no excuse

with gifts directly from god, like the dollar/$2.50 section in target, there is no reason not to exercise.

no time? give me a break. i’m in medschool and i do it. and not cause i want to. mostly because if i have the aims of someday advising a patient on how to be healthy, i should probably jump on my own bandwagon. and let’s be honest, i do have some vanity on my side.

it’s hard? no crap. if it was easy, everyone would do it. we’d all be fit and thin

it’s expensive? well, i just managed to get a killer cardio dvd from target (two, actually) for total of $2.50. plus, they had additional workout supplies for a similar price. you don’t need a membership gym to get in shape.  you just need fewer excuses.

today, for instance, i had no drive to work out. i wanted to sit at my computer and play stupid computer games. but it’s times when i think like that….those are the days i should work out the most, because once i start, i realize…this isn’t so bad. (but don’t misunderstand me, it’s still bad while i’m doing it.)  once you’re done, there are few things that feel so gratifying – both in accomplishing a goal and the stress relief it provides. unless we’re talking like strawberry or pumpkin cheesecake. that’s way more gratifying.

old hags, elevators, and parking spaces

normally, when i am interacting with old people, i instantly think of my grandma betty. i think about her, and i think about how i like to have my grandmother treated.

however, let me tell you old people – respect is a two-way street. and just because you’re old, doesn’t mean you get to be rude to everyone else. ARRGH. k;sfh;sdlkfjs;dlkfj.

today was a hectic day. as i emerged from my garage onto the newly fallen two inches of snow, i already know i’ve left late. realistically, i left the same time i always do, but you know how people are….a little snow and panic ensues. i thought i might get lucky and miss rush hour like usual. nope. i was a half hour late. i was driving an max of 15 mph on rt 8.

 then i thought i had to be at general by 1, when i was still at city hospital at 1230. not a big deal, but i was supposed to magically get lunch in this amount of time. i rush over to general, throw my car into the closest space to the bridge, and run (literally) to get food, and then speed walk to the room we’ll have conference in.

med students are usually not supposed to park on the third floor. we’re meant for the fifth floor/roof. i generally follow this rule, because the 3rd floor, or the bridge is reserved from physical therapy patients, and walking up and down stairs is not an option for them (although one may argue that the elevator should be all the same). whatever. i don’t have a problem with it. but when i drove in today, worrying about basics such as sustenance, i checked to make sure that there were plenty of pt spaces (at least 7) and i whipped into a space.

on the way out, after being done for lecture (which also actually started at 130, so i had plenty of time all along – dammit), i was telling a friend how i got a good space. apparently, there was this old hag behind us just seething about this, because just as i get in my car, she lays into my friend. and you know what she says?

“if she can’t even let patients park where they’re supposed to she should not be thinking about a career in medicine.”

OH REALLY. i didn’t realize that medical student parking choices so closely correlated with their ability to take care of patients. i have to now rethink my entire life. clearly my parking choice for that afternoon reflects on the inner workings of my morality and work ethic, and my character should come under some pretty severe question. i might offer myself up to the review board.

“i am here because i parked on the third floor for approximately 3 hours. i have turned myself in. i am not fit to be a doctor.”

if i were brave enough, i think i might have been tempted to slap the old bat for such an insult and ignorant comment. yeah right. the only person i’ve ever slapped is rach, but she had it coming. otherwise, i’d rather not come down to that level. but i can think about it.  >:)

not a cinderella story

this is why i don’t want boys over. and i use boys literally.

my intial irritation began with donnie having people over last night. sunday night. the night before my brother, brandon and i all go to work in the morning. i’m still confused as to why this was thought to even be possibly okay. nevertheless, i tolerated it. i did however, tell them to quit smoking in the house when i walked in the door. i am so tough.

anyway, i eventually fell asleep. unbeknownst to pretty much anyone in the house, ajay, our 17 year old next door neighbor beat up the “krazykorean” in our front yard. i knew that they had gotten into a fight, but not that this occured in my front yard. how did i find out? well goodness, it’s because the police called me this evening. then the same police called my brother. awesome.

entertaining point? as i eavesdropped on my brother’s conversation, this cop asked how old donnie was. matt replied with 21. then the cop asked the question i have been wondering since these boys moved in…”why is donnie hanging out with these younger guys?”

most of the reason, i know, is that they all live close by (i.e. next door). however, this is just the crap i don’t want happening. i have told matt again and again, that i am not putting my life in jeapordy for these kids. i mean, really, the next party that happens here, if i don’t know them, and they’re not 21, they can leave.

i will add that the krazykorean is a wackjob. he still didn’t deserve to be beaten to a pulp. sick. i wonder if there is blood on my lawn. sigh.

