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A continuation of my journal "Almost Angelic" |
| Welcome to my life! The ups and downs, ins and outs, tos and fros. Its a crazy ride...hang on! |
| Dating is way to darn complicated! Since January 1st I have worked my way through four different men. Alan apparently wasn't that into me once I expected our "talking" to turn into something more serious. James lacked ambition entirely and really was interested in dating someone, anyone. He ignored the fact that we were completely incompatible except for both being generally pleasant people. Next. Jason was very interested in convincing me how smart, witty, sensitive, and humble he was. In fact he is the smartest, wittiest, most sensitive and humble guy I'm likely to ever meet! And all his friends think so too! And his family! In fact I'm pretty sure there was a ticker tape parade in his home town just to honor him for those very traits. *eyeroll* Roger the PhD student was nice, interesting, smart(!!!), and attractive. But we had one lunch, Dutch treat, and it was over so quickly it made my head spin. He gave the classic "We should do this again sometime." I responded with "Great, why don't you give me a call." He's out of town this week at a conference so he gets a small grace period. However, my girly senses are tingling and telling me that somehow I did not live up to his standards and I'm likely to not ever hear from him again. We shall see, but I'm close to writing him off. So in less than two months I've been through four guys. Two were complete misses and two, apparently, thought I was a complete miss. I guess it means I'm getting good practice in dating, but it'd be nice to actually connect with someone.  How in the world do I actually do that, the connecting part, if you can't even get both people to agree that they're interested in seeing how something could progress?I'm starting to believe that an arranged marriage might not be a bad thing! GoCartCherub ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** |
| Those of you who have known me for any amount of time, or met me, or seen me across a crowded mall know that I struggle with my weight. To be honest I'm not even sure what I'd look like if I ever got down to a healthy weight. Sad, huh? Well for the past four months I've put in an effort to lose weight, once again. This means eating a little less and exercising a little more. I cut out take away and hospital food (except for milk cartons!). And while I'm practicing my healthier lifestyle I'm also trying to learn a little bit about how and why I relate to food so poorly. And, to be honest, this time it feels a little different. I'm not stressing myself out over going to the gym everyday- the weeks I go to the gym more I lose more weight, but some weeks I really do just need the sleep. I'm keeping track of what I'm losing but I don't freak out over a small gain or a mini-plateau. I'm not in some competition to see how quickly I can lose this weight. I'd rather the weight just be lost permanently! So far I've lost 30.8 pounds. Let me repeat: I've lost 30.8 pounds!!! I'm starting to feel better about myself physically and my clothes sure are fitting better...probably because I've dropped 1 1/2 dress sizes.  But there is still that little niggle of doubt that you're faaaaaaaaat and that's all people will ever see in you. Especially when you've lost 30 pounds and no one seems to notice. Of course I'm still overweight even 30 pounds lighter, but you would think SOMEONE would notice!This week, however, really bolstered my self-esteem.Yesterday and today two women stopped me to tell me I looked pretty AND skinny.  They didn't say anything big, but those two little compliments made my Monday and Tuesday. They even made it easier for me to imagine Skinny GCC!And to those of you too afraid of saying anything to a dieting coworker or friend let me give you this piece of advice: If you can, give an honest compliment! Losing weight is hard work and an honest compliment can motivate someone more that you can possibly realize. GoCartCherub ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** |
| *Warning. Way too much information/girly talk ahead* A couple of years ago I went to wedding, after wedding, after wedding. Now there is baby, after baby, after baby. (Fortunately, as a Med Student I am exempt from Baby Showers as I'm usually working/too far away.) What's strange is that these people are now, on average, 3-4 years younger than me. And while I'm excited for them one question keeps popping up: When is it my turn? (This is where the girly talk warning becomes pertinent, for real.) I've come to realize something. I really, really, really want to be a mom. I've been putting off this feeling for years and I wouldn't want to have a kid tomorrow as I'm certainly not ready. I just wish I was in a place in my life where I was ready. I wish I were married, had a job, and was paying down debt instead of gaining in debt (it's now in the six figures, and I don't even have my degree yet.) Today at Target I saw a little girl with blonde ringlets and a pink pacifier toddling along very determindly. I melted...completely. Hell, I nearly ran after her and snatched her. (Not really! You don't have to call the cops!) I want so badly to have a child that looks like me, and is sweet and adorable and tiring and frustrating and will grow to hate me when they're a teenager and then remember they love me when they're in college. The problem is I also wouldn't just want to have a baby as I strongly believe in being married and having a solid relationship for a few years before you have kids. And since I've waited this long I may as well wait some more. Plus I probably wouldn't be in a place career-wise for at least 4-5 years. So I'm not getting pregnant tomorrow. But the fact that my biological clock suddenly starting ticking louder than Big Ben means I'm looking at things differently...specifically relationships. I was dating A but after him only ever e-mailing, rarely calling, and not bothering to ask me out on more dates I got it through my thick head that he's just not that into me. So I let him be. About two weeks ago J contacted me via match.com and we went on two dates this past week. He's nice, a bit shy, but he calls or texts me every day and has made it clear he's interested. Great, right? Except I feel like its a bit like pulling teeth getting to know him. And (please don't judge me) I don't think he's ambitious enough for me. Currently he's an associate manager at a Walmart and he has no plans or ambitions to do anything else. He also lives in a trailer with his brother, and has for the last 7 years. I'm just not sure there's any long term potential there, though there may be some short term potential. At the moment I'm trying to just enjoy the fact that I'm actually going on dates and getting to now a nice guy and NOT focus on "why it won't work". But then the "tick tocks" get louder and I think "Am I wasting my time? Should I just let it go and move on?" Tick Tock, after all. GoCartCherub |
