The Waiting.

This was my Perfect Song on Friday morning………

 

 

I sent it to one of my best friends, a fellow Vedder lover, also stuck in the middle of one of life’s unavoidable, at times almost unbearable, holding patterns.

I feel like I shouldn’t have anything to complain about right now. I’m on the last of three weekends off, basically unheard of, but most likely due to the hellacious call schedule I’ve got looming over the next two months.

I am absolutely dreading/terrified of it, it’s been building over all these weekends off, just waiting for it to start.

Mostly I am terrified of the 24 hour, Big Girl call shifts we start taking second year at the Mothership.

Last year it was all 12 hour shifts on L&D. Really, no big deal, and after I’d done a few, mostly just fun. But this year, my remaining (we are down one resident, hence all the extra call I’ll be taking over the next few months) 20-something, Energizer Bunny-esque, classmates have decided to switch even L&D calls to 24 hours.

I have no idea how my body and brain are going to take it, but I’m thinking, it is not going to be good. When I mentioned this to one of my cohorts last week, they replied that I am definitely in the wrong specialty if I don’t want to be taking 24 hour calls, as many of our attendings do all the time. Which stung, until I remembered and replied with, well that’s why (at least one of the reasons why) I want to be a hospitalist on L&D (with the much more humane 10-12 hour shifts that will entail).

 

OhSnap

 

Career aspirations aside, I still have all those imminent 24 hour calls to deal with as long as I’m in residency here. I say that because I really am so freaked out about being able to do them. Like I said, especially at the Mothership, where I’ve had mostly horrible experiences so far. I’m pretty sure (/very hopeful) that they won’t actually, literally, kill me, but I am still extremely concerned about my ability to metaphorically survive them (and, therefore residency here), while maintaining competency, and a modicum of sanity.

Today I coped with all the dread by burying myself in bed, the (really, thankfully) meager food supplies I had on hand, and book two of the Game of Thrones series (which, btw, is also thankfully freaking amazeballs). Until my temporary roomie (it’s a long story) came home from her own over night call shift at the Mothership and (unintentionally, but again thankfully) shamed me out of my gluttonous, dread cocoon.

Mostly to go buy the third book of the series, but as long as I was up and briefly disengaged from the battles of Westeros (Okay, the girl at the book store who checked me out just named her new dog Drogo, I’m not that bad. Erm. Yet.), I also cleaned my apartment and did laundry.

And now I’m blogging. Seems a more productive step in coping with the dread than just going back to bed, reading, and dreading. And cheaper than therapy (as if I would actually be able to make it to an appointment).

And as I’m blogging about it, as I told a friend recently, I can’t help but think of all the tests and trials (sometimes seemingly insurmountable) I’ve made it through to get this far. I just seem to keep making it, and hopefully, I’ll make it through this too.

Until then, I’m waiting.

 

 

 

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I want more.

I love art, and one of my very favorite mediums is music.

Of course I can’t carry a tune with a five gallon bucket, and I’ve always been too impatient to learn to play any musical instrument with any sort of skill. But I love searching for and finding, or just by chance hearing that Perfect Song that pumps me up, makes me laugh, soothes, or expresses exactly how I’m feeling at the perfect moment. (I was lucky enough to discover The Black Keys during Gyn Onc last year – Yes, yes I have been living under a giant media-deprived rock – irregardless, fairly certain that was the essential factor in surviving until the next rotation.)

My brother and I have developed a habit of exchanging mix CDs of these Perfect Songs we find since I started med school. We send them to each other as gifts for birthdays, Christmas, and at random intervals just because we’ve accumulated enough of them or one of us really needs a new infusion. I’m not exactly sure how he feels about them, but not being a big accumulator of ‘stuff” myself, they are some of the most useful, meaningful, very best, and really my favorite of gifts to receive. (I’ll never forget my study buddy’s horror second year when he introduced me to the Drive By Truckers with “Nine Bullets” and “Gravity’s Gone”. I was busy falling in love with a new band at the time, but it still managed to register. Hah.)

So, my contribution to the Intern Welcome Basket this year was a mix CD. Initially I asked for input from friends for songs for the Perfect OB/GYN mix CD, needless to say the majority of the suggestions were not fit for general public consumption, but did give me a good idea of what the general population thinks of our specialty (and let me just say: #1. Yikes!! and #2. Really guys???!!). Luckily I have headphones or the radio on most of the time when I’m on my way into or out of work so I heard a lot of those Perfect (and not necessarily X-rated) Songs over the course of intern year and I ended up compiling a list of songs I thought embodied the ups, downs, and in-betweens of OB/GYN intern year.

