Gaaaaaargh!

i'm a very bored pirate these days. days are dragging by. and again, i know how fortunate i am to have the easy breezy hours i do-especially compared to some of my classmates. but i am just kind of tired of being a student. tired of having to prove myself day after day to different people and tired of still being wrong, wrong, wrong all the time, time, time. i'm on the home stretch- it just seems like a long way to go still. and it kind of stinks that i'm feeling so burned out while doing something as cool as ER. i am getting a lot out of it....just very much ready for vacation.

so, in my eagerness for the upcoming spring/summer weather and in anticipation of the death of this, the longest winter in the history of mankind, i am pleased to announce that we are now in April- National Humor Month. in honor of this tradition, i ask that you all post your favorite (mildly clean, please, my grandmother reads this blog) jokes for us all to enjoy. i'll start with a few i've heard from patients on my rotations. a bit morbid, but fun nonetheless.

1. A guy goes to see his PA in the office and says, "I haven't been feeling so good lately. How do I seem to you?" The PA shakes his head sadly and so the patient asks, "Well, geez, doc. How long do I have?" The PA responds "3." The patient says, "What? Months? Years?" The PA replies, "2....1..."

2. An engaged couple dies tragically in a car accident. They meet St. Peter at the pearly gates and while they're doing all their admission paperwork, they fret to St. Peter that they never got to get married while living and desperately want to be together in eternity. St. Peter says, "Well, normally we don't do this kind of thing. But you seem like a nice young couple, I'll see what I can do." He goes into heaven and leaves the couple outside the gates to wait. He's gone a really long time and while they're waiting the couple begins to discuss marriage and eternity and things and decide that they have some concerns about the enormity of this decision. When St. Peter returns he says, "Good news- I think we can get you married here in heaven!" The couple looks at each other and says to him, "That's great, but we were thinking- what if eternity proves to be too long for us? What if we ever needed to get a divorce?" St. Peter smacks his forehead and yells at the couple, "You two are something else! I had a hard enough time finding a priest to marry you, there's no way I'm going to be able to find a lawyer!"

again, i encourage you to submit your favorite jokes for our enjoyment. extra points for jokes related to medicine or healthcare. or manatees.

also, famous birthdays in april include: john madden, steven seagal, shannen doherty AND jennie garth, jane goodall, muddy waters, merle haggard, butch cassidy, hugh hefner, michael moore, william shakespeare, willie nelson, queen elizabeth AND joey lawrence.

just in case you want to send a card or something.

You're Here for WHAT?

it's amazing what brings people to the ER. i've seen too many healthy 20-somethings complaining of a slight cough for 3 days- clearly just a viral upper respiratory infection (flu bug) that needs rest and fluids. and NOT A TRIP TO THE ER. i don't get it. are people just not educated? do we think that we should never be sick or broken and if we feel at all off, it's some sort of disaster that needs to be fixed at whatever inconvenience and cost? first of all, even if you're guaranteed to be seen in 30 minutes like a lot of ER's across the nation boast, that's a lie. and after you're initially evaluated you will be lying in an uncomfortable bed in the hallway or behind a thin curtain for hours and hours and hours while you wait for test results, get ignored by the busy nurses, and are exposed to all kinds of actual sick people. and it's boring! no tv's or magazines, nothing to do but lie there and listen to the baby cry next to you or that crazy old man across the hall asking anyone who passes by his room to "dust him off."

and then there are those patients who had a massive fall with head trauma DAYS AGO or who have been having unremitting chest pain for a week now who really should have come in quite a bit sooner. again, poor judgment.

ah, well. what are you going to do?

i've seen and done some interesting things. helped insert a chest tube yesterday to someone who was having a pneumothorax (lung collapse). have drawn arterial blood on someone (much tricker than venous blood draws), have sutured some, read a lot of CT's and xrays. overall, have gotten enough blood on my shoes to make me feel productive. :)

it's not all procedures and fun and games. there are some really devastating moments, too. brain dead on arrival with the family in toe.....young patient with sickle cell weeping from pain- chronic and horrible pain- begging for relief.....etc...

but it's been good. i really like ER. the staff is so laid back and fun, too. it's a great rotation. and when i'm done w/ this one, i have a vacation (tra-la!). so thats always on the back (and middle, and sides) of my mind.

this is funny- brian regan on a patient's perspective on visiting the ER.