| There is something creepy about driving onto the campus of a 150 year old mental institute. Perhaps its simply the wind whistling through the abandoned buildings. Or maybe there are ghosts wandering about reminding you of their pain. Or perhaps there is a psychic echo trickling down through the years from generations of disturbed patients. Or maybe its simply the collective plaintif cries of "When can I go home?" from a hundred mouths at once. When the person asking you the question also asks to show you the letter she got from God proclaiming her the co-heir to the throne of Christ, as well as allowing her to get free stuff from Walmart, the answer is a pretty solid no. Needless to say, the last month has been full of "interesting" individuals. After seeing so many psych patients I understand that, despite my multiple neroses, I'm actually quite normal. Especially as I don't hear voices telling me to take my clothes off, beat up a nurse for taking my temperature, or see deer following me on the side of the road. See? Perfectly normal! ... .. . . .. ... Did you hear that? GoCartCherub ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** |
| So I bit the bullet (awhile back) and started doing the online dating thing. A little over a year ago, after I broke up with a man child, I decided to see what else was out there. Its been rather hit or miss. There was Michael the Violist who was really interesting and fun. We went on about 4 dates and would talk for hours, but then he would never call me back, in fact he never called at all, only texted. It took about 6 weeks, but I figured he just wasn't that into me. After I stopped trying to contact him we never did go out for that lunch like we planned. Straaaaaange, right? Then there was Zac the teacher. He seemed to have a lot going for him. He taught math, was a music major in college, and was in grad school. But he seemed bored by his own life so, following his lead, so was I. We didn't even bother trying for a second date. Since then there have been some flirtations and come-ons, but nothing serious. Of course there was the man who asked me to be his fifth wife (not consecutively, but in conjuntion with the others). He envisioned our relationship to be a purely sexual one. I crushed his ego using only my words. But my connections online have been rather limited. There is one guy, A, that I'm e-mailing with several times a week, as well as ocassional phone calls. But beyond that I don't seem to be matching with a lot of people. My friends say I'm picky. I don't think I'm that picky, except on things that are important to a lot of people. I have four "Must Haves" that I look for: single, Christian, non-smoker, and a Bachelor's or more. I'll grant that the education thing is a bit weird, but I'll be honest; I just don't see relationships working when there is a huge disparity in education levels. I'm working on a doctorate, so I don't see myself really being that interesting to, or interested in, someone with a high school level education. But the other three I think are pretty standard limits. Single- I don't date married men, or separated men- they need the time to sort out their relationships before they date me. Christian- my religion is important to me, and I believe strongly enough in it to want someone else who shares that integral part of me. Non-smoker- I don't want to die from asphyxiation, and I refuse to breathe around smokers. As for "Nice to Haves"- political beliefs, and hobbies are in there. I consider myself to be slightly left of middle on the political spectrum, which is odd around here. I don't particularly like to date people on either end of the political spectrum- they tend to not think about their beliefs and just parrot party lines- something I'm not interested in. As for hobbies- I'm not a big sports fan, so we need to have something to do other than watch foooooooooootball! together, and it would be nice if the person enjoyed something in the Arts&Culture sector. If my standards aren't crazy then the problem must be with me, right? So, am I too picky? Am I crazy to think I might find someone that could actually meet these standards? And if my standards aren't crazy then why am I not meeting more men? Anyone have any good adivce? Or someone they think I should date? GoCartCherub https://medstudentnarratives.blogspot.com |
Despite yesterday being Thanksgiving I managed to not overeat...much. I did have slightly more pie than I needed, but hey, I only eat pumpkin pie once a year.  If you've ever met me you know I weigh too damn much. I started being truly overweight somewhere in Junior High, although I was never a skinny kid. In high school I started going to the gym more regularly and lost a lot of weight "without trying". Of course I eventually stopped going to the gym, gained weight, went to college, gained more weight, and landed myself firmly in the fat category. Over the years I've gone through cycles of gaining weight, losing weight, exercising, and sloth. My first real attempt to "diet" was my senior year of college and I lost about 30 lbs. Then I moved and started grad school and gained most of the weight back, even with more attempts at dieting. I moved again (away from the depressing apartment) and tried losing weight again. See: "Invalid Item"  . I was doing pretty well, and then, for a reason I can't remember, I stopped trying. Enter med school and I become the definition of yo-yo dieter, sometimes on purpose, sometimes as a natural response to stress. At the end of second year (Spring 2009) I made a