a high school reunion

ah, nothing like meeting up with some people from high school. 

i was supposed to spend some time with my friends from hs, linds and ash when i got kind of tired.  i bailed and told them have fun.  they text me telling me, hey, we’re going to MM’s, you should come.  i keep saying no, but then some of the boys there, get a hold of my number, and i realize there is a zero percent chance of me getting any work done. 

here’s a roster for you (rach):  shane b., matt m., shane s., and mike m.  some of those you won’t know, but the most entertaining one is the first, one rachel will most certainly know.  SB was the most popular boy in school, and consequently, the most obnoxious.  from grades 7-10 he teased me incessantly, sometimes to the point of meanness.  then there was a turning point in 11th grade and he was nice.  i never bothered trying to figure out why, because i never cared. 

if we go forward a couple years, bri and i go out and run into him and his buds.  bri had always been better friends with them, but i never had much inclination for anyone in hs.  we hung out with them, and at the end of the night, he asks me to “make out” with him.  barf.  i simply say, i have a boyfriend, and all of a sudden he’s like ‘oh well, i didn’t mean it, i have a girlfriend, i’m loyal.’  this is why i have so little faith in boys and relationships and marriage.

so the other night, telling him about a story from 7th grade regarding his poor treatment of me (cause i hold the power now, dammit), and after his interspersed “sweethearts” (barf again), the conversation goes something like this:

“oh well maybe i had a crush on you.”

“or maybe i always gave you a good reaction to keep you going”

“maybe, but i could have had a crush on you.”

“i doubt it.”

people do that kind of thing to atone for the past in hopes that they have a chance in the future.  it’s sickeningly obvious and if i didn’t transmit it well through this post, then i apologize, but that was the ploy.  around the time all of these people started getting drunk and disgusting (like commenting on my boobs and other such nonsense), i left along with my friends.  it makes me look back and thank god i never wasted time in high school trying to hang out with people like them.  it makes me so much happy that i spent time with my best friends and family and didn’t waste a moment on that drama.

it’s kind of sad to see such a legacy (albeit highschool legacy), become so pathetic.

“let’s call it as it is”

dicussing the topic of a working up an abnormal pap, i noted a couple concepts we didn’t quite go over.  i started asking about “CIN I” and how to work it up after you reach a certain point on the diagnostic and management algorithm.   CIN = cervical intraepithelial neoplasia - it’s basically what happens when you get one of the nasty hpv viruses (16, 18, the 30s, etc) and can’t fight it off yourself.   i should also preface this story with the fact that i pronounce acronyms, so CIN is “sin” - sort of ironic when you are talking about what is considered a sexually transmitted infection. 

“so after a patient has a repeat pap after their biopsy shows ’sin’ one - er, i guess i shouldn’t say that, i could really offend someone.” 

you know what a classmate’s response was (albeit joking - still not funny)?

“oh come on, let’s call it like it is.”

normally, this is the type of joke i might laugh at.   what makes this person’s joke not funny, is the person who made it.  she is one of my best friends (although a little less so now), who has known about my trials and tribulations when i went through having an abnormal pap, which was positive for hpv.  this was followed by a colposcopy and one biopsy (which made me hope it wouldn’t turn out bad), and was found to have probably CIN 2, which is moderate dysplasia.  then i underwent a leep, which is where they burn off half your cervix, which was a tough decision because it increases your risk for cervical incompetence (but the other option was worse).  cervical incompetence means my cervix in the future may not be able to support the weight of a baby and i will have an increased risk of preterm labor and miscarriage.  awesome.  

this ‘friend’ knew all this.  it doesn’t help that she has also lived an absurdly sheltered life.  she was married to her high school sweetheart and didn’t have sex until marriage.  she has never had that person cheat on her with another person - and her greatest difficulty in life is her mother driving her nuts, her husband being in another state, and now, she’s pregnant (although that garners less sympathy because it was secondary to her supreme laxity with birth control pills).   living this sheltered life, she continually makes inappropriate jokes around attendings and other people in general, such that she is bound to offend someone.  me in this case, but everytime she does it, i try and suggest her watching what she says.  she just brushes it off. 

well, that’s all fine and good, but i refuse to tolerate that kind of behavior.  no friend of mine has ever said anything so disrespectful or thoughtless regarding a disease i will probably have to worry about for the rest of my life.  a disease 60% of the population is able to fight off, but my body is apparently unable to (probably a lot to do with life stress). 

