Recent Study Reveals Carob Chips and Ricecakes Cause Childhood Nostril Cancer

...not really. i just like to tease my "#1 bloggie" about the hippy healthy things she feeds her kids. carob is, in case you haven't encountered it, a chocolate substitute made out of hay or shoes or something. fake chocolate is kind of like fake sleep. just not satisfying. but my #1bloggie is another one of my very favorite people- in part because she is such a conscientious and amazing parent who is working hard to keep her kids healthy and happy.

but seriously folks, don't feed your kids carob. it's just cruel. trust me- i'm practically a doctor, practically.

so i'm wrapping up this surgical thing and it's been a wild week. i would tell you about the patient i had recently who i'm pretty sure is part of the mafia and was talking (wide awake while we worked on him-creepy) about "hits" and strippers and pizza pie and all kinds of big sounding guys like "little tony" and "joe joe" and how they get out of going to jail by paying people off/knocking them off, etc, etc.....but then i'd have to kill you. i just hope we did a good job on the surgery. i laid a little low in that one, as you can imagine. and when the nurse loudly asked me my name, i totally made it up. (don't leave a trail).

i did wound care today and it was great. i love wound care. lots of diabetic ulcers, venous stasis ulcers, a few abscesses. i got to debride (cut/dig dead skin off/out of the hole) and it was fantastic. sounds gross, smells a little gross, but is actually really cool and i felt useful. the body is incredible how it rejuvenates, regrows. the products available to encourage wound healing are really impressive, too. there are grafts made out of everything from pork (porcine), cows (bovine), and human tissue (even some infant foreskin- i am NOT making this up!) and there are dressings that contain antimicrobial agents with parts of human growth factors that hasten tissue growth. then there are wound vacs that suck the bad juju out and encourage vascularization.....and hyperbaric oxygen treatments where patients with terrible blood flow get in 100% O2 rooms and bask for a few hours so the wound gets saturated in O2 so the sad little new skin gets a chance to get strong and grow to close the wound. the list goes on. amazing.

so i'm bribing my surgical preceptors to give me a good evaluation by baking cookies for them (by this of course i mean having my husband bake cookies for them) and taking those tomorrow. my hubby just yelled in the kitchen meaning that he either burnt the cookies or burnt himself. if he burnt himself, maybe i can go practice my wound care on him...(i don't have any foreskin lying around, so i'll have to make do) but if he burnt the cookies, i'll have to have my new mob buddies take him out.....(the burnt cookies will prolly STILL taste better than carob chips do).

Only one week left!

i'm ready to be done. surgery was cool and a great experience to get me started this year, but i'm eager to try something else. i worked a few cases on friday w/ an OBGYN and he was very compassionate to his patients, extremely skilled and graceful and i was impressed...i really hope my experience in OB (starting oct 8) is a good one, because i could see myself really enjoying that discipline. studying this weekend for my exam coming up next week. somehow these hours + my being lazy and all haven't been very agreeable to studying, so i'm quite behind. but i shouldn't whine...one of my friends also in surgery now recently changed to the hospital's trauma team and has to start rounds at 4:30am!! and doesn't finish until 5pm or so. mad-ness. i would be so grouchy all the time, i'd just start kicking random people in the shins as they passed me in the halls.

i have to add something. one of the cases w/ the OBGYN i did was a dilation and curettage- where the cervical os is dilated and then all the tissue is sucked out into a container. an early abortion, basically. but it wasn't a fetus, it was a "blighted ovum" which means that the egg is released w/o a nucleus (so no mother's DNA) and gets fertilized by sperm and so only has the father's set of DNA growing in it. some placenta will start to grow and the pregnancy test will be + and the symptoms of pregnancy will manifest, but there's no baby. so this lady went in for her routine check up at about 8-10 weeks and there was no fetal heart beat and then no image on ultrasound. very heartbreaking and difficult to explain the biological mishap to a grieving family. but again, the MD was amazing. fortunately, it's a very rare, freak thing and doesn't decrease her chances of having further viable children. still pretty sad, though. a lot of trauma and disappointment. so incredibly many things can go wrong with fetus development and labor, it truly is a miracle when everything goes well and you get a perfect baby out of the deal.