concentrated effort to lose weight again, and managed to shed 30 lbs in 4 months. And then my 3rd year clerkships started and it all went to hell again. Six months, and one anxiety inducing family meeting later I'd not only regained those 30 pounds, but put on and six pounds. I'm not just fat, I'm freakin' obese, at my highest weight ever, and thoroughly disgusted with myself.I KNOW how to do this. Hell, I'm in medical school, of COURSE I know how to lose weight. And yet here I am, 27, obese, single, and amazingly unhappy with how I look and feel. On top of that I feel guilty every time I counsel patients on their eating and exercise habits. So I began again. I restarted WeightWatchers (online), started tracking my food, going to the gym, and getting on the scale. A month later I'm down 15 pounds and starting to feel better, but still unhappy with my weight. But what really frightens me is that I know how likely I am to fail. Not only does my past experience suggest I'll screw this up in about 2-3 months, but the research shows that most people fail in their weight loss attempts. So what to do? How do I stay motivated? How do I avoid stress eating? Its all well and good to plan for weight loss and success, but I'm not very good at planning for failure...and I likely WILL fail at some point. What to do? If I keep this yo-yo pattern up I'll kill myself via "biscuit poisoning". What if next time I fail and gain I weigh 250? Or 300? or 400? Can you ever come back from weighing that much? Can I come back from weighing what I do right now? I just want to be healthy. I know if I keep this weight on I'm looking at decades of anti-hypertensives, statins, and probably oral glycemics. I don't want to feel like a hypocrite during patient counseling sessions. I want to feel confident when I put my clothes on...or take them off. I want to not be embarassed when I get my picture taken. And (I admit this is shallow) I want someone (reasonably normal- not a creepy guy at Walmart) to ask me on a date because I'm attractive. But...it feels unreachable. I'm trying to take this one step at a time. Heck, I cheer for my patients when they lose 5 lbs, or even 1 lb in a month. I've managed to drop 15 lbs in 4 1/2 weeks, so I should be over the moon with joy, but I'm already worrying about the next step. What can I do differently to make it actually work for real this time, to make it a forever change? I'm running out of ideas, and I feel like I'm running out of time. GoCartCherub |
| Guilt is a funny thing. It makes us see things and do things we wouldn't normally do. Sometimes guilt can be good, especially if it stops you from doing something you shouldn't. But often times guilt is more of an after thought, a feeling you get when all is said and done and nothing can be changed. Clinic was busy without being hectic. I was enjoying the tempo of my work: read the chart, see the patient, report to a physician, see the patient again, write my note. Rinse and repeat until the day is done. My next patient had called in for an appointment regarding a "kidney infection", like ones he'd had in the past. I walked into the room and introduced myself. I asked him how he felt and he started nervously laughing. Odd. I tried my best encouraging smile and asked him to go on. He'd been counting on Dr. B, a man, seeing him, and he was really embarassed. "I've heard it all, and these conversations are private. You can tell me." Famous last words. At this point the differential in my head was running the gamut from forgien object stuck...somewhere, to the razor blade slipped, to sex with a prostitute. It turns out my differential wasn't half bad. "About a week ago I was traveling and visited this friend of mine... We had unprotected sex. And since then I've just felt...off, not right in my body. It just kinda happened, like before when Dr. B treated me." "Any symptoms?" "Naw, just feelin' off." At least now I knew I was dealing with a possible STD, but I needed more information. Was this friend male or female? Was he or she sick? "Did your friend complain of any problems or symptoms?" "Naw, she and I don't really talk much. We just hookup when I'm nearby." Success! We chatted a few minutes longer and he expressed his desire to get treated right away, before his wife came home. Charming. I then had the privelege of reminding a 47 year old man to practice safe sex. I made my report to Dr. B and wrote out a script for doxycycline. We also ordered lab work to test for syphillis and HIV, as well as set an appointment to retest for those diseases in 3 months. All in all it was actually a simple visit. I was actually quite pleased with my ability to not blush or giggle, and to get all the information out of the patient without making him more uncomfortable. It was, however, my first run-in with that particular STD- Guilt. GoCartCherub |
| Well, Saturday with the family went about as well as can be expected. No one was rude or demeaning (or overly charming) and we ended up sitting for three hours instead of just one. A few awkward silences but mostly filled with polite chit chat about the food with occasional stories from each of us about work. It was actually a more balanced conversation than is typical for our family. I still don't fully trust my dad, but at least we both know we can put up with each other at short family functions, although I still think anything longer is completely out of the question. All in all it went as well as we could have hoped for, and my mom was really happy with the outcome. I'm still not ready to be penpals or phone buddies, but I probably won't go out of my way to avoid him anymore. So...progress! GoCartCherub GoCartCherub ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** |