call it like it is?  okay:

people who contract hpv are not whores, and it’s not a sin to have hpv.  all it takes is to date a guy who has had sex with multiple partners, or basically anyone who has had sex with more than person.  it could be 2 people. your whole life.  or just one but that person was with more than 1.  that’s it.   and what super sucks?  you can’t test for it in doods.

and we definitely do not need future doctors out there propagating the social stigma related to it, when parents are already up in arms about the possible implications of giving their daughters the gardasil vaccine when it has the chance to spare a woman the stress and anguish of cervical cancer or its precursors. 

philosophizing

i know that’s not a word.  or at least, i don’t think that’s a word - it’s tough with medical school - grammar, spelling, etc all go down the crapper. 

so, i used to like ethics.  then medical school happened.  and not just any medical school - my medical school.  our primary ethics teacher would spend hours finding out what we thought about different issues as we sat in a classroom of 130 students.  she would only manage to get the same 5 people to debate (i was not one of them - mostly because i skipped these lectures once i figured out their stupid structure).  at the end of the hour and lots of “mm hmm” and “okaaay” ’s later, we would have no idea what was actually legal within the medical field, which is kind of important, especially when in one year you’ll be working in the field.  

well the horrors of those classes were nothing compared to the tard who came in and spoke with us last week.  her job was to be an ethicist for the hospital, and part of her appeal to us was that when something controversial comes up - consider also asking for her help, not just the lawyers.  bitch please - i’m gonna do what’s legal, not spend hours debating.  which is AGAIN what this new lady tried to get us to do. 

now, i dislike this woman very much for three reasons:

1.  she scolded some students for side conversations after she asked the class a question because she felt they were being rude after she strolled in 15 minutes late because of “traffic” - hey lady, who are you kidding?  it’s 2 pm and this school is in b.f.e.  (there dave).

2.  she had us debate over a case regarding aspects of neonatology when we are on ob, without any of us having peds yet.  none of us were even remotely qualified to be speaking on the topic.

3.  she pushed her opinion on us.  she was clearly biased.  when i stated that i believed there was a difference between removing treatment and never initiating it, she was like “are you sure?”  uh yeah.  “well, there is no difference.”  to who? (whom?)  you?   well, i don’t give a rats ass what you think.  i care what my patients think.  tell that to a patient.  tell that to parents of a baby patient.  she was rude and completely insensitive to any of our stand points unless they agreed with hers, and to me, that’s the worst sort of person to lead a debate in ethics.

and because i can, her clothes were too tight - whore!

a harmless trip to the chiropracter…

as i spend my enlightened days doing retrospective chart reviews for research, i see cases of stroke after stroke.  most of them are 70 year old men, but then i came across a 34 year old woman.  and, i stop and think to myself, wtf?

so i start reading about this woman.  and you know what happened?  she went to the chiropracter who was doing some “safe” manipulations on her neck - and she suddenly developed stroke like symptoms.  She chalked it up to a side affect of her migraines (not totally unreasonable).  She eventually got worried and came into the e.d..  after much imaging, you know what they found?

a vertebral dissection.  what’s that you ask?  it’s when you get tears within the vertebral artery - which coincidentally runs in the vertebrae in your neck.  she had a stroke at 34…thirty-four.  so, great - this 34 year old woman who just had a baby (yeah, didn’t mention that in the beginning, but yea - new mom) now has permanent disability because of high velocity neck-cracking.

boo alternative medicine.

eth eth arr eyeth

this post immediately reminds me back to my sister’s post of thupplieths and thervitheths, or however she spelled it.   unlike rachie, i do not have a lisp, and despite her apparently having one for all 23 years i have been around, i still can’t even notice it (which sometimes makes me worry i have one and i don’t even know it.)  i rest assured in the fact that someone would have told me by now if i did.   to the point, though. 

 today was another terribly boring day of fp.  i still can’t even explain the torture to it’s fullest.  what is worse, however, is going back to the med school to hear the other students’ “practice based learning” presentations aka pbl.  it consists of “asking a clinical question” and then looking up a journal article that answers it, then you eval the article.  what ends up happening is we just pick an article and make up a question because it saves a whole heck of a lot of time.