Worn out on Wednesday

sleepy today. not sleeping well lately. on call tonight instead of tomorrow as tomorrow night is the season opener of "the office" and "my name is earl" and that seriously trumps someone's urgent need to get their appendix taken out or something. today was a good day. saw an interesting bowel resection w/ a rectal (up the butt) GI staple anastomosis. it was probably pretty obvious in my eyes that i was thinking, "you're going to do WHAT now?" when they explained it to me. but it was pretty cool, though a less than comfy recovery for the patient, no doubt.

Totally Twitterbrained on a Tuesday

i could write a "totally dumb" moment any day you ask me, but i thought since i started this theme this week, i'd make it today. so about 3pm today i was feeling like on the list of dull crayons in the box or blunted tools in the shed i was falling smack between paris hilton and anna nicole smith (may she rest in big blond peace).

the one lousy question i was asked on a thoracic case was, "where do the pulmonary veins empty out?" and i friggin' know cardiopulm anatomy and what did my stupid self say in my panic to say SOMETHING, "ummm...the subclavian vein." geez God. it's the left atrium, of COURSE it's the left atrium. grrrr. the subclavian doesn't even go the right direction for what he was asking and has nothing to do w/ the bloody lungs! stupid, stupid, stupid. i wanted to throw myself out of the window. but then i might get maimed and couldn't use my body to make money in a pinch when this PA thing doesn't work out and so would then HAVE to depend on my rapier wit. hell.

anyway. got to see 2 thoracic cases today and then a vascular case. so it was a cool day. i just need to learn to think before i squeak out an answer.

Meditative on a Monday

so i was reminded of something really important i need to reflect on by one of my all time favorite people in the world- how does my experience stack up to TV versions of the OR?

(side note: this favorite person of mine recently moved to a very cold, icy place in the far north and is writing the great american novel about her new life among the Inuit people and is also (in her spare time) being the lone voice of news (and hope!) for a rural fishing outpost all while wrestling brown bears and mining for coal...and oil...and gold...and riding whales and then burning their fat for fuel and using their umm....eyelashes for...er... ink.. i might tend to exaggerate her accomplishments and live her adventure vicariously through her and she most certainly exaggerates mine and lives my medical career experiences through me. she says she wants a boob job when i graduate and God save her, if she trusts me to potentially maim her for life, i say it's the least i can do. anyway....)

so she was musing today about how cool it would be if my experience was like that of gray's anatomy's interns' experiences. in that image, i would be getting shuffled into linen closets for romps with my attendings, i might fall in love with a patient and thusly cause his death, perhaps help my gimpy wounded hero/lover with intricate vascular surgeries as he recovers from neuro damage, maybe even fall madly in love with a married gay troll and lose all of my mental power and dialogue to the cause of winning him back....hmmm....

it is amusing to me how everyone looks so fresh and clean and wide awake on that show and in reality we're all without makeup, often covered in blood/feces, wearing masks and hair nets and shoe covers, and tired as hell. i don't feel much romance in the air, i tell you what. the only drama is work related from what i've seen, and there has yet to be a bomb or river boat collision. attendings are old married men none of whom can really be described as "Mc-anything appealing."

sorry to piss on your parade, if the plotlines on gray's made your life worth living or something, but i'm relieved to find my experience has been wholly w/o drama, sexual harassment, or manic muffin baking.

but this is still my first rotation, there's still time.