| I've been stressing lately over my third year schedule. Without going into a long drawn out discussion of the complications of third year scheduling...Basically my third year clinicals plus mandatory research is scheduled to be completed August 20, 2010. Panic. We submit residency applications on September 1st and I need to complete my Step 2 exam close to that. On Monday I began to wonder if it would be possible to change my schedule. On Tuesday I wished I could change it and thought of a few variations that could work. On Wednesday I e-mailed the Director of Academic Affairs at 3:00 in the afternoon. By 4:30 the next 9 months of my life drastically changed. I got my schedule changed in a way that allows me to submit my application on time as well as take my exam 1-2 months earlier than I expected. I didn't ask for any help and I didn't spend weeks plotting this change. Normally I'm so careful about big decisions, I premeditate everything. But this time I just did it. I didn't worry and stress. It was exhilirating to take a gamble and have it pay off. I grabbed the spoon. It felt awesome. 100 gift points if you can tell me where "I grabbed the spoon" is from! GoCartCherub ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** |
| The rules to being a successful medical student during your third year are fairly simple. 1) Put the patient first 2) Work with your residents/attendings to help them and not cause (too) much extra work 3) Don't piss off the nursing staff 4) Be on time and do your own work so you don't dump on your fellow students There is an individual on my team right now who, apparently, knows none of these rules. He has a code name given to him by his fellow students. (Take your index finger and lay it in a slight curve across your top lip, below the nose, in a facsimle of a creepy porn actor 'stache.) 'Stache, so far this week, has 1)failed to round on a patient 2)lied to an attending about it 3)continues to annoy the nursing staff, but this has been true since he arrived and therefore not of particular note 4) was late, copied another student's patient note and presented it as his own, and then failed to do his own work 5) has the world worst moustache 6)is more annoying and creepy than is possible to describe. I may kill him in the next 5 weeks. How, HOW, how does someone with NO social skills manage to get into medical school? And how the HELL is he getting good grades? And WHY have no attendings taken him aside and told him what a jackass he really is? Thank goodness he wants to be a surgeon. I just hope he keeps the mask on when he goes to talk to patients to hide that creepy moustache... This round of kvetching is brought to you courtesy of Big Fat Whiney Baby Medical Students. We now attempt to return you to your regularly scheduled Neurotic Medical Student Woes. GoCartCherub ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** |
| Let me tell you a secret, perhaps one that is unsuprising on this site: I long to be a published writer. I have no talent for anything longer than a few pages, or for poetry. I love my word pictures, I love inviting you into my world. I believe that in every life there are moments that crystallize in memory where each detail shines so brightly and clearly you can't help but write it down for others to see. One of the joys and tragedies of the medical field is that there are many of these moments. So my not-so-secret secret is my desire to collect stories from my career in medicine and publish them. I suppose I fancy myself to be a bit like William Carlos Williams. Hopefully in time my writing skills will improve enough that someone would be willing to print, bind, and distribute my little jottings. I've created a folder to hold my narratives: "Narrative Medicine" . I'll likely write stuff here first but plan to slowly transcribe my stories. Some stories I've written in the past I placed directly in the folder. "Invalid Item" , "Invalid Item" , "Invalid Item" . As always I am terrible at titles and would appreciate any suggestions.GoCartCherub |
| I suppose I should add a warning. Sometimes Medicine is not black and white, and medical ethics, dealing with life and death is, at the best of times, difficult. This was a situatiion in which there was no good outcome, no matter the route chosen. The medical team, and I, recommended what we thought was best to the family. You may disagree with the decision that was made. But with all that I know of medicine and life I still believe we did the right thing. But sometimes the right thing is both bad and ugly. Thank you for being my teacher, Little Man. I rocked you, you know. The chair and your feet, Little Man, we all noticed the same curve. I wonder if God made you that way because He knew only strangers would ever hold you. Your mom was too young and sad and scared to see you, but we looked upon each other and rocked. You held my hand, Little Man, as you passed through this world. Your fingers crossed, one over the other, over another. You clenched your fist when you tried to breathe, and squeezed my finger with each momentous struggle. You made me laugh. The pediatrician had to examine you and, like all little boys, you peed, with gusto, in the cold air. Your sense of timing, Little Man, is like that of all men and I’m glad you got to share in that experience, even at the expense of a pair of scrubs. At first you were silent, and then you finally cried. And when you cried I couldn’t help but shed the tears you couldn’t form. I closed my eyes, Little Man, as you struggled to bring your lids together about your solitary eye. I watched you gasp for breath, Little Man. And I counted the seconds between each moment of agony. Your little chest caved in as you finally opened your mouth, sucking in life prolonging air. It was so hard for you; your nose never completed its journey and rested useless, like a brand, on your forehead. I prayed for you, Little Man, as your lips slowly turned blue. I know each moment of your life was a struggle and I asked God to help you. Your parents were so young and scared. I asked that they be able to find the grace to understand you. After we said “Amen” your father came to say goodbye and to give you a name. It was a sweet name, Little Man. Your heart beat so valiantly against your ribcage. I watched it closely, so closely, Little Man. And finally when it was still and I laid two fingers on your chest I couldn’t tell my own heartbeat from yours. But you had finished your struggle. I catalogued your imperfections, Little Man, and for that I’m sorry. But I forgot to mention how your shoulders had a beautiful curve, and that each tiny fingernail was perfect. You had a soft, round belly and adorable knock knees. Your lips were a Cupid’s bow; your skin was soft and smooth. You were beautiful. I am so sorry, Little Man, that I could not do anything more for you. I sat and watched while you lost your