December 1

1. On the first day of Christmas...

Happy Thanksgiving to All!

What Extreme Carnivores Ate This Thanksgiving (The "Turducken"):




What Normal People Ate This Thanksgiving (The turkey):



What We Tree Hugger Hippies Ate This Thanksgiving (The Turk'y Roast by Quorn):




...hey, don't knock it 'til you try it. it tastes surprisingly like the real deal. the main ingredient in it is "mycoprotein" which is a fungi-based high protein, high fiber, low fat substance. there's other delectable things in the ingredient list like tapioca and pea fiber.

delicious.

I Got Poked.

and not in the woo-hoo sense. but rather in the way that i got stuck w/ a bloody needle while sewing with another PA on a knee case yesterday.

it's a drag. bound to happen sooner or later...since we work w/ sharp objects in close proximity to each other...it happens to everyone...but it sucks because then both the patient's and my blood has to be tested for all flavors of infectious diseases (Hepatitis(es), HIV, etc) and now i have to worry about the slim possibility that i actually picked something up from the patient. and in order to give a blood sample, i had to go down to the freaking ER at the hospital in the middle of the day and wait 30 minutes with all the plebs. me, in my surgical cap, booties on my feet, and scrubs next to the 4 year old with snot running down his face and the 150 year old asking everyone who passed by for a cracker.

sigh.

and next week i have to go to employee health to have a meeting where they reveal to me if the patient did in fact show positive for any of the scary diseases and if so, how i'd go about getting treated for them.

fun, fun.

thankfully, according to the history the patient provided, he seemed pretty domestic and conservative and did not reveal anything like time spent in ghana, full body tattooing, S&M tendencies, or partiality toward shooting heroine.

but you never know.

this is more of an annoyance to me than anything. i knew it would happen eventually. it's almost happened a few times before. we take every precaution in the world not to get stuck by a knife or a needle or cautery or anything, but i've seen it happen a half dozen times to other people since i've started. (for the record, i just witnessed these events, i did not in fact stab any of these people). it's just a matter of course when working with sharps. and i know the statistics and how unlikely it is that anything will be transmitted to me.

plus, i guess i take kind of a fatalistic attitude about this. i work in health care around very sick, infective people. i've been fitted for a airtight mask in the event that i am treating a TB patient or there's a germ warfare outbreak or something. when people encounter horrible, deadly things, where's the first place they go? the hospital. and who takes care of them? we do. (most especially if there's obvious boils or rotting limbs- this would be a time when the MD would cheerfully send the PA to the front line). so we do the best we can to compulsively wash our hands and stay clear of obvious sources of infections, but there's only so much you can do and fear before you make yourself nuts.

so that's my story for the week.

off to eat obscene amounts of delicious food tomorrow. after revealing to my family what i just told you, i bet no one will want to share a glass with me. they might even make me sit at the kids' table by myself in the next room. :(

("hello, guys? anyone? can you pass the potatoes? a little help? i just wanted to let you know that on this thanksgiving, i'm thankful for you, my family. hello? i said, I'M THANKFUL FOR YOU! oh...never mind....")

Good Time for Good News.

tired. brain hurts. but it's been too long since we've talked and i wanted to drop you an update.

so as i mentioned earlier, things are bad financially for our hospital. everyone is in an uproar. they're announcing a bunch of cost cutting measures like eliminating our extra overtime pay and a variety of employee programs and benefits. but we all still have jobs and our salaries aren't being cut. (which can't be said for some of the execs and in-house MD's-yikes!). so we're losing some benefits and some morale, and we have to get used to living low on the piglet instead of high on the hog for a while...but it'll be alright.

and...it's dark and cold out and i wear 3-4 coats at any given time to try to stay warm and am threatening (again) to let all my body hair grow long and shaggy and gain 20 lbs to provide myself a little extra insulation. (my husband finds that joke heelarious, i assure you).

but everything will be fine. the poverty of the nation and the unfriendly weather cannot really phase me today. because today i passed a very important goal. i eventually didn't totally suck at a pretty tricky surgery.

so, here's the thing...i have to be able to be competent assisting in every major type of general surgery before i can take call. and my 'orientation' period is practically up when i will go before my boss and be assessed on my progress and asset as an employee, and it will be determined if i am ready to be solely on my own and able to take night call (finally making me a productive member of the department, an integral part of the team).