Code Brown

had a beautiful Easter weekend with my family. we had a lot of fun. i have good people. and my gosh, we eat well. getting back on sweets was a real pleasure. i ate my weight (104 lbs, if you must know) in chocolate of all delicious varieties. it was awesome.

i finished internal medicine last week, took my exam and moved on. started ER today. i think my schedule is going to be great- 4 10-hr days each week with weekends off. i have had the bestest schedule this year so far. i love it.

today was a good day. i think i'll like ER. it smells bad, though. we call it a "code brown" when there are wafts of poo smell in the halls. and unfortunately, there are a lot of code browns here. more than code blues (cardiac arrest), thankfully. but really in a code blue there are more exciting and useful things for us to do than in a code brown. i got to do some cool things- got to stitch a fella's eyebrow back together. got to do a bunch of interviews and initiate work ups, do some rectal exams (woo-hoo!), etc.

being in the ER is a horrible, long, painful, embarrassing, and boring time for most patients. i am trying to be a calm figure at the end of patients' beds and to make them laugh (when appropriate). and then i compliment them on maintaining their sense of humor.

i'll let you know how things go. i'm guessing i'll have lots of stories. for now, i'm off to sleep on the couch in my skivvies. i'm pretty exhausted i started my day at 4:30am.

Solution to Cell Phone Toilet Plunge

my brilliant friend from far away lands who is the rescuer of all things electronic gave me advice on how to preserve my old (potty) phone long enough to get my data off of it. and he was gracious enough to let me share his insight with all of you.

to take the wet phone and absorb all the moisture from the inner workings w/o trying to take the whole thing apart and make an even bigger mess out of it.....simply remove the back and battery and place the phone in a tupperware container full of dry rice. leave for 8 hrs. flip over and leave for another 8 hrs. take out and put the battery back in and try it.

it totally worked for my phone and will likely work for yours, should this ever happen to any of you ("sas" et al). my friend says that adding a little tech nerd prayer right before you try to start it again might help, too. (something like "dear st. stewart, patron saint of gadgets, please have mercy on my stupid self for besmirching this here cell phone with water of the most unholy nature...").

so thanks, man. you're a lifesaver.

and if you're curious as to what i'm actually doing while i'm supposed to be studying for this upcoming internal medicine exam, i think that this is way more useful in the long run.

Zen Moment

and so since last we spoke i have been ill with a respiratory infection that my DOCTOR says is nothing but a typical upper respiratory viral infection, but...while i like my doctor very much and usually trust her judgment...this thing that i have is, in fact, the bloody black lung pneumonia death plague of 2008. it's very serious. seriously.

fortunately, i'm feeling better than i was a few days ago- antibiotics and cough syrup, cough and cold tablets, an inhaler, an old priest and a young priest, cough drops, and many hot totties seem to be helping some. my cough now originates around my belly button instead of my toes, so that's improvement.

i did take one day off when i had a temp, but otherwise have been working through it. hopefully not contaminating too many patients or staff members in my path. i'm sure it's not very confidence inspiring for patients to hear their practitioner hacking and coughing. a bit like a hairdresser w/ a mullet. (unless you're into that kind of thing- i'm not judging).

and, because my mood and general satisfaction with the world couldn't get any better, 2 days ago i dropped my cell phone into the (UNUSED!!!) toilet, rendering it totally useless. it was completely a slow-mo horror moment where i juggled with it, almost caught it, and finally lost it between my fingers into the murky (BUT CLEAN, I SWEAR!!!) depths below. and only after it was soaked and totally non responsive did i realize that i could have and should have been backing up my contact list, calendar, etc all this time onto my computer. so now i'm like an island with no schedule and no phone numbers for my loved ones and friends....just hoping they'll sense my isolation and misery and know that i have no way of reaching out to them and they'll know instinctively to call (or better yet, to send soup). well, i guess i COULD email them.....but then they might send e-soup, and that's just not going to cut it. i'm just relieved that i got the insurance for my phone- since this is the fancy smart phone (not smart enough to avoid water, is it??) it would have cost me a ridiculous lot to replace it without the insurance. i'll give credit for that wise decision to my husband, who knows my slovenly tendencies only too well.

so my internal medicine rotation is almost over. i've enjoyed it, but i'm ready to move on. i've been at this hospital for 8 wks now and am ready for a change of scenery. i've had a few docs interested in possibly hiring me, so that's a good thing. but graduation seems very far away and i still am not totally positive what i want to be when i grow up, so i'm hesitant to commit to anything. i still have a few rotations to figure it out. i'm thinking PA figure skater or PA firefighter maybe.

off to try to study for my exam....here's to cautious cell phone use in the loo.