 we do this for each rotation, and let me tell you how peeved i was when my least fav med student strolls up there and basically reuses his presentation from psych (lazy lazy lazy).  he is currently the only med student i fear becoming a doctor.  which brings me to my title - how bright can someone be when they have the lisp of the damn century (co-morbid with the thickest indian accent i have heard yet) and they choose to spend an entire presentation using ’s’ words.  ssris, tcas, depression.  i mean…really?  this is an example of a time when i wish it was socially acceptable to hit people, or at least throw things at them.

 otherwise, life on fp is [thankfully] winding down with the shelf due this friday.  i can’t wait for this stupid rotation to be over.  i cannot believe sometimes that people choose this as a profession.

take THAT subway

subway used to be my go to for cheap and healthy fast food.  i always ordered the veggie 6 inch on wheat with provolone with everything on it except for cucumbers (and a special request for spinach).  no condiments just salt and pepper.  this delicious feast would cost me all of 2.99.  and then then unthinkable.   one day i walk in and it’s 3.29.  outrageous.  

 i decided it would just be easier for me to make my own.  i went to the big ge, and bought all the ingredients i would need plus “sausage rolls” which are really just 6 inch buns that are better than those crappy hotdog buns.  all told my total was 13 dollars. that will make me 6 subs…but when i’m ready and i buy my other 6 buns, bringing my total to 16 dollars, i am now making equivalent subs for 1.35-1.50 per sub, less than half the cost of subway.

additionally, i streamlined the process.  my start up cost was 5 dollars because i purchased a veggie tray container.  i cut up all my ingredients and placed them in there.  now, it actually takes me less time and money than if i were to go to subway.

i win.

too boring to even write about it

while family practice has it’s variety.  i still can’t manage to find anything exciting about it.  i spend my days counting down the patients.  if i could, i would probably make those paper chains that we made in elementary school to count down the days until christmas.  i would wear it around my neck and tear off a ring for every patient. 

not much could make the experience worse (it’s not all that bad), unless it involves a resident who has no redeeming qualities.  i spent an afternoon working with this resident, and then i had a lovely saturday and sunday morning with him while i was on call.  and by lovely, i mean horrible.  usually a resident will have at least one redeeming quality that makes up for some of their douchitude (an official word on this blog).  not this resident - he’s annoying, loud, rude to patients, arrogant, calls them “dummy”, disrespectful of other people’s time, lazy, and all-in-all, not that bright.  He has no social skills and he’s going into family practice.  except for one surgery resident, i have never heard a doctor or medical professional call a patient a dummy or stupid.  and his reason for this recent one?  she didn’t know which medications were for her supposedly high blood pressure…but i dunno, there could be a couple reasons for this:

1. she was newly diagnosed in december
2. at the same time, she was slammed with a bunch of medications

she was diagnosed in december with sle - aka lupus, and some idiotic resident at this same time, determined she had htn…and put her on three medications.  they put a 20 year old, thin girl on 3, count ‘em, 3 blood pressure medications.   flippin’ ridiculous.  for those who don’t know what the big deal is:

1. the diagnosis of htn requires 2-3 separate readings of elevated blood pressure 4-6 weeks apart - hers was based on 1
2. you start with one medication at a time not 3
3. being a young female who is thin it’s highly unlikely she has primary htn (aka unexplainable htn)
4. she had just gotten a new diagnosis of lupus and underwent surgery at this time, not a good basis for determining if someone has htn

i mean really, the whole thing is ridiculous.  and what is worse, is once she left the hospital in december she followed up with this resident in january…and rather than him be like…hey why you on all these meds?  he just refills because he’s a lazy bleepin’ ahole.  i can bear a lot of the personal hell he puts me through, but for that kind of irresponsibility alone i despise him. 

and who the hell put her on 3 medications??!?!  sometimes i am ashamed of the people who manage to make it through medical school.  how do i manage to have a better comprehension of certain basic topics than a person who is at least 2 years ahead of me?  it’s the kind of information that makes me fear for my family’s life when they go into a hospital (the place where you’ll find the residents).

they don’t teach common sense

when you have two diet cokes sitting on your desk (because to hell with giving up soda when you’re this close to that special time of the month), and you’re not sure which one is the one you brought home today, you have several options to discover which one is the pop you want. 