I made a bunch of copies for the interns and one for myself, and listened to it constantly until a couple of weeks ago when in a fit of 5 am, sleep deprived, pre-coffee frustration/irrationality I tried to fix my car’s CD player by cramming two CD’s in to try and make the mix play. (Yes, yes I realized then, and still do, what a terrible idea this was, and have to reassure that I am a much better MD than user/fixer of technological equipmentry. Much better. I swear.)

That being said, here’s the mix:

  1. First Day of My Life – Bright Eyes
  2. Portions For Foxes – Rilo Kiley
  3. Help I’m Alive – Metric
  4. Blackout – Breathe Carolina
  5. Land Down Under – Men At Work
  6. Let’s Talk About Sex – Salt-n-Pepa
  7. Push It – Salt-n-Pepa
  8. I Wanna Be Sedated – Ramones
  9. Over My Head – The Fray
  10. I Need A Dollar – Aloe Blacc
  11. Breathe – Anna Nalick
  12. Paradise – Coldplay
  13. Some Nights – Fun
  14. Everybody Hurts – R.E.M.
  15. Hold On – Alabama Shakes
  16. Keep Your Head Up – Andy Grammer
  17. Do It Anyway – Ben Folds Five
  18. My Body – Young The Giant
  19. Girls Just Want To Have Fun – Cyndi Lauper
  20. I Love It – Icona Pop

I haven’t heard any the of interns’ reactions to the CD, or if they even actually got their copy as I was in the middle of my South American Medical Mission Adventure when they were supposed to have received it, but I really miss being able to play that CD. There is a Perfect Song for everything I am needing or feeling on my way into or leaving work if I can’t find it on the radio.

I just finished my first rotation of second year on L&D and the song I most listened to on my way home, and most wanted to hear before I completely ruined my CD player was #18. The lyrics of the chorus played through my head most nights as I walked out and drove home after the ruination anyway, “My body tells me no oh, but I won’t quit, ’cause I want more….’Cause I want more!”

It was, hands-down, the best rotation of residency so far.

I was exhausted most days, after 12 to 15-ish hours of non-stop L&D action – high-risk, high-volume, 5000 deliveries per year, one resident on at any given time and responsible for pretty much everything action – and I loved every minute of it.

I think, I have found my calling, and I absolutely loathe leaving it, even for an out-patient “vacation” rotation (followed by another Gyn Onc rotation, the very contemplation of which makes me nauseated even though, rationally and logically, I know The Worst Rotation Ever was primarily due to the The Most Giant A-Hole Chief Ever, so I’m going to not think about it until approximately 5 seconds before it actually starts).

Until I am happily running up and down your hallowed halls again L&D………..

The Daily Something: Nope.

So, I was really hoping that the in-patient Gyn Onc rotation would be one of those things that I build up in my mind to be so horrendous, that then turns out to be not so bad.

Nope.

A few things come to mind:

#1 – Why in the name of all things rational, would a person keep doing a job where they work so hard, for such long hours, for not great pay, where they are mostly treated like crap?

#2 – I never want to be the a-hole who treats my co-residents, med students, nurses, or anyone else I work with (including patients) like crap. Including dumping work on them, not helping them when I can, humiliating them in front of others, or just plain being mean to them. Especially if they are really, obviously trying. Even when I am completely overwhelmed myself.

#3 – I hope I make it to be the person who gets to be the nice, non-a-hole Chief that people like to work with, and that if I do I am so good that I never get completely overwhelmed no matter what is thrown at me (literally and/or figuratively) ever again.

#4 – Gyn Onc is rapidly ruling itself right out as sub-specialty choice, on a very short list of sub-specialty choices. 😦

#5 – For the millionth time, I am ridiculously grateful for my classmates, who are the best classmates I could have ever hoped to have in a million years, who make me feel like I’m not alone in thinking these things, and just plain not alone.

#6 – And I am grateful for these shoes:

AwesomeSuperPinkPowerShoes

AwesomeSuperPinkPowerShoes

Which I splurged on just for this rotation (in my defense, I had coveted them months ago and was pretty much obligated to buy them when I found them miraculously on clearance and in my size). Because they are super comfortable, they make me feel a little more awesome and little less awful, and remind me that I am human being who dares/loves to spice up a straight month of boring, drone OR scrubs with the craziest, brightest shoes I can possibly find, every time I look at them as I am sprinting around the hospital.