struggle with life. I know we both agreed to be brave, but I think you’re braver than me, Little Man. I wish I could have made your single hour on earth better. You didn’t realize perhaps, Little Man, but you were a teacher. Thank you, Little Man, my Little Teacher. The child in this vignette suffered from Trisomy 18, or Edwards Syndrome, as well as holoprosencephaly. In short he had an extra chromosome, such as happens with Downs Syndrome. Like Downs it is associated with advanced maternal age, but most commonly it is simply an unfortunate chance occurance. The mother in this instance was only 16. Edwards babies rarely live longer than 3-6 months, and often need to be intubated just to breathe, and live in incubators. They are small and underdeveloped at birth, have heart defects, "rocker bottom feet", an unusual hand clenching, as well as underformed brains and other organs. Often they die in utero or the mothers undergo a theraputic abortion before 24 weeks. In this case the mother did not find out about her child's diagnosis until she was 28 weeks and so, by law, had to carry him until she wennt into labor or to term, in this case she carried him 37 weeks. Holoprosencephaly means that the child's brain failed to develop. The amount of damage inside is reflected in the abnomalities outside. In this case his nose was a non-functioning "proboscis" on his forehead, and he had a single eye, which means he had very significant brain damage. Given his chances, we recommended that the chil not be treated at birth as his life would always be short, but it needn't be filled with needles and tubes. The mother agreed, but not before changing her mind several times during the birth and immediately afterward. We gave the baby oxygen, but did not intubate which means that he eventually "pinked up" to breathe, and began to cry. After the father saw his child in the delivery room they stopped all measures. Eventually the baby's greatgrandmother, grandmother, and father all came to see him. His mother never saw him in this life. If you're interested in more I have some wiki links for you and you can google the pics, but they are graphic. The wiki articles are incomplete but offer slightly more explanation than I have offered. http://en.wikipedia.org/wiki/Holoprosencephaly http://en.wikipedia.org/wiki/Edwards_syndrome GoCartCherub ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** |
| My mom called this evening to talk about my dad. I don't know if I've mentioned before but since around Christmas my parents have been seeing a marriage counselor somewhat regularly. I haven't pried much into this whole thing except to ask my mom if they're still going, and if she thinks its helpful. (They are, and she does, but in a non-commital voice.) When my dad and I last communicated I said I would not be accepting anymore communications from him except a request to communicate via my mother. Apparently my father understood this to mean that my mom would be relaying the messages entirely, and despite a few attempts to correct that notion he persists in thinking that way. Until recently, that is. Things have been "happening" in their therapy sessions. Apparently Dad is cooling off, and not so angry anymore, more than a year later. And more importantly, he's starting to listen to someone other than himself. For example, my mom recently asked my dad to talk to my brother about a counsulting business Josh is thinking of starting. Dad's response was "I would never presume to tell Joshua what to do." Later, in therapy, Josh's career choice came up again and Mom pointed out that this response is so different from how he treats me. When I stated I might be interested in OB/Gyn I was subjected to 6 months of lectures on how the field was going downhill, being taken over by immoral people, etc. etc. So much so that one of the requests I had before last year's trip was that he not bring up OB at all. Supposedly Mom's comment hit home. So their therapist suggested we try and get together, just to be in the same room. Initially the therapist suggested Christmas, but that is a volatile time of year even in the best of families. So my mom suggested an hour or so meeting in a neutral place. Josh recommended drinks and appetizers. Mom asked when I would be free and, while I wouldn't mind meeting with everyone tomorrow, I asked that it be put off until after my next rotation is finished in 8 weeks. Last time I interacted with my father I went through a depression that lasted about 5 months. After this next rotation I'll be on research for 3 months so even if I do have a mental breakdown it won't affect my work during a clerkship. It sounds rather cold and calculating in plain text but the reality is my father is a man who does not understand boundaries. So I have to set boundaries for myself. I know that he can be an emotionally destructive force in my life, and when I'm deeply upset emotionally it is difficult to get work done. I'm not going to run away from him, but I am going to keep him in a place where he will be least destructive to me. So I have until the end of October to get mentally and physically prepared. Any suggestions? GoCartCherub ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** |
| There is nothing so loud as the sound of silence. I don't mean the silence of a vacuum. But there is that silence that is the lack of the noises of life. There is no sound of a husband's annoying snores. No baby's soft sighs. No angry teenager blasting horrid music. Not even an oven timer signifying the completion of a loved one's birthday cake. Rather there is the sound of your own heartbeat, your own breaths, your solitary meals warming in the microwave. There is no sound of a shared life. My life. MY life is so very, very silent. Only filled with the sounds of self, sounds that makes no noise. And even the splash of a tear makes no noise without someone beside you to hear it. GoCartCherub ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** |
