Why I may need a tetanus booster

My last call, as usual, was long. Endless, you might say. My few chances to lie down resulted in the inevitable page. One aspect of taking call on OB is to do "courtesy checks" for the community docs. This can vary from everything from looking at a slide a nurse prepared to a full vaginal and cervical exam to a complete delivery. I am also the person on hand to assist with c-sections, of course. Between my bazillion speculum "courtesy checks" I assisted a handful o' sections and slept barely a wink. My own patients didn't deliver overnight. Which was particularly fine as two of them were preterm anyhow.

This afternoon, after a couple hours sleep after that endless call, I decided to walk to the post office to mail some letters. On the way I was brutally attacked by a crow. I was listening to my iPod, innocently walking on a well-traveled path, surrounded by kids, homeless people, campers, families, gangster wannabes. The park was pretty crowded for an early Wednesday afternoon. I get to a less populated part of the park (but equally as urban with a big construction project across the street and a bus stop) when my head gets slammed from behind so hard that my neck snaps forward. At first I thought maybe I got hit by a rock until in my peripheral vision I see big black wings and talons.

It got me good. Thankfully wasn't bleeding all over myself (last thing I wanted to do was go back to the hospital) but I do have a rather large lump, a very tender scalp and a few nice scabs where some hair used to be. After the attack, the bird followed and continued to scream at me. I pulled out my Nalgene bottle, turned to face the oily thing and dared it to come at me again, completely prepared to defend myself with deadly force if necessary. I didn't have to, but the way my adrenalin was pumping I was more than willing to fight back.

I love nature. I feel, in most cases, we have encroached on nature's little beasties. I'm starting to feel that crows, however, are less the victim and more the perpetrator. They are just plain mean. They drive out native birds and take over. I've seen a murder of crows (yes, a group of crows is called a murder) attack a lone eagle or barn owl before here. The are just big black feathered bullies.

I decided it was time to learn a little about crow attacks. My first source was Cornell:

My 10 year old son keeps having crows trying to attack him. He will be out in the yard and they come swooping down on his head. He has done nothing to them and he is terrified to go out side alone now. I have been out there and they have not bothered me. Please tell me what I can do.

Since you gave no indication of where you live, I have to guess on exactly what is happening. But, right now (late May) in most areas of the country crow babies are just fledgling (leaving the nest). In the first couple of weeks that the young are out of the nest they cannot fly well and are very vulnerable to predation. They hide in the trees and the parents are very protective of them. At this time the parents will mob (attack) any potential predator in the area. Usually this means cats and dogs, but it appears that your son elicits the same response. You are too big to risk getting too near. Just wait a few days and the fledglings will leave your yard and the parents will calm down. Try to keep in mind that these birds are not vicious fiends bent on your son's destruction, but merely dedicated parents trying to defend their own young in the best fashion they know.

Hm... so am I like a 10-year-old kid these crows? What aren't I "too big to risk getting near"?

Apparently, this is an issue in London as well. Check out THIS article. More than one Hitchcock parallel made surely.

And, now, a 60 second video about the true nature of crows as I see it:

Resident Evil Extinction-Crow Attack
Uploaded by systemofevil

The Old Gray Mare

Thank god for Shiloh (right). I can't remember if I mentioned, but my last couple weeks of pediatrics were hard on me. We had more than our fair share of tragedy. There were kids we diagnosed with cancer, babies we diagnosed with fatal and permanently debilitating diseases, a violent rape of a little girl, it was harsh to say the least. Earlier in the rotation we did have a handful of cute kids with lacerated organs from horse accidents.... bringing me back to my original topic. Some people have yoga, some people have meditation, some people have church. Me? Right now I have an old gray mare and endless fields of clover and wildflowers. I manage to get out there two or three times a week. most weeks. I don't ride every time. Sometimes I only have time to pet her a bit, let her graze at a clover patch (above). And the only fee for all this horse QT is the bridge toll ($4 per trip).