1.  taste both

2.  shake them and see which fizzes the most

i tried both.  i opened bottle one, tasted it, and it seemed flat.  still unconvinced, i took bottle two and shook it.  ‘well that seems fizzy’ i think to myself.  to be sure, let’s taste it.  right after i shook it.  i think we can all guess what happened.

didn’t know where to start

the past week or so has been rough.  for a multitude of reasons, i have been severely sad.  i think a lot of it has to do with the stress my brother causes me.  his continual inconsideracy has, on more than one occasion, pushed me to looking up alternative places to live. 

how has he been inconsiderate?  it’s been a bunch of little things that have added up.  one little one might not have bothered me, but when you stack them up, the load breaks my strength.  i have spent 2.5 years in medical school, and i question that there has been a time that i have been more stressed out.  i have managed every year with ease.  i know it’s not a matter of being this year either.  before my mother left, i was doing just fine.  during surgery when i was rarely home, i was just fine.  now, on the easiest rotation of the year, i am breaking down.   the amount of stress and responsibility put on me is overwhelming.

i am notoriously matt’s “second mom”, which is always a good joke, but when push comes to shove - i am not actually his second mother, nor have i ever wanted that responsibility.  i don’t want to tell him to clean, i don’t want to tell him to pay people back, i don’t want to check to make sure he’s awake in the morning, i don’t want to worry about him going to court.  this f-ing ridiculous.  i don’t want to answer calls from my father regarding matt not answering his telephone.

what i want, is to spend my time studying when i am home, and studying in peace - apparently another luxury in this household.  The day brandon moves out, that tv is going downstairs, because i cannot stand the congregation of people in the living room, right outside the room i study.  i have told my mother that i will not tolerate having a fourth roommate who i don’t know.  i know cougar steve a little, but that’s about it.  i have reports that he’s clean, which for me, would be a miracle.  however, i would rather pay extra rent than take on another person, which i definitely explained to my mother.

 my concern for her is the continued unreliability of these guys.  all i can ask of her is to put her house on the market, put in laminate floors in the common rooms, fresh carpetting in the bedrooms, and hope the house sells.  she could pay matt and i to repaint neutral colors.  i have no doubt of my ability to handle an apartment on my own, and at this point, i don’t really give a rats ass what matt does.  i know of some new apartments that take dogs (aka delilah) and i’ll peace out.

i have only reassured my mom that i’m not going to bail on her and put her in a lurch.  i will have to talk more formally with her regarding putting the house on the market.  i don’t know what’s involved in selling a house, but if she’s willing to put it up now, by the time summer rolls around she might have  sale.  hopefully, she’ll just read this blog and i can save myself a phone call.

i told you so

no phrase could be more satisfying than the speaker and more irritating to the listener, but as i relished saying it, joseph, my boyfriend of some made up time, handled hearing it with grace.  the scenario that elicited it consisted of joseph buying two bottles of patron tequila and giving them to my brother, dubbing the ensuing party the “patron party”.  this, of course, was all done with my grudgingly given permission, which was only done because of the incessant requests. 

as you can already imagine, i was thoroughly annoyed with the whole event, but knowing that i would be, i set the plans for joseph and i to go out for the evening, only to return when the event was in full swing.  i knew if i had the opportunity to get away and spend some relaxing time out of the house, i would be able to better cope with the choas i would face when i arrived home.  that was exactly how it played out.

we had a really wonderful dinner together, which is nothing particularly new.  he and i have yet to hit that rocky patch and have only had a few potholes along the road.  some might say that it’s due to the distance, but usually that’s a reason to fight as evidenced by my previous, horrible relationship that will not be spoken of beyond vague references.  nevertheless, after our time together, we returned home knowing there would be a multitude of people there.

whenever i come home to a party, there is that instant irritation that begins with seeing other people’s cars in my driveway.  i walk inside to see people congregating in the kitchen, but there are still few people at the house yet.  we play with the dogs, play some guitar hero, and retreat to my room.  the final blow of irritation involved: 1. seeing approximately 4 tramps walk in the house  2. see several of them attempt to use my bathroom.  how did i know their sexual promiscuity?  it was based on the sole observation of being able to see the full outline of one of the girl’s butt cheeks through the huge whole in her jeans she cut out.  this wasn’t some seductive whole in the jean to show the back of the leg - this was full on ass, like whoa.  knowing most of the these girls live at home, i have to wonder how on earth they manage to leave the house like that.  my mother would have murdered me.

 the night ended with vomiting compliments of my brother and his friend brandon w., and after joseph was sure they weren’t going to die, he left me to manage the party, which consisted of me falling asleep locked in my room, with only the thought that brandon g.’s items were more valuable than mine if someone decided to steal something.