Take that Rotation From Hell.

Take that.

The Daily Something: Working With Med Students

I love working with med students.

I remember very well what it is like to be a med student, and I cringe at all the horror stories I hear about how residents treat med students badly. Especially on L&D rotations. That is total crap. Med school is hard enough without someone taking out their frustrations and residency-related rage on some poor med student who is trying to learn, who we have a responsibility to teach, so they can go out and be a competent resident themselves soon. And hopefully not scare them out of a career choice just because we were an A-hole to them.

But I don’t love working with them because it’s my responsibility to. I actually enjoy the responsibility of teaching, of watching their knowledge expand before my very eyes, their brains soaking it all up like hungry, impressionable sponges. I love that they love that I make at least half an effort to teach, and include them as much as I can, if my evals from this year are any indication anyway. (They were awesome, literally, the biggest self-esteem boost I’ve had in my medical career to date, reversing at least some of the damage Intern Year has wreaked. Forget the diplomas, I may have those evals framed.) And fine, I love working with them because, frankly, I love having a buddy to hang out with in the trenches (so to speak). When we’re working all buddy-cop style, and I’m rambling on about how great OB/GYN is, I remember myself, and when I’m trying to make it fun for them, it always ends up being more fun for me too.

And also, of course, every time I work with them on L&D call it is invariably A Night Of Firsts. With the last med student, it was The First C-Section. I had them scrub in as third assist (this being The First for them, and all). It was a challenging repeat, the baby was (for lack of a better term) a Big Fella, and I got to be primary. So, I was too busy during the actual surgery to pay much attention to how the med student was faring (aside from the fact that they were right there with suture scissors and bladder blade at appropriate intervals, and didn’t appear to be faltering or swaying in any I’m-totally-going-to-pass-out-right-now sort of way).

Afterwards, when we left the OR to put in the post-op orders, I finally remembered my buddy and asked, “Oh yeah! Hey, So what did you think of your first C-section?!” To which my (completely reserved and apparently introverted up to this point) med student compadre replied, “What. Just. HAPPENED in there???!! OH MY GOD!!! There was just…like…stuff….coming out everywhere!!! And then, there was…like…a BABY!!! And it came out…and it was all, like……….”

(Best reenactment I could find of what the med student did at this point.)

(Best reenactment I could find of what med student compadre did at this point.)

I stopped, watching this graphic reenactment, and then I laughed. Really, really hard. For awhile.

I have done, or scrubbed on so many sections at this point, I forget what it what must look like to people who haven’t. There is a reason why it’s is my favorite surgery. Triple-bypass-multiple-transplant-sterotactic-robotic-Whipple’s got nothin’ on us. I mean, I’m always highly aware of this, but med students are Awesome for (graphically) reminding me of it.

I love working with med students.

The Definition of Insanity, Or, The Daily Something…..

“Insanity: doing the same thing over and over again and expecting different results.”

~ Albert Einstein

I think of this quote a lot.

Which, probably sounds kind of bad. So, let me (try to) explain – I think of it when I’m frustrated or not getting results that I want, which happens a lot. Hence, the quote, popping up like a warning light on my mental dashboard (except that I actually have some idea as to what this particular symbol means, versus the scary, flashy, light bulb-y looking thing I have been trying to ignore for the past two days on my automobile’s dashboard).

In this particular instance of frustration, I have been trying unsuccessfully to write and actually publish a post for weeks now. And when I thought of the quote today, I realized that it is time to change tactics. (This realization being accompanied by the always comforting secondary realization that I am probably not technically insane yet. At least, not according to Einstein.)

So here’s my New Tactic: Instead of setting out to write and publish some fantastical, deeply meaningful, thoroughly comprehensive Masterpiece Of A Post that covers and compensates for the months of absolutely nothing (that will apparently never, ever happen), I will just try to write a Daily Something.

I know, and now you’re like ‘Um yeah. A Daily ‘Something’ sure sounds like a thing I would like spend 3 minutes of my precious, fleeting life reading. Or not.’ But hold on now, I do solemnly promise that I will I only distill it down to the most interesting, entertaining, funny, important, etc. of Something’s. Because I do believe my life is full of them, if I’d only get around to sharing. And certainly Something will be better than nothing.

