing. He got a chemical peel afterwards and thanks to me it probably burned like the dickens. But his face will clear faster and, more importantly, I had a good time (evidence of me having good time at clinic at left)!

Cannibalism is always funny
My mother tells me a story about how she was at Big Boy's. Her usual fare was the liver and onions. The waitress informs them that she is sorry but they don't have liver anymore. My mother nefariously remarks, "But you have a liver..." The waitress responds she doesn't think her liver would be very tasty. Chuck in that dry manner of his comments that it might actually be tastier. And such is my mother and her husband, a senior couple out for a happy dinner at the local Big Boy.

Live Show
Saturday I went to a concert in Seattle with a queer family doc who's a friend of a friend, and a friend of hers. It was all part of this massive city-wide jazz festival. The band was Musafir (photo at left, click on band name for more info). It was truly awesome -- especially since we got to sit in the VIP section as this FP had the Uberpass (that's what I call it). The concert was a combination of various Northwest Indian musical influences with very cool instruments and awesome vocalizations. The artists had only arrived in the US the day before. The dancer was extraordinary. She danced, on a bed of nails, sword blades, more, with an urn of water on her head, balanced atop of drinking glasses. Tomorrow night I'm heading back to the same venue for an African band, Tinariwen.

AAA is Evil and Should be Punished
And, for those interested in the car update... it's been a nightmare. Here's a snippet from a conversation I had this morning:

Me (friendly): Hi Ms. Claims Adjuster did you receive my fax?
Claims Adjuster (rudely): I received your wimpy fax, and I got your wimpy phone message.
Me (not believing she just opened with that!): Um, I'm sorry, what kind of fax did you say you got from me?

And it went on from there. They refuse to settle my claim honestly and timely. They won't fix the car or agree to give me what it's worth as a total loss. But I won't dwell on it here. I've talked about it all day and, frankly, I am tired of it. I've enlisted my lawyer parents in the fight and I hope to have a speedy resolution.

Halloween
Tomorrow is Halloween and I have plans to wear little polka dotted doggie ears (maybe they are rabbit ears... but does it really matter?) and polka dotted clothing. This way I can whip off the dog ears when I'm in with a more serious patient and pop 'em back on to show them off for the kiddos (and coworkers!) I also found my old 70's sparkly three piece suit, but that one is harder to play off as professional. Unless I was a professional 1970's lounge singer. Which, sadly, I'm not.

Some serenity

I wanted to make a more peaceful blog entry as the last couple were certainly more cold pricklies than warm fuzzies (anyone remember that book?). So here is a video from the Point Defiance Zoo and Aquarium. It's one of the two Beluga whales. Amazing beasts. (Dont' mind the shakiness at the end... I forgot how to stop it once I started recording.)


And an as an addendum, a little birdie was on my window sill appearing to try and get in! Sive put an end to that by leaping and thrusting herself at the window. No harm came to the cat or bird. But it was interesting to see the bird exploring my windows. I wonder if the people who lived here before left seed on the sill or something. I think I'd have to avoid that as there are way too many crows in Tacoma to go bird whispering. They call a group of crows "a murder" for a reason... ;) Okay, go back and watch my peaceful video again :)

Moving on... kinda

Well, I still haven't received word back on my car. The weekend and all. I have been online searching for compact fuel-efficient alternatives to my car in case I can't have her back. I probably can't afford it, but I really like these three vehicles: the Honda Fit, the Scion XA and the Toyota Yaris (in pretty much that order). I would like a hybrid or natural gas powered vehicle but they are rather pricey and reportedly not as energy efficient or cost-saving as reported. Regardless, I'm pretty sure I can't afford a new new car and I'm hoping the get MY car back anyway. But it's fun to look - distracting at the least until I find out the fate of my civic. At left is a picture of just some of the damage that was done.

Today I have a bit of a post-call hangover. That's when you're not immediately post-call (like I was yesterday) - those days you are just wasted. I think I spent an hour staring at my laundry post-call (not doing it, mind you, just staring at it). But today, the day after being post-call, is the day of the hangover. I'm sleepy, have a hard time concentrating and can be generally grouchy (although I escaped the grouchiness today - probably because the sun was out for a few hours and I reveled in it from patient rooms).

I did some surgery today which was cool. It was a facial tumor removal as well so I had to be especially careful with my stitching techniques. The attending thinks I did a "perfect job". (Awwww). It felt good to get a compliment (they are so few and far between in internship). I'm definitely getting slicker with suturing and, thanks to pathology, have decent scalpel skills overall. But there are a lot of techniques and little things here and there that I still don't have a good grasp at. Practice practice practice right? Any volunteers? ;) (My Step-Mom is exempt since she let me extract millia when she was visiting).

