GrrShhNguyen's Xanga

ERAS photo - pick one please!

Thu, 28 Aug 2008 05:27:33 GMT

I guess I could open this poll up to my xanga buddies. Much obliged.

The fact that I need sunscreen for my hair, duly noted. Does such a thing exist? I would color it again at home, but I have bad luck with black hair dye and carpets. And this is a new carpet in my apartment. You know, I should have preemptively jotted in "mysterious black carpet stains in bathroom" on the move-in inventory. Well. There's an idea.

urology

Thu, 24 Jul 2008 21:56:14 GMT

I ought to quit while I'm ahead, while I've got them where I want them. Can't they just evaluate me now? My attending gave me a lot of grief about psych at first, but since this rotation is pass/fail, I'm not so nervous about being myself around him. Since we have the same sense of humor, and I know the same Latin trivia, he thinks I'm brilliant. "Smartest medical student I've had in 20 years," he said. "I'm touched," I said, "I'm going to blog about this moment as soon as I get home."

He didn't realize I was being serious.

backpacking at Greenleaf and rock climbing

Tue, 22 Jul 2008 19:42:27 GMT

Ah, now I remember why you keep your shirt on while backpacking. . . even if it is 102 degrees out. DEET doesn't seem to keep chiggers away. It's only good for screwing up my manicure. Anyway, I've got chigger stylostomes tracing the outline of sportsbra, waistband, and leg bands. FUN TIMES. Anyone have any chigger remedies? Bactine and caladryl aren't working, and I can't stop scratching. :(

We managed to hike about 11 miles all told. Wouldn't have made it that far if he hadn't volunteered to carry my backpack on top of his the last 5 miles. (what a man!) I was in no position to argue. We stopped to camp at dusk, but I was too tired to do anything but stare vacantly at the lake. "Get in the tent? Oh . . . yeah. Good idea." I've never slept outdoors before, unless you count dozing off on a park bench. All night, raccoons bumbled through our "camp." Didn't get to fish this time either, but something about cooking outdoors makes kielbasa, onions, and boiled eggs taste amazing.

Also, I went rock climbing for the first time at Rock Town. I'm still really scared of heights, and still really scared of falling. But I managed to clamber to the top of one of the 1 star climbs in the end, and am looking forward to trying it again. Climb on!

laundry and garden

Thu, 10 Jul 2008 05:28:26 GMT

For someone who, for the last 26 years, has always had a washer/dryer in her home, the realization that you can do not one, but three loads of laundry simultaneously in the apartment facility is quite thrilling. Efficient! I like it! (I was going to do four, but I didn't want to be a washer hogette.) That's really swell. Anyway, I was reveling in this thought until I came home and did some light gardening. Then I realized something serious. . . I've thrown all my towels in the wash.

Reminds me of an unnamed friend who did something similar in the name of efficiency. He stripped down to his underwear and went about his merry, and oh-so-efficient way. . . until his roommates came home and found him in the altogether.

Speaking of the garden. . . I'm a little sad about this. I had planted some empty heart spinach stems earlier in the week in hopes that I could squeeze another dish or two from last week's batch. WELL. Stupid rain, no, deluge, came and flooded the whole darn tootin' thing. I think the chocolate peppermint will be ok though.

Billy contends the sexiest thing a woman (womun) can do is to use semicolons correctly. I think the sexiest thing a man can do is to say, "I can fix that." (and then proceed to fix your sliding screen door, your computer, that crick in your neck. . .) What do you think?

Only one thing to do

Tue, 08 Jul 2008 13:58:35 GMT

when you feel a little sad. . . and that is to watch Sound of Music while eating Honey-Ohs cereal. I love that part where she's trying to pump herself up before going to meet the Captain 'n' kids. Even in her dumpy castoff clothes and hideous carpet bag, she's totally psyched (through the magic of music, naturally). And you can totally tell 'cause she's swinging that bag and guitar about her, with that determined "I'll show 'em!" look in her eyes.

Then she gets to the enormous wrought-iron gate and the look on her face classic, "oh shit. . . "

Oh yes, I have tango lessons tonight. YAY!

Argentine Tango

Thu, 19 Jun 2008 23:28:37 GMT

Danny is one of my favorite tango partners. Partners switch off all the time so the more experienced can dance with the more clumsy (i.e. me). He explains things really well, and since he is an engineer, he talks in physics and math terms. In theory, I understand tango now.

Danny: I'm glad you have a math/science background. It makes explaining the dance so much easier for me.
Me: We'll be ok as long as you keep describing it in terms of mechanics and basic math. Venture off too far in, say, discrete mathematics, and I'll be totally lost.
Danny: No Kim, tango is supposed to be fun.

And it is! I wish more of y'all were in Tulsa, because the more, the merrier. There's tango just about every other night, so give you three guesses as to what I'll be doing this summer.

Also, I need these tango shoes.

One more week of 3rd year

Mon, 16 Jun 2008 00:24:40 GMT

Which unfortunately, means one more week of internal medicine. I forgot to blog about how much I hate it now.