Onto the first [Of Many!! She confidently (mentally) exclaimed.] Daily Something………

As I left work today I realized something. (Yes. Yes I do just walk around all day realizing stuff. Tyvm.) Lately, I have been feeling like crap. As in, What in the h*ll am I doing here, stressing myself to death in residency when life is too short to feel like crap all the time? I want to go home and be a dog groomer. Or anything but a resident. I wish I had never gone back to medical school and/or could go back in time and Ninja chop myself as I’m about to submit that d*mn application. (I recently stumbled on an article in a respected medical journal from 2008 that said something like 40% of medical residents regret going to medical school, which makes me feel, if not better about, then slightly less alone in that last bit.)

I mean, for pete’s sake, I think I actually have an ulcer. That, admittedly, may be due to my habits of drinking coffee and Diet Coke like water (instead of actual water, which I never, ever drink), and several glasses of red wine per week. But I’m mostly blaming work-related stress, because that, and just the thought of Work, is mostly what wakes up and seriously p*sses off the angry badger that has been clawing at my epigastric area for the last five days. At least that’s my story until I get to see a doctor in about a (friggin’) week. (Because same day appointments apparently do not exist in this place filled with 50 gazillion doctors, if you are a resident, and you refuse to use the ER – i.e. Pit of Doom – unless you are half-dead. Oh. The irony.)

I am also on Gyn Onc right now. The rotation I have been dreading all year, because it is Oncology and I already feel bad for all the poor cancer patients, and it is by all accounts a work hours wrecking, intern scut horror show. And stuff like this little gem I just found in my pocket reference:

photo - Copy

Do not help in my attempts to approach the rotation in a rational, non-panicked manner. Very funny Dennis Siegler. Very. Funny.

Luckily, they are starting me out slowly on out-patient, but the badger was still angry and clawing away when I walked in today. Armed with a bottle of Tums and coffee cup (sadly) full of milk, I went anyway.

And then time went by very quickly. I saw several very nice patients, worked with a couple completely reasonable attendings and several very sassy nurses, and the day was over.

I left, and as I walked away, I realized the badger was quiet. My stomach didn’t hurt, and I was thinking about the nice patients I saw, talking with them, helping them, and I was….happy????

It’s maybe the hundredth? thousandth? time I’ve had that realization. Here’s to hoping for a hundred, thousand times more. At least enough to get me through the next three years.

******************************************

And, here’s a picture. Because along with the Something’s, I’ve been saving those up too.

🙂

Easter Cookie. Yumsies.

Easter Cookie. Yumsies.

How do I love thee L&D?

I had such a great weekend of call on L&D. Once again, I left so I tired I had to call someone to keep myself awake on the way home, but wishing I could just be on L&D until residency is over. And pretty much forever after that.

How do I love L&D? Let me count the ways……..

1. New Dads on Postpartum wearing hospital footies, pushing their babies around in their little hospital cribs, up and down the halls, every so slowly, ever so carefully. Stopping every few feet to ever so delicately adjust a blankie, or a onesie, or little baby hat.

2. Nurse Grumpy’s baked goods. I’m going to have to find a new name for her, because she is showing signs of slowly, infinitesimally, warming up to me. Probably because every time I see her I run to the lounge to look for the brownies or cookies she invariably comes with, and then return to lavish her with praise for being the Goddess of All Things Baked she most assuredly is (she is also a d*mn good nurse, but I’m usually too full of baked amazingness to get to all that).

The BEST chocolate chip cookies in the WORLD. I start drooling every time I think about them. Not even kidding.

The BEST chocolate chip cookies in the WORLD. I start drooling every time I think about them. Not even kidding.

 

3. Compliments from the nurses. There have never been residents at the hospital where I was on call before we started there last year. So there has been quite a bit of confusion as to who we (residents) are, what we do, and where we fit in. And honestly, a fair bit of resistance, and occasionally, the kind of passive-aggressive hostility nurses (Yeah, I’m a nurse too, I know how it works) can specialize in. Part of the awesomeness of last weekend was seeing the change in this dynamic that has slowly evolved since we started. Little things, like getting paged to see patients before the attendings, having gloves on the table before a delivery without having to get them myself or remind anyone of my size, and most telling of all, stopping outside a patients room to slap on some hand sanitizer, and inadvertently overhearing the RN telling the patient who I was, how nice I am, how good of a doctor I am, and how lucky they are that I am the resident on to help take care of them. These are really great nurses, and I understand and agree with the fact that their respect and praise has to be earned with consistent hard work, a good attitude, willingness to be a team player, and excellent and competent patient care. An endorsement like this, from one of them, means more to me as far the kind of doctor I am becoming than any kind of off-the-chart CREOG scores. It’s (really) good to (finally) be part of the gang.