| This has been an awful two weeks. I was on call this weekend, and on trauma call on Saturday. Basically that has boiled down to lots of surgery everyday plus really long hours...like 15-17 every day. Oy. Saturday was trauma call day. That means that every few minutes you're beeped with a new consult, and you're always afraid of starting something because you're likely to get called away. That one horrible call came in just as we were finishing putting a feeding tube into the stomach of a man with esophageal cancer. At that point my head was already pounding and I was bone tired but the "Beeeeeeeeeeeeeeep! Beeeeeeeeeeeeeeeep! Beeeeeeeeeeeeeeeeeeep!" of a beeper disturbed the quiet of the OR. We waited while the circulating nurse dialed the number and informed us of a new single person MVA, with the driver ejected from the car. We rushed down as soon as we could to find the patient in the CT already receiving blood. As the images flashed up on the screen I suddenly realized his spleen was nowhere to be seen and his left kidney was squished and blurry. The trip from the ED to the OR was a blur but I suddenly found myself getting scrubbed in for surgery as a man was stripped of clothing and debris while getting chest compressions. Anasthesia put up a half curtain and tried to find a blood pressure while giving him oxygen and putting him to sleep. We cut into his abdomen starting at the bottom of his sternum down to his belly button. As we cut the blood welled out of his abdomen and poured over the sides of the table onto the floor. Finally his heart started beating again and compressions were stopped. I used a sucker to try control the blood but soon one was obviously not enough. More blood, plasma, and platelets were hung. We started a special suction device that recycles a patient's own RBC for retransufsion. Surgery was officially in full swing. I sucked blood, held up his liver, his intestines, and his stomach. In order to get a decent blood pressure to his brain I had to clamp his aorta against his spine using my fingers. I was elbow deep inside a fellow human being. His spleen came out looking as if it had been stepped on by a linebacker in cleats. The kidney looked much the same. The bleeding seemed to have slowed, we packed him with sterile pads and closed him. I looked up to realize that two hours had passed and 20 units of empty blood bags were laying on the floor. He was alive. It was time to talk to the family. To be continued when I'm less exhausted... GoCartCherub ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** |
| Just as a warning this entry may be incredibly gruesome to some of you. I'm earning my 18+ tonight! ... .. . . .. ... .. . This morning I helped remove a woman's leg above the knee. And by helped I mean I held it it place while my attending sliced through skin, fat, muscle, and bone. As each layer was cut open we carefully stopped any bleeding. Skin and fat parted easily before the dividing line of Dr. T's scalpel. Everything proceeded quickly until we hit muscle. The cautery was brought out to help cut through muscle and stem excessive bleeding. The problem with muscle is that it looks like meat and once that thought occured to me it couldn't unoccur. The cautery created a cloud of smoke that smelled like a cross between a sulfur match and charred barbeque. With one hand I was gently retracting the upper part of the leg and with my other hand I supported her leg. And suddenly all I can think of is this leg as so much butcher meat and I'm truly and fully horrified by the bloodbath. As these thoughts sear through me and steal just a touch of my humanity the very chilly OR suddenly is quite warm and I can feel the sweat streaming down my face behind my mask. The blood left my head so quickly I could feel it roar as it passed by my ears on its way to my feet. The OR became brighter and fuzzier. Fortunatly I had the presence of mind to hand off the rake, step back, and sit down, and still maintain my sterile field. After a few minutes of watching from the sidelines I was feeling much better, though the headache I'd been staving off all morning arrived back in full force like and angry elephant stampeding through my brain and across my eyes. Despite this I stepped back up to the table just in time to help with nerve dissection and the bone saw. As the nerve was split it caused her calf to twitch and her toes to point like some sort of Frankensteinian experiment. Lastly there was only bone connecting the two halves of the lef. The charge nurse blocked the bone chips from spraying me with a cloth while I retracted the muscle and skin. The bottom of the leg fell into Dr. T's hand with a soft thwop. "Specimen bag!". The leg was suddenly gone into a trash bag made special with some red coloring and a few extra symbols. We began to suture when the thought happened again. Meat. The OR took on the same surreal quality and I found my seat again. Dr. T took pity on me when I returned to the table and sent me to put in orders on another patient. I removed my blood stained gloves and gown and gladly left. Outside the OR I wiped my face dry with a paper towel and leaned against a sink. I was relieved to be away from the gore, to have gotten rid of the sensation of blood cooling on my gloves. But, selfishly, I thought more of myself and the shame I felt at leaving. The embarassment. The feeling of inadequacy, of failure. And for the second time that day I felt just a little less human. GoCartCherub |
| It's been over a year since I've entered anything in this journal. And what a year. I finished my first, and second year of medical school. I'm currently on my second of 6 clerkships for my 3rd year, surgery. In my 9 weeks on the ward I've helped diagnose two men with terminal lung cancer, taken care of another man with terminal multiple myeloma- who died shortly after leaving the hospital. I've had my fingers in all sorts of strange places, and stapled a man's abdomen together. But more than just medical school being a challenge, which was expected, life has been a challenge, in more ways than I expected. A year and a day ago I was in Florence, Italy, sharing an apartment for 8 days with my parents, my brother, and my sister-in-law. I was the 5th wheel in my own family, stress was running high, and all of our unfortunate traits came out to play. My SIL was whining, my brother was dictating based on SIL's whining, my mother was manipulating, I was being bratty and bossy, and my father was alternating who he was most mad at/ignoring. Suffice to say I couldn't totally enjoy Florence, despite its beauty and the glorious art collections. On that fateful morning the