An Open Letter to the People Who Stole My Car

To the People Who Stole My Civic:

I apologize for wishing you unspeakable harms as I followed the flashing lights of the police car to the abandoned grain elevator across from the railroad tracks on the Southeast side of town. When I jimmied that white plastic thing into the black plastic thing dangling from the skeleton of my steering column in just the right position so that I could actually start my car with my key, and not a screwdriver, I apologize for imagining your slow death from exotic infectious diseases. And I’m sorry for implying any incestuous activities in regards to your mothers as I picked through the cigarette butts, trash and drug paraphernalia you left in my trashed interior. It obviously wasn’t your fault. It appears that my Honda Civic is the “most stolen car!” as people have been excitedly telling me every time it happens to come up that my car was stolen. It is as if you have vindicated this random piece of trivia they own. They are so excited to prove their wisdom to me: See! You have one! And it was stolen! I’m right! Yay me! So I apologize for being mad at you, car thieves, since apparently it wasn’t up to you, it was entirely the fault of my car for existing in the make and model as such as it is.

However, I do have a few words I’d like to share with you. Please, if you will, lay down your crystal methamphetamine or crack cocaine (if, indeed, after leaving your plastic tubing in my car, you are still able to manage to carry the smoke from its heat source to your lips). I can’t even begin to start to understand what you were thinking. In a well-lit parking lot, for which I pay a hefty $45 a month, you decided, of all the vehicles available, to steal my car. No, I’m sorry, it wasn’t your decision, it was decided for you, as I have “the most stolen car in Washington!” Congratulations, car thieves, my car was the first ever stolen from this parking lot. Who knows, maybe they’ll reduce the rates? Wishful thinking, I’m sure.

Additionally, you left some credit cards you stole. I’m leaving them with the Sheriff’s Department. Feel free to come by and pick them up there.

I also have to remember to thank you. I was scheduled to work 12 days straight. But thanks to my car being stolen that number was reduced to 11. Mondays are evil, but thanks to my car being stolen, Monday was a free day off. Who cares if it was spent talking to the police, driving to the most godforsaken part of town to recover the scraps of my vehicle, and talking to the insurance company for hours? Plus, thanks to the excitement and the resultant catharsis, I got the best night sleep I had in weeks.

So, car thieves, I’m sorry I wished you maimed, hurt, dead, or worse. I hope you enjoy my speakers, stereo, dashboard controls, chargers, iPod adapter, and my dead dog’s ear fur I saved in a little leather pouch. And that Stella Star CD was my favorite, I’m sure it will bring you much joy, as will the four or five mix CD’s my friends laboriously assembled for me on various holidays and birthdays. I also hope your hands are soft and cocoa butter sweet thanks to the Bath and Bodyworks lotion you now own. I’m happy paying for a rental car for a week to a few days. And, hey, if the insurance company decides they have to total my car, then I can thank you for allowing me the opportunity to buy the best transportation $1200 has to offer. Awesome!

(images courtesy of Google images)

Cowboy

I have learned that my program is considered a "Cowboy" FP program. For some this makes sense. For others there are visions of pretty horses and 10-gallon hats. To clear up the confusion I posted the following on my Facebook page. I'll put it down again here on my Blog for everyone else. Excuse the nerdy X-Files reference but two points for everyone who recognized it!

"Cowboy = hard core.
"In other words, after these three years you supposedly can put me in the middle of nowhere with a scalpel and stethoscope, tell me the truth is out there, and I can fix anything. ;) Cut out an appendix, deliver a baby (any which way it needs to be delivered) and resurrect the dead - you name it. True go-get-em cowboy style. Of course, I have to hand my soul over to my program for safekeeping while they prepare me. Horsies are much more fun."

And speaking of souls - I have to admit that I am feeling mighty drained, and my first vacation of the year gets closer and closer I start to think I may see light at the end of the tunnel.

Overall, Derm/Family/Gyn is going well. Life is quasi normal-ish I suppose. I get to see Mt. Rainier on the way to work Mondays, Tuesdays and Fridays which is swell. Assuming the fog isn't crazy and it isn't raining - um, which is kinda most the time. But that last couple days have been special.

Oh, and I got my car registered. It has a fancy license plate in the front! That's right, here in WA they ear their plates in the front and the back. So West Coast.

If ya'll are lucky I may come back and post about my fabulous adventures this weekend in Seattle and at the Zoo. Here's a sweet floating Walrus and Helene being touristy and blurry. (first pic is another one of my awesome sunsets. The silver lining to a rainy day.)

kittens and cable

Had to post this. It made me laugh so hard I scared the cat. I still think Scrubs is the most realistic medical show on TV. However, they do sit around a lot and talk about stuff. And they all manage to have lunch together, or the same days off. In real life? Not so much.