4. Random conversations overheard at the nurses station. They routinely kill me. I never know what I’m going to hear, from in-depth explanations on ‘Vagazziling’ to spirited debates about gun control. The latter of which yielded my personal favorite quote of the weekend from one of my favorite funny girls/nurses: “Fine, if there’s a Zombie Apocolypse, I guess I would use a gun. Actually, forget it, if a Zombie Apocolypse ever happens, I’m just going to let one bite me and get it over with.”

5. Dads at the bedside right after a delivery, with silent tears rolling down their faces, too choked up with emotion to do anything but stroke their wive’s sweaty foreheads and gaze adoringly at her while she cuddles their gooey new progeny to her bare chest.

6. The Ladies In Labor. I had such great patients (I always do, but these peeps were especially, awesome), the labors weren’t all easy and the dynamics weren’t all hearts and flowers, but we all worked hard to manage labors, keeping things moving along, alternately encouraging, cajoling, kidding, coaching and teaching, and the deliveries were all great. To the best of my ability, and from what I heard from my patients, everyone had the best experience possible. And the board was empty at the end of at least one of my shifts. Doesn’t get any better than that.

7. And then, I was in the nursery doing circumcisions and one of the Dads I had met, helping manage his wife’s labor, but missing the actual delivery as I was in the middle of two others, spotted me. I returned his wave happily, and went back to work. Then I heard one of the nurses call me, “NurseMD, someone is here asking for you by name.” “Ahhh, kind of busy here, I’ll come talk to them in a few minutes.” She came over a few seconds later and said, “They just wanted to give you these.”

photo(3)I don’t care how hungry I get, I am saving them forever, and never eating them.

Privacy For Dummies (Like me).

So, a great benefit of my residency program is that I have 24/7 access to our EMR off campus. Which allows me to work from pretty much anywhere, anytime. Extremely helpful considering that I am working most of the time, wherever I’m at.

One downfall is that no traveling company phone comes along with the anywhere EMR access. And sometimes I have to call a patient from home at 8 o’clock at night, or other “technically off-duty” hours with test results, or instructions, or whathaveyou.

So I have to use my own phone to call, and BINGO, patients got my number. If you don’t mind random phone calls in the middle of the night (On nights when you are actually lucky enough to be in your own bed sleeping, or trying to sleep depending on what kind of shenanigans your idiot upstairs neighbors have planned. Swear to G, last Thursday night, it was Riverdancing. Right above my bedroom. There is no other feasible explanation for mere human beings creating that kind of racket.) asking for a prescription for condoms (This would be funny if I didn’t know for a fact it actually happened to another resident. Wait, no, still kind of funny.), go right ahead and use your own phone.

I know that many residents have used their cellies to call patients and unwittingly (or being much more kind-hearted, and less bear-sow-with-cubs-possessive of their rare, precious Free Time than my own self, wittingly) handed out their personal digits like Halloween candy. To patients who have absolutely no compunctions about calling their physicians, day or night, with any and every twitch, twinge, question, complaint, sign, symptom, Google-induced syndrome, etc that might (or might just theoretically) be causing them a moment of contemplation.

Of course (!), not all patients are like this. But some are, and if you call enough of them from your own phone, you are suddenly on call. All the time. And your rare, precious Free Time ceases to exist. Period.

Naturally, I am writing this post because I am an idiot, I called enough people with my own phone (that I really did have to call and I was no where near a company phone at the time), and I have managed to procure my own 24/7 patient.

[Please note that I absolutely do always provide my patients with other, perfectly acceptable, numbers that they can call 24/7 for whatever may be niggling at their minds and/or bodies because I want them to have access to quality care/advice whenever they may need or want it! That is why God gave us Being On (Real Valid I-am-being-paid-as-a-competent-professional-to-respond-to-every-and-any-call-that-comes-through-here) Call.]

The point of this post is – for any and all fellow Free Time cherishing idiots like me out there – it doesn’t have to be this way. Just dial *67 before you dial the number you don’t want calling you back at will (P.S. This also works for The Exes, and The Other Assorted Please Don’t Call Me Backs, Like Ever TYVM, numbers you might be forced to call for any number of assorted, uncomfortable issues).

Everyone else on Earth probably already knows this.

But in case you’re a ding dong (like me), You’re Welcome.

Of course, this only works in the US as far as I know. Internationally? You're on your own. Suckers.

Of course, this only works in the US as far as I know. Internationally? You’re on your own. Suckers.