Old Age: The Pros and Cons

pros= *by definition, it means that you're not dead, *you probably don't have zits, *you can get away with saying ridiculous things and people find you more charming than creepy, *you likely lived through several sweet fashion/style eras and have crazy cool pics to prove it, *you might still own stuff that was made when they made stuff "like they used to," *you are expected to fart in public, *you know nifty ways to convert Christmas tree tinsel into rifles, support stockings, and butter- whatever Uncle Sam needs at the time, *you no longer have to worry about menstrual cramps or having babies (although, see "bladder prolapse" and "ungrateful children" below), *you can eat all the sweets you want because they're not your teeth anyway (and besides, fluoride's for sissies).

cons= *all of the following are falling, shedding, rotting, degenerating, slipping, weakening or loosening: hips, back, butt, boobs, teeth, hair, joints, heart, lungs, liver, kidneys, bladder, prostate, colon, stomach, mind, arches, eyes, ears, nose, sense of taste/smell, dilly wang, and bladder/bowel control, *you grow hair only where it really ought not grow, *your kids for whom you sacrificed everything to birth and raise up right are at best, living far away and not calling often enough, and at worst- living in your basement, *nothing is sacred and there doesn't seem to be any respect anymore (ie: sales clerks on cell phones, movies with all swear words, McDonald's now serving yogurt, laws about wearing seat belts, that damned fluoride), *since when can you not back up on the shoulder of the freeway if you miss your exit? *music is getting louder, crasser, and less interesting and when you want to hear the good stuff on the radio, you have to be reminded that you are a "golden oldie," *previous generations had pensions and financial security in retirement- you have the slots, buying/selling prescription drugs from Canada, and shoplifting.

i jest, i jest. i LOVE the elderly patients i get to see at the clinic. they are so interesting, dynamic, and wizened. some have a lot of health issues with which they're battling, but others are still working in their 80's and 90's. some still climbing on roofs, chopping wood, and practicing law...(which one of those makes you the most nervous?). there are a lot of challenges that come along with aging. the body, mind, and world changes and i imagine it can be very frustrating. but despite these things, so many take such joy in that stage of life. it's wonderful. i am VERY blessed to have vital, happy, healthy grandparents....their youthfulness has colored my perception of what it means to be old. it's shocking to me to see the 65 year olds in the office who are hobbling around when my grandparents run circles around me in their 80's.

so...a 92 year old with quite a pile of eyebrows today told me a joke that i thought i'd share. the doctor introduced the patient to me and told me that he was 92. the patient, without missing a beat said, "yea, i come from good stock. my grandma was 105 when she died...but the baby survived!" he was a funny guy. he also told me that i was too pretty to bother with all this medicine stuff. "you don't need it," he said. then i swear i heard him mutter something about fluoride under his breath.

What Day Is It? Is It June Yet?

internal medicine is going well. the doc who i'm with now is great. fairly long days, though. he and i round at the hospital at 7am, then go to his office to see his clinic patients. then he goes home and i come back to the hospital to do admissions with the PA service and pick up consults and deal with other stuff he gets paged w/ (he calls me with these pages from home, while relaxing)... and i end up finishing my day between 5 and 7pm. but it’s cool. i’m learning so much. and i still love this hospital. i’d really like to work there. i think i’ll blackmail someone into hiring me.

don't forget to spring forward on sunday morning. (man...i wish i were working nights on THAT night).

here's some free motherly advice from my own favorite mom: if it's icy where you live- please walk carefully! slip and fall wrist injuries are very dangerous and can seriously interfere with doing your normal daily activities....things like bowling, fencing, noodle wrestling, eating with both hands, and being without pain. try to keep these in mind next time you consider taking a spill. :)


more later. too sleepy and lazy to write more now.

I Have a Dream

you can have the piece that's missing. the rest is for me. and i am not above stabbing you in the back of the hand/head with my spork if you try to take it from me.

amen.

lent is so much longer than i remembered.