Anyway, the first week of the new rotation is moving along well. I have had pretty much normal business hours (8ish-5ish) except for Wednesday which managed to be a 13-hour day. Mostly because I had an "off panel" patient. What is this "off panel" I speak of? It's when the TFM resident in-patient panel is full to their limit of patients, but TFM patients keep getting admitted. Then those that are admitted aren't on the regular panel but off panel (aha! a term that makes sense) they are also occasionally called pop-offs because sometimes they are on panel and pop off the panel to make room for other patients. These off panel patients still need a doctor to see them everyday. So it usually falls to their primary care provider (PCP) to round on them. Cue: moi.

I had part of the morning to do errands today. And thanks to the time difference I was able to call AAA of Michigan at the crack of dawn here in Tacoma and work out them paying for my windshield repair. The errand that really did me in was my cable bill. Get this: I got a special cable deal for $33/service/month for one year. It included a cable box and remote which I never used. They sat in my closet for three months. I finally decided to return them to Comcast, as I am a generous person and would never hold Comcast property hostage unnecessarily. Bathed in light on a sunny, early September day, fate was smiling and I passed the equipment to a Comcast employee serendipitously parked in front of my building. "Here," I said, "you guys can have this back, I don't need them."

Then I was socked with a bigger bill.

Apparently I should have left their junk rotting in my closet. The extra features from the cable box were part of the deal and my sunkissed generosity came back and bit me on the ass.

After some finagling and my "sweet voice" I finally got my deal back.

Comcast 1: Liz 1
but the game is not over....

One last rant: Why does Comcast have to call to try and convince me to change my phone? And why does Qwest (my phone company) have to call to try and convince me to change my cable? Can't they just take all the money I give them every single month and be happy?

Hm... maybe I should give myself another point for not being suckered in by either of them!
Comcast 1: Qwest 0: Liz 2 (woo-hoo!)

greener pastures

I type with one dog on my lap and another curled on the couch above my head. I'm house-sitting for one of the TFM docs the next few days - two dogs two cats. This evening we went for a long walk and encountered a deer. I was pretty sure she was initially more interested in us than scared. She ultimately ran back in the woods but not after taking a few curious steps in our direction. It was a quite a moment.

I miss Spike. He was such a good dog. He would have scared the crap out of that deer though, that's for sure - I can hear his "wuh! wuh!" now.

So I finished my last medicine call of intern year. This rotation was a blast, and true to form, I went out with a bang. The stats for the night:
7 admissions: 2 peds, 3 medicine, 2 TFM (okay)
2 ICU patients (okay)
Handful of cross-cover calls (good)
1 incredibly MEAN consulting physician (bad)
1 2 AM crying jag (thanks to mean consult) (bad)
30 minutes of sleep (from 3:30-4 am) (bad)
three cups of coffee (good)

A few words on the mean consultant: I came the the realization that if we were in any other profession and an employee treated another employee like I was treated, and did this on a regular basis, that person would be fired. No doubt. Abuse like that is NOT tolerated in the workplace. In addition, I am mad at myself for letting him get to me. I take pride on my resilience in the hospital. Yes, sometime I come home and am a heap of goo, sometimes out of the hospital I can only communicate in monotone and vacant stares. But at work, I believe attitude is everything. I know his anger wasn't personal, I know he hates his job. And he hates anyone who makes him do it even more. And I know that isn't my problem, it's his. Typically, when I get shit, on I try to be the bigger person. I wipe it off and do my job. But, at 2 AM, (to continue this metaphor) sometimes shit is a little stickier.

After my memorable encounter with this consultant the nurses informed me that this guy is always a jerk. "One time his patient was crashing, I tried to tell him, and he told me that I was 'not to speak unless spoken to.'"

The nurses were great. One even went all out and made me a cup of coffee with vanilla cream to cheer me up. I hadn't actually cried at this point. I felt the lump but had managed to just have a shaky voice now and then - something I might have been able to chalk up to fatigue. But their kindness did me in. I thanked them for the coffee and on my way out of the unit I stopped in the chapel and had a good crying jag. It lasted about 3-5 minutes, I wiped my face on my sleeve (what kind of hospital chapel doesn't have tissue?) and left for the ER for yet another admission.

Now I start Derm/Gyn/Family med - mostly regular-ish hours, M-F with some exceptions. What I look forward to most, however, is the visit I will have from my Dad and Julie in the middle of the month. How nice to see family!

Hopefully I can update more this coming month. Until then, two moves to tide you over. The first one is dedicated to Chuck!



And CLICK HERE for a song all about medications from the same folks.