 update: i figured i should clear up the issue – this actually was not matt’s fault for once.  matthew was also soundly asleep in bed. not that this couldn’t come from his doing at some other point. also, my mom got a call from the cops. yikes!

it’s a calling

boring

for the next week, i will be on what i like to call normal psych. these are basically patients who are sick in the hospital for some other reason, and they happen to also have depression. since modern day doctors freak out at handling anything other than their specialty (probably for legal purposes), psych is consulted for these people.

 that’s what staying in the hospital pretty much means nowadays. you are seen by a whole batch of doctors who know nothing about you. not that i think much of this matters because the majority of the patients in the hospital don’t really seem to be sick – a really bizarro concept. the things i see people in the hospital for, i would never waste such money. i can understand the elderly – little things put them at a greater risk than if i came down with the same thing.

there is a whole group of doctors who only work in the hospital and will see the patients of the other doctors who only work outside the hospital. it’s a good system for us, but i question the good it does for patients. and i’m not talking specialties, because most of the time a person will have never met that doctor when they are called for a consult. that’s not a big deal. however, it is the rare internal medicine doctor who is in the hospital every morning. but do keep in mind, they do exist, and if you’re shopping for a doctor – consider that a big selling point. if your primary care doc still goes to the hospital to check on their patients, you’re probably going to have better continuity care and you’re less like to have to tell you same history 12 million times.

just don’t begrudge the doctor who doesn’t do it. it really is a luxury for patients…that kind of work is difficult. and hospitalists (internal medicine docs that just work in the hospital) are really good doctors. but from my point of view, nothing compares to seeing your doctor whether in the hospital or out.

 my whole point is, we go in and see these patients, expect them to tell their life secrets, then peace out. seems counter productive. BUT, i will be happy to go back to the ward in a couple weeks assuming that my time away will be sufficient to give you-know-who the boot.

(despite my title, i admit i’m actually kinda excited about the doctor i’ll be working with because he’s super smart – as most are – and he really offers me some great advice regarding my future…and he likes ayn rand.)

previously unheard of

 i recommend maybe watching it with the sound off, because, dammit bailey. no worries, i kicked her once i turned the video off. (joke rachel). i had to put this video up though because i don’t think anyone would ever believe me who knew delilah before.

 

except for when we had our first bloodhound, ellie, delilah has never been playful. she became worse after she was run over a car (a long story).

before my parents moved to atlanta, there were three bloodhounds in the house and two people (before i moved home). that usually meant delilah getting the short end of the deal, and as much as my mother would like to deny it, it’s true.

we were worried she’d be depressed without the other two bloodhounds, but instead she’s the happiest i have ever seen her. she probably got tired of georgia drooling on everything, drinking all the water and eating everyone else’s food.

 the next video i hope to get is delilah chattering. 

cigarettes and sunshine

yesterday could not have been a more glorious day…

1. there was sunshine.

2. my mother told me she had scheduled a doctor’s appt on feb 12th to obtain a prescription for chantix.

among my other diagnosable psychiatric conditions (specific phobia, obsessive-compulsive personality [not the disorder]…), i am convinced i have SAD – seasonal affective disorder. basically, my mood is altered by the lack of sunlight. the gloomy string of five days with gray clouds blanketing the sky do not bode well for me. thus, with the sun out so brightly that it was roasting me in my car, i was the happiest i have been for a number of months.

compound this by the fact that my mother, after months of nagging, begging, pleading, bribing with first born children, and other such tactics, has agreed to see a doctor to get a prescription for the wonder drug chantix. i am not sure that it is a wonder drug per se - but i have yet to hear a poor report, and it would take quite a wealth of literature to convince me that the drug is so unhelpful to warrant not even attempting it and continuing smoking. i have seen the ravages of cigarettes from the very first days of my clinical rotations, and everytime i saw a patient in these conditions, i pictured my mother in this position with my vigor for harassing her renewed. there could be no better news for me.

i’m not cheap

today i had the usual honor of visiting my favorite patient on the psych ward with the psychiatrist i am following this week. if you recall, two days prior, she very tactfully told me to wash between my legs. i personally think she out-did herself today, but i will let you decide for yourself.

we walk into the room, and the doctor is ahead of me, obscuring my presence.

“hiii doctor,” she says in a mildly friendly tone.

then…she sees me.

“i have nothing to say if she’s here.”

“well, this is a teaching hospital, so students will be with me from time to time.”

“i already told you everything i have to say if she’s here.”

at this point, she quickly gets up and storms out, and as she left, i had that instant thought that she might very well hit me. you can just see the scorn and hatred seething out of her, and i definitely believe she’s capable of it (which is actually an uncommon feeling on the ward, i think). the doctor and i follow about 10 feet behind her, knowing today is another day of defeat, when she turns around, and spittingly states, “and keep that cheap slut away from me.”

what does the doc say?