so one of the types of surgery that i need to be good at, and that is considered one of the most challenging, is vascular. it's very demanding and particular and each tiny move can be disastrous, since you're playing with people's major vessels and all. it also so happens that the vascular surgeons at MBH are rather...tricky personalities. so it's important that i build the skillz but also that i have the trust of the MD's to provide the needed help in those ruptured aorta moments in the middle of the night when i'm on call.

so, to build said skill(with a "z!") and said trust yesterday i was scheduled to scrub w/ another PA on 2 carotid cases with one of the vascular surgeons. (carotid arteries, when filled w/ plaque can lead to strokes, so when they're over something like 80% occluded, you go in, open the carotid, and take the plaque out, then sew them back up. pretty routine, but also pretty dangerous if not done meticulously, as you can imagine). the goal was for me to 1st assist on the cases and so prove my independence, with the other PA just being there for backup if i needed them.

well...midway through the first case, the surgeon wasn't satisfied w/ my knot tying skills and so yelled and made me give up my position to the other PA. when the case was over, i did not cry or anything, but was pretty down in the dumps and the PA told me to give the doc some space and not to come back for the second case. but i'm bull headed and wanted to prove that i wasn't giving up, so i scrubbed the second one, too. the doc eventually softened to me a little and after the second case he demonstrated what he wants and gave me some good pointers. so in an attempt to show him my interest and desire to improve (i really do love vascular and want to be good, dagnammit), i told him that i would practice my knot tying skills and that the next time he saw me he would be "very impressed."

so, naturally, last night before i went home, when i looked at the assignments for today, what am i scheduled for? same surgery. same doctor. so all last night...in the car, at bible study, while watching TV, in my sleep...i practiced knot tying. and i didn't sleep much last night, tossing and turning (and tying). i kind of knew that if i blew it today, it might not bode well for my job. and certainly not w/ my future w/ this doc. and most definitely not w/ my aspirations to be an awesome vascular surgery PA.

but it went pretty well. i had a PA scrub w/ me on the first case, and the whole room kind of held its collective breath while i showed him my knot tying. but when it didn't completely suck, i just kept going and i finished the whole case as 1st assist. so then we did a little minor fistula surgery....and then we had another carotid. and i did it ALL. BY. MYSELF. and it also went pretty well. not awesome. i have tons of room to improve. not sure if i would consider him "very impressed," but it was alright. and i'm pleased. and i'm just really glad i didn't back down or panic and run into the woods (as i considered briefly in one dark moment yesterday). i showed that i have the desire and am teachable and that eventually i will be a good help.

and now if you'll excuse me, i need to go drink.

"I Promise that My Personal Tragedy Will Not Interfere with My Ability to Do Good Hair"

so i'm feeling kind of down in the dumps. just blah. the weather turned cold and gray blocking out any shred of sunlight...which always spirals my mood down the drain. i just kind of want to be curled up at home under a blanket on the couch all the time.

i did get off the couch this weekend and went to our double wedding extravaganza. my classmate's wedding was awesome. they're precious and put together a really nice ceremony and reception. and my coworker's reception (that's all we made it to after the first wedding, just the tail end of it) was great, too. it was nice to spend some outside of work time w/ my coworkers. although, i'm still a bit nervous and trying to impress them. my husband met them all for the first time, too. which was fun, but i was then also nervous that he impress them, also...in retrospect, i probably shouldn't have let him wear those ass-less chaps. :)

and, since i'm still totally absorbed with work, my moods fluctuate depending on how that's going. and i find that hard to evaluate. i feel like a dumb ass everyday. but i think that's how it's supposed to be and not because things are going actually badly. for example, i picked up a defibrillator by the paddles today, almost dropping it on my foot. nice. and i apparently don't know how to staple or suction or hold suture. and this is all just today. don't get me started.

i think honestly that it's mostly the weather making me feel this way. i always get into a winter funk. at least the price of gas went down so i can afford to keep my house balmy to fake myself into thinking it's summery weather. while i'm sitting inside on the couch.

anyone know that quote in the title line of this post without looking it up on the interweb? who said it and what movie is it in? 10 points if you know it.

