And Many More!!!

i hope everyone out there had a wonderful Christmas and is well-rested and fat like i am. we had a great week w/ family and will be heading back home after New Year's.

i start a pediatric rotation on wednesday at a local clinic. can't wait. snotty noses and vaccinations and foreign objects found stuffed in every available orifice.....so very excited. :)

So far...

so i've been reflecting on my rotations so far. i'm officially one semester down. grades are already in the bank and i'm moving on. two semesters to go and then graduation in august. it actually seems attainable now. i have 2 weeks off right now and then i start in a pediatric clinic. what have i been doing on my time off? well, i'm lying in bed typing right now, haven't gotten up other than to yell at the dog and tell her to lie down and leave me alone....that's pretty much what i've been up to. some lunches w/ friends, some shopping, some movie watching. generally just being lazy and happy. some of my classmates are using the time to get back in shape or to clean their houses. not so much on this end. that would involve getting out of bed, right?

on my rotations i've seen a lot and learned an incredible amount of medicine, exam skills, and patient interviewing tricks of the trade. also how to be a student out in the real world and to make myself useful.

this year is completely different from last year. my husband was reminding me recently how last year i wouldn't even go to the grocery store for an hour because i felt like i couldn't stand to lose that much study time. not so this year. we've had weekend get aways and i'm staying on top of cleaning the house, cooking actual meals at night. it's great. some of the rotations have long hours, and i haven't done internal medicine or ER yet, so i might still have some long hours ahead of me, but overall, i have so much more time to myself. and less guilt about not spending every waking minute reading/reviewing medical text.

and it's so much more fun to be practicing on actual patients with actual ailments than on our fellow students who are faking heart attacks and ear infections and such. it's really rewarding. i feel like this is pay off for all the work of last year. and i've felt very confident in my decision to become a PA. the more time i spend around medical settings, the more i want to be there. i have no regrets about choosing to be a PA instead of an MD or anything. most PA's are impressive w/ how much they do/know and pretty much practice like docs, but w/ a little less pressure and responsibility. i like that.

i do wish i had retained more of the knowledge i learned last year. there's a lot of reviewing and learning to be done right now. i think that's just how it works. with a patient sitting in front of you, it's a lot harder to come up with a diagnosis than it is when given a case study w/ all the buzz words of the condition.

overall, i'm very satisfied at this point. perhaps lying in bed all the time puts me in a good mood. that is entirely possible.

Fa la la la la.....

so my husband and i went Christmas shopping last night and i have two observations to make.

1- we went to our separate public restrooms down the mall bathroom corridor to do our separate businesses. upon walking into the women's room i observed a heinous, dead animal smell hovering over the baby changing table. the perpetrator was maybe 6 months old and even the mom seemed to be gagging a little as she changed his diaper. it was awful. i mean aw-ful. like dear God in heaven please have mercy on all of us in this shared restroom space and spare us from certain, slow odoriferous death. and it occurred to me that women's restrooms always have baby changing tables and i do not believe that men's always do. and that we women are ALWAYS lumped with the stupid children. it means we (womenandchildren) get to be saved off of sinking ships first and all that, but it ALSO means that we women are stuck w/ the children in all venues, including public restrooms. i think i would rather take my chances swimming to shore and let the men deal w/ the children just once in a while. thank you very much.

2- my aunt has always avoided shopping at a certain preppy clothing store that has been around for a while and is famous for its "layered look" and naked-ish photos hanging all over the store and in the catalogue. she has commented (in so many words) that a store that sells clothing should have models modeling said clothes and not showing off their ass cracks and that the pics are offensive and inappropriate for the eager youngsters wanting to buy their expensive, boring clothes. that being said, it's more the unstylishness (not a word, i get it) that revolts my husband about the store and when we walked by the store the first time last night he said, "ah! help! it makes my skin burn." so we quickly moved on. the second time we walked by it (we were at the mall for a while), he actually glanced in and said, "it smells like...date rapists in there." a very poignant and funny observation. the clothes do indeed smell somewhat of non consensual sex.

Off Subject

i am trying not to think about my exam tomorrow nor of my mixed feelings on this family med rotation. so....in the name of wasting time and avoiding my responsibilities, here are my top favorite characters on modern television. (i don't actually watch that much prime time tv during prime time...i catch up w/ the full episodes on the web on my laptop at random times throughout the week--independently causing the writers' strike-- while i cook/clean the house and stuff, i promise).

please feel free to leave a comment about your top picks...

1. stewie griffin ("family guy")


2. bob kelso ("scrubs")

3. joy turner ("my name is earl")

4. dwight schrute ("the office")

5. marc st james/amanda summers (as a comic duo, "ugly betty")

6. olive snook ("pushing daisies")


ok. i'm done. seriously. back to work. right now.