Slacker on a Sunday

i had a meeting on campus last week w/ all my classmates and our clinical rotations coordinators where we all shared our experiences thus far and got some updates/info from the professors. it was great to see everyone, but i'm realizing what a total slacker i am (scofflaw, if you will). some of my peers are working daily 12-16 hr days and THEN coming home and studying, giving presentations to their site preceptors, working weekends, etc. one even left our lecture friday afternoon and went back to the hospital to work. nuts. i've been practicing my sutures at home and occasionally reviewing anatomy, preparing a little bit for my upcoming surgical exam, but not a whole lot. i'm just tired (lazy) all the time and want to sleep (lie around and drink wine). i'm starting to wonder if my lack of motivation/fatigue perhaps means i have caught mononucleosis or that, the most dreaded of all human pathological parasitic infections, pregnancy.

i don't actually think i'm ill or prego. i'm just trying to find excuses for why they're studying circles around me and i'm trying to squirm out of the small bit of guilt i have that i'm not doing more work.

but i'm really enjoying not having to be in the books all the time- i am taking full advantage of it, for the record. my husband and close friend and i went to a national amusement park this weekend and rode all the new, scary coasters. funnel cake + french fries + elephant ears + caramel apples + spinny rides + heat stroke= a great day of fun. i am endlessly amused by what we humans do for entertainment. besides wearing tube tops and tight shorts w/ the words "cutie pie" written in sparkley letters across the butt, we also find it amusing to wait in line for several hours to be dropped from 100' just to get that WHOOOOOAAA feeling in our stomachs.

you know how babies/toddlers can be entertained for hours at a time by "dropping" them a few inches or supporting their heads and tilting them back toward the floor? these rides are basically giant mechanical simulations of that feeling. if we adults had giant huge parents who could throw us in the air and catch us or safely tilt us backwards like when we were kids, we wouldn't need these thrill rides. apparently the only fear we're born w/ is the fear of falling, so we're just trying to make our hearts pitter patter over something very basic and instinctive. that's all we're going for.

that being said, the rides were AWESOME and i totally thought i was going to die, but didn't. one ride you are strapped in (barely) in a (teeny tiny) harness and go way up to the top of the hugest height imaginable where i'm pretty sure i saw China in the distance and my husband and friend are like, "oh, isn't that sunset beautiful, gosh, it's so neat to be able to see across the whole park like this, blah, blah, reds and oranges, blah, blah" and i think that's about when i passed out. i went into a zen-like meditation on how my life had been a full one and i was prepared to meet my personal lord and savior Jesus Christ and that falling off a carny ride isn't THAT bad a way to go and that at least i'm with people i love....and then we were safely on the ground and i was like, "you wanna go again?"

hope everyone had great weekends....

Feminine wiles, oh what the hell....

so it's been a good week so far. i've gotten to do a lot of things i haven't seen yet, and my suturing is improving mightily. i am still breaching sterile field all the time, dagnammit, but even my awareness of DON'T PUT YOUR HAND THERE seems to be getting better. everyone is just so nice and supportive. while they threaten to throw sharp instruments at me when i do stupid stuff, no one has actually done it (or not that i've noticed, anyway).

so today i did 2 total hips in a row w/ the same surgeon. the first time, he told me to use the "bent" retractor....so i used it and didn't think about it again. the second surgery he asked me to tell him what kind of retractor i should ask for and i said loudly and proudly to the scrub nurse, "i would like a bent retractor, please." they all started laughing and staring at me. apparently the "bent retractor" is actually a Bennett retractor and is pretty common and something i probably should have known. so from then on he laughingly referred to it as the "bent retractor" and i just laughed it off. he then said that sometimes it's ok for women to be more whimsical and not always serious and just for the smallest of moments i was grateful for my feminine wiles and ability to charm my way out of sticky situations without being seen as a total boob...(every pun intended), and as long as he wasn't yelling at me, i was ok w/ the fact that he's probably sitting around the doctors lounge right now telling of this young female student with her bent retractor. but to be honest, there was a large part of me that just wanted to tell him to get.....you get the picture.

sleepy. several 12-13 hr days this week and i'm on call tomorrow night. sleepy and sleepy.