family was set up to go to a small museum in Florence and then take a day trip to Pisa. Brother and SIL were running late (as they had every day). Mom and Dad were puttering around, and I was taking advantage of the extra time to order tickets to an exhibit in Rome the next week on the only computer in the apartment. I finally pulled up the appropriate site and dashed into my room to grab my passport and came out to find Dad on the computer. I asked him to let me finish up my order and he told me that I hadn't been on the computer and so I could wait on him. (This story gets more lame each time I tell it.) I explained I had just stepped out of the room, and needed to finish my order. He called me a liar, and then yelled and called me a selfish bitch. I lost my patience with him and called him a bastard. At that point he started yelling and screaming (they are two different things). He said several more, very personal, very unpleasant, and very untrue things about me. I got very quiet and told him several unpleasant, but true things about him. He stormed out of the apartment and the family didn't see him for the rest of the day. (This happens at least once on each family vacation I can remember since I was a child including the trip to Colonial Williamsburg, a family reunion in SC, and my college graduation.) I finished my order, we went to the museum, and then on to Pisa. When we got back from Pisa I attempted to apologize to my father for yelling at him, but he chose to walk out of the room. The same thing happened the next morning. After that I decided I would not repeat the pattern of years past where I groveled for his forgiveness and he never asked for forgiveness for his hurtful actions. My mother, ever the placator, begged me with tears in her eyes to "make it right". For the first time in my life I turned her down and told her I had tried, but until he could treat me with human decency I wouldn't debase myself for him. That moment is probably the moment I truly left all the last vestiges of my childhood behind. That day, July 4th, was our last full day in Florence. Awkwardly, the five of us, stayed together on the walk to Boboli Gardens, but quickly dispersed. That evening my mom insisted we go to dinner together. My father still was not speaking to me, and in general pretended I wasn't there. I wasn't included in pictures, he "couldn't hear me" when I asked for the bread or the wine to be passed. I was an empty chair to him. The next day we all went our seperate ways. Josh and Rachel were headed home. Mom and Dad were going to Rome. I was going to Venice and then back to Rome. My father did not say goodbye to me, and that was the last time I saw him. I spent my time in Venice and headed back to a hostel in Rome (a feat made more difficult by a country-wide transportation strike). I had originally made plans on July 9, my birthday, to meet up with my parents and tour Vatican City. Instead I toured it on my own and made friends with Holy Pigeons. I flew back home on July 10th, as planned. At the end of August my father sent me a letter. In the letter he stated that "If you think I have done something wrong then I ask forgiveness". Its the closest he's ever come to apologizing to anyone, including my mother, in my lifetime. Unfortunatly the rest of the letter was filled with further degredations on my character, and my mother's. I returned the letter to him. He sent me a second letter, filled with more vitriol. After thinking about it for a month I finally decided what I needed from him vs. what I wanted. The things I needed from him, just to be in the same room, were to speak to me with common courtesy (no yelling or belittling), to listen to me, and I needed him to not try to direct my life (the year prior I'd been getting weekly lectures on which specialty I should go into.) The things I wanted from him, but told him were optional depending on the depth of relationship he wanted, were to be encouraging, loving, and kind especially verbally. At this point it was the end of September and I had failed (barely) a Neuro exam and was spending more and more time in bed. I cried three times in four days at school. At one point I missed three days of classes, didn't shower once, and didn't study. I ate peanut butter sandwiches and drank hot tea. I couldn't get to sleep at night and couldn't wake up in the mornings. When I did study my brain felt sludgey like cold molasses. Because of my exam grade I managed to get hooked with a counselor that specializes in treating medical students, residents, and physicians. I was diagnosed with adjustment disorder with depressive mood and began counseling. My counselor read the letters my father and I had exchanged, and I told her about my family dynamic. She suggested my father might have Narcissitic Personality Disorder, and after reading the DSM-IV criteria, and several books, he fits the profile to a T. My father's third letter came and, between the insults, he told me he had no interest in any of my suggestions, and made none of his own. Currently all of his letters sit in a file at my therapist's office. At that point I decided that until he could treat me like a human being I didn't want him to contact me. I told him he could go through mom to talk to me, but otherwise he was not to e-mail, call, send letters, or visit. That was shortly before Thanksgiving. Since then he sent me two letters, both of which I returned unopened with a reminder of my wishes. My brother finished his MBA shortly before Christmas. Josh asked me that if I ran into Dad at his graduation I would behave civilly. I agreed. When Josh asked the same of my father, my Dad declared he wouldn't be coming to the graduation because he couldn't be sure how I would behave. At that point he started sending me berating text messages, fortunately my cell phone battery died. Dad, in the end, did show up to graduation, despite all his threats, and we did not run into each other. At Christmas I was visiting a friend who was getting married. My father took exception to the fact that I'd gotten him a present (something I'd bought in Florence, by the way). He did not open it, and sent me several un-Christmasy text messages. I blocked him that night, and have not unblocked him yet. Since Christmas I truly have not heard a word from him. I continued with counseling until about 2 months ago. I have changed addresses so he can't show up on my doorstep anymore. I'm no longer depressed. And my family picture, while complicated, is no less complicated than before and causes me consideralby less angst. My parents started counseling, and my mom is finally standing up for herself. I don't miss him, which is telling in and of itself. When I think back to a year ago I feel the difference. It's like that rainy day that's cold and grey and truly dreary, but suddenly the sun breaks through and the wind picks up and starts blowing the clouds away. The air feels fresh and full of possibility. And while your rain coat is still damp and the ground is muddy you can at least see far enough in front of you to know where you're going. I just wonder where exactly that will be. GoCartCherub |