The one highlight of this rotation came while I was suturing a man's hand in our free clinic. He was a former football player from Arkansas. Big tough guy. Anyway, I asked him what he had done for the pain, and he casually remarked, "Oh, 20 Tylenol or so." . . . "Extra strength??" . . . "Yeah." . . . "Oh my gosh, you CAN'T DO THAT, man!" That's when I noticed he was wearing a grubby Corona hat. Tylenol and alcohol are a bad combination. Keep in mind I had just seen someone successfully commit suicide taking 15 Tylenol, and I was still pretty shaken by it all. I sent him to the ER immediately. Savin' lives, y'all. Savin' lives! :D

Oh yeah. I hate my second medicine team. My intern yelled at me incessantly yesterday, and I actually had to duck into a bathroom to cry out of frustration for the first time this entire year. The thing is, he's so incompetent and his communication skills are so poor, I know he is trying to put me down to compensate for what he lacks. He's a foreign med graduate, and no offense, because I know some fantastic attendings and residents who are FMGs, but the vast majority of them are sub par.

Anyway, we had a patient with suspected myocardial infarction, so he asked, "What do you want to do now, Dr. Yang?" (side note: I hate being addressed as Dr. Yang when I'm not a doctor yet.) Most of the time, it's said in an effort to belittle anyway. I told him I'd start MONA BASH therapy (morphine, oxygen, nitroglycerin, ACEi, beta blocker, aspirin, statin, heparin). Great. So I started writing orders, and wrote one in for lopressor (beta blocker). "Vat deed you vrite lopressor for?" "Secondary prevention after an MI." "Vat, so eef, I take lopressor, I von't be getting an MI? You steel haf vun more medicine rotation, correct? You haf much room for improvement."

Good grief, someone needs to repeat intern year.

Then we ran through the patient's problem list, and I left something out. "See, that's the problem with you psychiatrists. . . you only see the patient as having only one problem. Medicine is much more complicated." (The accent just makes my blood pressure rise. you get the point)

I bit my tongue as I remembered him freaking out and ordering a psych consult on a bipolar patient last week. Jerkface.

new logo

Thu, 08 May 2008 12:08:29 GMT

Are you kidding? This is a joke, right?

Medicine, week 1

Fri, 02 May 2008 17:23:49 GMT

I love medicine, and medicine loves me (so far). The hours are glorious (mostly half days, with a lecture or two in the afternoon, and call q3). Attendings/residents really expect very little of me, so when I diagnosed my patient with Crohn's the first day, the attending practically wet himself.

Still waiting for my new stethoscope to come in the mail, since my last one was stolen during surgery. LAME. Oh well, the new one will have my name engraved on it.

Apparently when people decide to go the Family Med/Psych route, they mostly end up in Psych. That extra year of residency - all for naught. There's a "grieving period" in which you mourn the loss of your white coat, the stethoscope. . . the prestige. The sooner you realize that, despite the MD and years of training, colleagues and patients will no longer see you as a "real doctor", the smoother the transition. The thing is, I didn't go to medical school for these things that I will supposedly miss. I came because I want to help people. (Didn't we all?) I think the challenge over the next few years will be doing just that, but maintaining a healthy distance from my patients. My favorite psych attending always leaves her white coat at the office when she goes home. It's a simple mental trick - a reminder to leave work at work.

Top three choices for now - 1. Psych, 2. Neuro, 3. Medicine(!)
Location - 1. Portland, 2. Seattle, 3. Tucson

Rules of Surgery (AKA Grossest Story EVAR)

Wed, 16 Apr 2008 02:00:13 GMT

1. Don't goon your classmates.
2. Eat when you can.
3. Sleep when you can.
4. Never make extra work for yourself.

I'm not the sort of person who hangs out in the trauma bay, wishing for a horrific motor vehicle crash so they might get to put in a chest tube. I'm pretty good at blending in and slipping away to study/sleep/anything but drive the camera during a hundredth lap chole. Our euphemism for going home in the middle of the day is, "looking for my pager. . ."

Anyway, you'd think I'd know better than to answer the phone in the student call room when I'm not expecting a page. But you'd be wrong. I'm the only one here. If I weren't here, some nosey resident would notice everyone else was gone, and harsh words would be exchanged. So yeah, I'm taking one for the team today. I'm a team player like that. And because I'm on call tonight.

I'm getting sidetracked. Debriding is the one thing I hoped to avoid during this rotation. It basically involves taking a gnarly wound and scraping the necrotic flesh away until it's beefy red. Believe it or not, this actually promotes healing.

Yesterday, J's patient came into the ER for altered mental status. Um, what they didn't mention was a year's history of venous stasis ulcers (link to a photo, mild in comparison), with suspected fungal infection. This worst one was so severe, we could TOUCH HER FEMUR at the pit of it. Which I did.

Her skin looked more like tree bark. The man in this picture has a different condition, but I promise, those crusty spots on his legs look exactly like hers.

That's not the worst of it. THERE WERE MAGGOTS IN THERE when she came in. I kid you not. How the hell do you not seek medical attention for infestation?

Yeah, well, J is in clinic right now, and stupid, stupid me, I answered the phone. J's resident wanted a student in the OR to hold a 60 lb. leg during debridement. That turned out to be me. I was showered in fungus and dead skin flakes.

Now that I've scrubbed myself clean, there are no more XS scrubs. I look like a little kid who decided to dress up as a doctor for Halloween. This is exactly how I feel.

EDIT: I've just gotten the back story on this woman. She had been sitting in the same chair for 4 months. She moved in with her elderly mother, ostensibly, to care for her. Instead, her mom became the one to bring her food and water as she grew into the chair. The patient became a little more lucid later on, and when asked what brought her to the ER finally, she said, "Well, my leg got to smellin' like meat left on the counter a little too long." PSYCH CONSULT FTW!