The last few weeks of OB call have been predictably busy. I have delivered a bunch of babies the old fashioned way, and and am getting the hang of c-sections. Still not a big fan of the OR but according to the attending on the last c-section I apparently "have excellent surgical skills" with an added-on, "and I don't usually tell people that". Are you all laughing at the irony with me? What this really means is that I'm going to have a terribly hard time just assisting at this point and am getting some serious pressure to be the primary surgeon. Need I comment again on the irony? On my last day of pediatric surgery I sewed up a small hernia incision terribly - poor kid. But sewing together big things like a uterus or the tough stuff that hold the guts in (fascia) is a bit easier - and the needles are much bigger and easier to see squinty-eyed at two in the morning.

As an aside, I never went to the Tall Ships festival. But I had a pretty good view of the actual ships from various other spots in Tacoma, sometimes even my windows were enough. It looked a little campy, certainly touristy. I did, however, find some good pics of the event. In the last picture (below), click on it and you can see my apartment (and even my window) behind Stadium High School (the white high-rise on the left)!

Today is my last day off for two weeks. I've stocked up on groceries, did laundry last week, went for a short run, a long hike, and sorted through the last two weeks of mail. I also finally vacuumed (yay me!). I don't know how I did it but the day is over now. Back to the grind tomorrow. My next day off, while far away as July 26th, also heralds the release of the new X-Files movie!

Rah Rah Happy Birthday America

So my first call on the OB deck as a solo resident went surprisingly well. There was a three or four hour period where things were a little crazy. I had to call in help from the resident on call for internal medicine. However, by actually running between deliveries (literally) I was able to catch all the kiddos. The nurses, I cannot emphasize enough, are really amazing. In OB it's standard to have one nurse for one patient. Sometimes a nurse will go to lunch break (ah, unionization) but overall it's really consistent for the patient and, I have to admit, great help for me. The nurses really know their stuff. Sometimes there are conflicts as they have their idea how to manage the labor and you have yours, but overall the coordination of care goes pretty smoothly and we have a baby at the end. My nurses saved me last night. When I had five laboring patients, a cesarean section and triage was full with concerned moms-to-be, they help manage things to the point where I could pretty much just run from vagina to vagina to OR to vagina and catch babies. Heck, I even got about an hour or two of sleep in the 30 hours I was there...

...which is good since here I am, post-call, and there are fighter jets and B52s flying around outside my window in celebration of the USA. Sometimes, when the fighter jet flies spiraling up into the sky, flips around upside down and back toward the waterfront, it emits a sonic boom and all the car alarms go off. It's all very exciting but definitely not conducive for sleep. However, just to show how tired I was, I did sleep through it for about an hour or two. (photo, by the way, is patriotism, the Sisters of Perpetual Indulgence way).

I was on call last 4th so I'm not sure what is Tacoma typical, but especially exciting now is that the Tall Ships are here. Those who don't know what that means (like me until I looked it up) it translates as really cool ships with big sails (a rigged sailing vessel according to Wikipedia. - source of the photo). It's a yearly festival and at a different location each year. Tacoma is the lucky waterfront this year. For pictures of some of the ships and info about the various "villages" as part of the festival you can check out the Tall Ships Tacoma Website. Traffic yesterday when the ships were sailing in was apparently atrocious (2 hours to go two exits on the freeway per one report).

So this weekend is a Golden one for me. Which is particularly nice since I'm still recovering from pediatrics. Case in point: there's a stack of unsorted mail and random papers surrounding my couch like a moat. I haven't vacuumed since who knows when and I think the dust bunnies are so plentiful they are starting to organize a guerrilla attack.

The most ambitious plan for my sleepless post-call Fourth will be to ride my bike down to the waterfront to see the Tall Ships... if I can muster the energy (and if this iced coffee I'm drinking now does its trick). The rest of the plan includes laundry, sorting mail and watching fireworks from the windows. In all, not a bad post call day. If I'm lucky I'll get decent breaks between loud things to sleep! Tomorrow I head up to Seattle for my little cousins' joint b-day party. I bought them hula hoops. And couldn't resist so I also bought one for myself. (One of my cousins at left hula hooping - and, look, another Utilikilt behind her!)

Internship Over

Wow. I can't believe it's been a month since my last entry. I'm staring at my computer screen through slitted eyes, I'm so tired. I have finished my 7 weeks of Pediatrics and tomorrow start 9 weeks of OB. OB has a routine, it's hard as hell but at least I get to sleep post-call and I know, essentially, what I'm in for each day.