Mr. Obama, You Can Fix This, Right?

in case you live under a rock and haven't heard, there's soon to be a new feller in the white house after an election for el presidente de los estados unidos a few days ago. and he's got big plans for health care. it's pretty universally agreed that health care in this country is a giant money pit and even w/ all the debt it's creating, only a small percentage of people are covered. and so in turn the hospitals are going bankrupt trying to treat people who can't pay and then doctors are fleeing inner cities to go practice in the greener pastures of the suburbs, etc, etc.

and even though the hospital i work for, MBH, seems to have more money than God, it's tightening its belt a lot in this tough time. enough to make all of us worry about our jobs. other local hospitals in the past, when in an economic crunch, have wiped out all of their in-house PA's...MBH has never had a need...but now we're worried. and even if they're able to keep us, they're boosting our productivity by expanding our work load and requiring us to cover 24-7 shifts and such. in this economy, i'm just pretty glad to have a job...but things are shaping up to be a lot different than when i hired in. and now there's a hiring freeze, so i will be the FNG (f'ing new guy) for a long time to come. meaning all holidays and crappy shifts will be mine for as long as i'm low man on the totem pole.

sigh. but i really am mostly just glad to have a job that i like, even if we go through the projected changes and it means i'm working more and all that.

but i'm still whining in my head about all these things yeserday when i talked to a nurse who just returned from a medical missions trip to africa. she gave me a little bit of perspective. she went with a few cardiothoracic surgeons and they were doing open heart surgery- valve replacements on little kids and adults alike, coronary artery grafting, etc. and she told stories about the hospital being so poor that the surgeons occasionally had to operate by candle light when the generators blew. and when it got cold at night without the heat provided by the generators, the nurses would crawl in bed with the patients to provide them body heat. she had many examples like these.

so while our system is terribly broken and not everyone is getting the care that they need and that care might be hanging by a thread and deeply in the red...we have it pretty good.

i am curious to see what the 'future of health care' might be. one of my parents' conservative friends asked me after the election if i was looking forward to having a government job soon. :) so clearly, we're guaranteed lots of lively conversation on the subject from people on all sides of the issue.

off to get stuff done. this has been a completely crazy week. we've been gone a lot and our house looks like a wild boar let loose in it and tore all the clothes out of our dresser drawers and threw them on the floor and made all kinds of dirty dishes in the kitchen and...it was a very destructive boar. let's just say that.

and today we have not one but TWO weddings to attend, so in addition to cleaning the house i have to look all spiffy. grumble.

laters, loves.

What Did You Do Today?

oh really? that's nice. cuz i built a house. :)

isn't that why people do volunteer work? so they can feel smug? i thought so.

my husband and i did 8 hrs with habitat for humanity today. he put a roof on and i helped hang pre-siding stuff and organized the storage area. it was cool. the way that habitat works is that the future home owners take part in the construction (sweat equity hours plus a small mortgage once they're in the house for all the parts and such is their commitment to get a brand new house) and so they were there with their friends today along with a bunch of us volunteers and habitat employees. we were working on two houses at once. it's a really neat, community-embracing effort. if you've never done it, i would certainly recommend it.

and it attracts all sorts of do-gooders (like me, for sure) like medical students. there was a pack of about 10 1st year med students from our local big ass university (BAU). i noticed today and have observed in the past regarding med students that they're mostly all 23 yr old nerds/brown nosers and are sort of clueless about life. i overheard one itty bitty tiny 80lb one say "that lady told me to get water for everybody, but i don't know how to do it, so i'm just going to help over here." she will be torn apart when she pulls that kind of thing with an MD in the hospital. ("they told me to get the crash cart for that patient over there who is, like, dying or something, but i didn't know where it was...so i grabbed this stapler instead.") someone will just snap her into two 40lb pieces.

i mean, i'm sure that the individual families of these children/future docs are really proud of them and feeling secure in their future and all, but they often don't start out inspiring a whole lot of confidence.

and i'll stop with the tirade now. i sound so old. anyone who might be reading this who is a first or second year med student, please disregard my angry old lady PA mutterings.

halloween was fun. we passed out candy (that which we had not eaten ourselves- so we got to about 6 kids before we had to turn the front light out and start shouting "GO AWAY" when they approached our house) and had some friends over to drink mulled wine and play board games.

i'm tired and sore from a hard day of hating on med students...and hauling lumbar...so i'm off. but please enjoy a tribute to michael jackson's 25th anniversary of "thriller." this might be the weirdest/funniest thing i've ever seen.