| Well, I'm still in med school. I passed another course, which means they let me stay. Today finished 4 weeks of Pulmonology. Ask me something about the lungs, seriously. Restricitve lung disease? Fibrosis, Asbestiosis, Silicosis, Interstitial Lung Disease. Obstructive lung disease? Asthma, emphysema, chronic bronchitis, COPD, bronchiolectisis. I can tell you which organisms are likely to have caused your pneumonia based on history alone, and know which antibiotics to use. I know how to diagnose TB. I can figure out in you have a pulmonary thromboembulus, pneumothorax, or cor pulmonale. Drugs? Easy. Lung cancer? Show me the biopsy. I know all these things, and I don't give a damn at the moment. It is a Friday night, I just finished my 6th course in medical school, and Spring Break started at 2:45 pm. And yet I'm having trouble doing anything beyond sitting here and ocassionally changing the channel on tv. I can't even muster the mental fortitude to put shoes on and take out the trash. Blah. My brain is mush. Unfortunately neurology isn't until the fall, so I can't tell you the etiology of brain mush. But I have a feeling it has to do with me banging my head against a desk. GoCartCherub ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** |
| I forgot how cathartic it is to put everything down in words... Today a whole bunch of thunderstorms rolled through which, to me, is perfect nap weather. And naps mean dreams. As i'm fading in and out I had three strange dreams. The first was really disturbing. I pulled into a non-descript strip mall parking lot. I parked my car and checked my locks (I always do). For some reason I had a whole bunch of pillows and blankets in my passenger seat. I then walked down the row of cars to meet up with a group of friends (no one from real life though), including a guy I have a crush on (again, not from RL). We then proceed to have some kind of wacky adventure and end up at the exact same spot. Crush boy then something sweet that makes me float on air. I wave goodbye to my friends and head back to my car. I open the doors and notice that the bedding has been moved across both front seats and is warm. I look up and the passengar door is just swinging shut as if someone exited without my noticing. I get out of the car and see Crusty Old Homeless Guy running away. I shout at him and he turns and apologizes, claiming he was "so tired" I let him go and get back in the car. As I'm getting in the car I notice something shiny in my front tire. I pull on it and my entire (real life) key chain comes out from my tire. Just then Crusty Old Homeless Guy swings into a van and drives off, cackling, revealing Crush Boy making out with Hot Girl. I sit in my car horribly confused and betrayed. The second dream was...er...erotic in nature.  And very good, btw. The third dream I don't really remember but had something to do with misadventures at school. (Thrilling, I know.) Three very different dreams, and I have no idea where my subconcious is going with these. (Actually I have a pretty good idea on the second one...) Any ideas kids? As for doubts. I happen to hate this past Thursday. Not because I was all that sad on the day, but what happens to me the day after. Friday afternoon I got home from a long week, looking to catch up on my housework and R&R. I checked Facebook since its a great way to keep up with old friends. Suddenly I was just incredibly sad. I was looking at pictures from a girl I went to high school with. There were the typical happy pictures of her and her husband and then some very early sonograms of her twins. Somewhere during my internal debate on whether the twins were identical or not (they are) I was just hit with the overwhelming sadness. I was just convinced I was too unattractive, too weird, too know-it-all, too whatever to ever have the happy marriage and beautiful kids thing. Then I had that "moment of clarity" type feeling where I realized I would never be married, and never have kids. In that moment I was absolutely certain. And I seriously started crying out of self pity. Even now when I've decided that everything I though of was all crap I can't shake this feeling of doubt. What if that never happens for me? Its not like I date a lot, and who would want to date me anyway? And I'll get a half dozen responses telling me I'm being foolish, but the thing is not one of them will truly offer me any change. I'm 25 years old, I've been out of high school almost 8 years, out of college almost 4 years. I survived that first rash of weddings my first year out of college, but now my friends are having kids. It just feels like everyone is moving on, falling in love, being sucessful. And someway, somehow, I got left behind. Its like that feeling when you don't get picked for a dodgeball team only a million times worse. Yes, I'm a little bit jealous, but more so I'm just incredibly sad and wishful, and confused. Why haven't I met someone? Why hasn't this happened for me when it happens for everyone else all the time? Why? GoCartCherub ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** ** Images For Use By Upgraded+ Only ** |
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(I live about 2 hours NW of it, so I guess it makes sense!)
That being said, manners are a forgotten art in many parts and magnified by 1000-fold in the airport. People don't want to wait so they arrive at the last moment possible and expect others to cater to them because they are running late. Morons.