In the last month I have worked A LOT. So much so that my priorities list had been shuffled multiple times. For example, sometimes I have to prioritize something elective like emailing in regards to something crucial like sleeping. This last long rotation I had to prioritize the crucials, less sleep to eat, or less eating to get my work done. With the exception of the week containing my golden weekend I was between 80 and 90 hrs every week.

The other day I was making a joke about residency but I realize now there's some truth to it: residency has made me soft on the outside and hard on the inside. Looking back on my intern year I would be lying if I said I didn't have fun now and again, but... if you gave me the choice between having teeth pulled without anesthetic and repeating intern year, I'd lose the teeth.

Hey! And speaking of fun.... my golden weekend was during Solstice. I got to go to the Solstice parade in Freemont (it's a particularly leftist part of Seattle). The parade started, as is tradition, with naked bicyclers (one at left - click on it to see "details"). They had body paint designed to look like feathers, clothes, in hand prints, etc. It was really neat. After the naked bike riders came the actual parade, a celebration of summer, solstice, the sun, etc. There are no corporate sponsors of the Freemont parade. The floats are all man-powered, not motorized and if there was music it was thanks to live bands, not stereos. There was hula hooping, a flying spaghetti monster, pirates, unicorns, zombies, belly dancers, dragons, robots, free hugs, a giant joint, hula hoops, storks, stilts, a funeral for the statue of liberty, George Dubbya, chickens, chile pepper-people and "the last virgin" riding a pink, sheep-skin pony. I wish I could post all the pictures here. I took so many. I attended the parade with my cousins and their kids and sat with some friends of theirs who brought bubbles, hula hoops of their own, and pogo sticks. It was fabulous.

Then this weekend I had Sunday off. I went to Pride in Seattle which also had its own awesome parade. The night before I went to see the Seattle Men's Chorus, which was quite possibly the gay-est thing I have ever seen. Ever. And that's saying a lot! The next day was the parade which also featured pirates and the spaghetti monster. I also came to a revelation about the utilikilt. It's made in Seattle and I have seen it everywhere. I never made the connection but it's exceedingly popular in the gay community out here (for men, women and gender non-specific folks). They were everywhere. I have never seem them out of the NW (as far as I can remember). Learn more about them here.

This parade, unlike the Freemont one, did have corporate sponsorship, and being in the NW, Microsoft, Starbucks, Alaska Airlines and WaMu were very well represented (and very, very gay). The Obama love was everywhere. And, my favorite, Dykes on Bikes, was exciting! I can't help but blame my Detroit roots and the Woodward Dream Cruise conditioning to make my heart go pitter-patter with a rev of an engine. Some of the folks at the parade with me felt otherwise, but I couldn't help but find that as possibly my favorite part of the whole parade.

I have soooo many picture from these parades. It was impossible to pick the best ones for the blog. I may have to just post them periodically throughout the year... the pirates, the utilikilt peeps, the drag queens, the Sisters of Perpetual Indulgence, The roller derby girls, the leather fetishists, the rugby folks, WNFL players, the half-naked pregnant goth chicks (above), PFLAG's awesome signs, people dressed as fruits, people dressed as recyclables, more naked bikers and rollerbladers, and more! I'll try to see if I can email a few folks the photo album when I can get it uploaded but if you're interested and haven't received it, feel free to email me for the full photo fun! The photos I've included were picked at random. The one at left only partially shows the scope of the post-parade party that happened at the Seattle Center. Apparently there were 250,000 people there last year. I wonder what the count was this year?

And, as an aside (just to show where my priorities are on this blog), we had graduation for the R3's. It was a festive bitter-sweet event. I got to reunite with Molly, my fellow from my first month of fellowship who has been practicing for the last year in Port Townsend. I also got a fancy certificate saying I finished intern year. The graduating class each had a moment in the spotlight razzed or praised or even serenaded by their advisors. There were lots of speeches, some more relevant than others, mediocre-tasting, but fancy-looking food and a stupendous view (left)!


And, with that, I need to crash. This was a long entry. I feel obligated to reminiscence about the last year. Maybe later. For now sleep is trumping nostalgia. Until later...