Well, hell.

so yesterday i was feeling a wee bit competent in all things primary care. i was thinking that as long as you have an infection of the sinuses, the upper respiratory system, the bowels, the girl/ boy parts, and possibly even the skin, i'm your man. i might even be able to help you a little w/ your diabetes and high blood pressure. heck, throw in a malfunctioning thyroid, why don't you. i might even consider fixing your kidneys and liver on a really good day.

but today- i failed at everything. every question asked of me i got wrong- sometimes waaaay wrong, usually just a little wrong. i scrambled for simple anatomy words, i mistreated ailments all over the place, and i generally just made an a-s-s out of myself. one of my professors once told us that we should expect brilliant days and idiot days. i just wish my brilliant days were a little more stellar and my idiot days were a little less durh-du-durh. (carlos mencia). i mean for pete's sake- i'm supposed to be able to treat patients on my own. and SOON!!!!

maybe i should have gone into sales. or miming. i would have made one heck of a mime.

growl growl grumble boo.

I Have No Patience for Patients

seriously. for the love of all things holy, when we tell you to take deep breaths, TAKE DEEP BREATHS...we're actually trying to hear something in that hunched over cage you call a chest. and when we tell you to "open wide" JUST OPEN UP so we don't have to stick that wooden thing all the way down your throat. thank you. hell.

this clinic thing is getting a little tedious. can you tell?

i got very frustrated (mostly internally, don't really think the patient could tell) at a little old lady who came in today for a first visit. she had a regular doctor of 30+ years, but decided she'd stop in to our clinic with the complaint of several months of pain and bleeding because she happened to drive past and saw our sign. she OF COURSE listed no previous health hx on her intake forms and could barely remember the names of her meds. then she wanted us to fix her today and was put off when we asked for some records and recommended she see a specialist. awesome. it's a bit like going to target and asking to see their vera wang line of clothing. target has some quality merch and is really good at covering all the bases for every member of the family...but you don't go there for the fancy duds. and you don't go to a family practice clinic when what you really need is a butt cancer doctor. can i get an amen? amen.

i kind of hate myself a little for having no patience any more. i used to be so tolerant and really was interested in all the details of a patient's dire life situation or confounding medical conditions. now when i'm stuck in non-productive, never ending conversations, i'm looking around the room for sharp objects with which i can carve my eyeball out of its socket. does this make me bad? or just more efficient. the docs have their patients booked something like 7 minutes apart and they still seem caring and attentive. they just don't get bogged down in all the minutia. that's a good thing. means they can help more people. yea, yea. that's it. i don't have a cold heart. right?

....i think i'm ready for a break.

Almost done

i only have 2 wks left of family med rotation and then i go into (tra-la-la) Christmas break. well, technically, holiday break. i made the huge mistake the other day of trying to make conversation by asking an MD if she was all decorated for the Christmas holiday and she said kind of snappishly, "i don't celebrate Christmas." i felt like an idiot and mumbled something about how it's a good thing she doesn't have to be hanging lights out in the cold and how it's all overrated anyway and how...um...cool dreidels look when they spin...and, uh, how adam sandler is the finest comedian on screen today, and that barbera streisand isn't THAT annoying.....heh.

she pretty much ignored me the rest of the day. cuz i'm not irritating enough, as a student following her around and slowing her down, i have to be culturally ignorant, too. awesome. :)

so other than that...things have been going pretty well. i've found i have a great poker face with patients. i've heard and not reacted to everything from a mentally ill patient describing in detail her fantasies about choking people (while she gazed longingly at my neck- i swear i wasn't making that up) to descriptions of the exact size, shape, consistency and color of feces, boogars, and kidney stones. also, issues of limp willies and decreased sex drive, fights between couples about whose fault it was they couldn't get pregnant for the 6th time at age 45, and tales of all kinds of home remedies for anything that ails you (and the consequences of using said remedies). and these are just the grown ups.

kids of course will say anything at anytime. and they see right through our bullshit. a visit can be all fun and games with stickers and hand puppets, but you mention the words "diphtheria titer" and they are packing up their things and thanking the nice nurses for their time and trying to pay the copay before the staff can get the vaccination tray out. they just know. and the doctors are sneaky. you'll notice they're never actually present when shots are given. they make the nurses and MA's do all the dirty work. and the students. i am often responsible for holding little legs down while multiple injections are plunged into little scared thighs. but the doctors get to be the good guys.

besides having a good poker face, i also have to fake confidence regularly. i was sent into a room by myself to give a steroid injection into a joint and when the lady asked me, "ok, so you're a student, have you done a lot of these?" the accurate response would have been, "i've seen 1 and done 1 with supervision. as far as i know, that patient wasn't paralyzed by my efforts, but maybe i should call to check first." but what i said was, "i've been a student now for a few months and have had many opportunities. i'm comfortable with this and it will be done in no time and you'll be feeling SO much better." smile. pause. proceed. i kept telling myself not to sweat too much on her or say "oh, snap" if i miss and hit an artery or something.