“you probably shouldn’t interview her alone anymore.”

all i could do was laugh.

normally, i like to wear white

for several years of my life, i could only manage to wear white shirts. it was a compulsion i could not control. i think ultimately it bordered on laziness. white matches everything. and it makes you look tanner. unless of course it’s winter, and then nothing makes me look tanner – except maybe a person even whiter than i am. over the past year, i have made a conscious effort to stop this habit. this isn’t a crusade started by my own motivation as much as it is at the behest of everyone else on the planet. (yes! i got to use behest correctly.) I had become notorious at my medical school for my lack of color in my wardrobe. you know it’s bad when dude’s start mocking your ability to dress yourself.

despite this love of wearing the color white, there is one item i have grown to detest. the white coat. originally this was a powerful symbol in the healthcare field, and it’s still important when it comes to the induction of students into medical school. or when you need somewhere other than your neck or ears for your stethoscope.

i still remember the day of my white coat ceremony (need i really explain?). i was excited just thinking about everything this white coat symbolized for the next four years of my life. i still remember almost coming to tears during the speech by the internal medicine director. his speech was so moving that 2 years later i fought tooth and nail to work under his guidance for my internal medicine clerkship. and it was worth it.

now when i put on that white coat, i feel dread. i can feel the weight of it on my shoulders, i think about all of the unnecessary items i keep in it (books, a watch, random papers, pens, id’s, keys, my phone, you name it), and i think about the level of filth it accrues over the course of a clerkship. next time you see a white coat…take a realclose look at it. white coats are so dirty, they no longer allow their use in england.

the white coat has also lost much of it’s meaning in the medical setting. i can’t even tell who is an attending anymore for the sole reason that half of the healthcare workers are wearing them. the medical student white coat does still stick out like a sore thumb, though, with it just reach mid-hip on most students. i can’t wait until i’m an attending. i will not be wearing it.

the last reason i have no intention of wearing the white coat beyond residency is because i feel like it is a pretentious piece of fabric. it doesn’t serve any practical purpose any more, and i won’t wear something for it’s symbolism. a white coat doesn’t make a doctor, and continuing the tradition for simple dogma is not enough for me.

i might have previously agreed with someone if they told me it helped patients, nurses, etc recognize who the physician is – except now everyone wears one: pharmacists, nurse practitioners, regular nurses (depending on the hospital), doctors, residents, medical students. you can’t tell who is who.

but hey – if you need some extra pockets, by all means enjoy. but i’d much rather go without the stiff neck and coffee stained sleeves.

update: a doctor i’m working with now mentioned offhandedly that the white coat helps maintain the appropriate physician-patient relationship because it puts that barrier between you. i can see where he’s coming from, but i still don’t like to wear it.

you’re gorgeous

the day starts with me waking up late. i manage to save time by throwing my hair up and rushing this morning, only to still be late sans shower. thank goodness psych is low-key so going a day without showering isn’t as gross as if i didn’t shower during surgery (blood, guts, pus – you know the deal).

in the afternoon, i go to visit my patient that is soon to be discharged. he’s a very friendly man (even when in an acute psychosis) and he and i bonded over the beatles. when i arrived, he was working on some art work using those refrigerator poetry words that you can arrange in any fashion you like. as i look at his assemblage of words, i notice how many of them correlate to his life and the hardships he has faced – alcoholism, copd from his smoking, the recent death of a family member. as i sit and watch his participating in this art group, occasionally talking to him, he holds up the word ‘gorgeous’, and says, “you’re gorgeous”. i was very flattered and slightly embarrassed but i see the word courage and without thinking, i pointed to the word and told him i thought he had courage. at this he looked up at me, straight in the eyes, and thanked me.

it’s really hard to share the intensity of the moment with readers in the regards that it’s really difficult to explain. there was no awkwardness. just two people knowing the hardships a man has faced.

HOWEVER – i will note that not all patients give that wonderful rewarding feeling or great physician/pt relationship. for instance, with the psychiatrist, we entered the room of a patient that had continually refused to talk to me or anyone else for that matter. the patient talked relatively openly with the doctor (which shocked me because it was the first time i had ever seen this pt talk to anyone). most of what she opened up about ended up being untrue, but she actually spoke to him. at the end of their discussion, he said that he would like for the pt to talk to me later in the afternoon, to which the pt replied, “no, i don’t have anything to her. she probably doesn’t even have a college degree….or a high school degree. yeah, she probably didn’t even graduate from high school.”

“no, she graduated from both of those.”

“no, she didn’t. and tell her to wash between her legs after she does that.”

of course, this was all said right in front of me as though i wasn’t there. i don’t know what i’m supposed to wash after, and i don’t want to venture a guess. man, awkward.