afreakforjc's Xanga

The unflattering profile of my gut

Thu, 08 May 2008 23:28:39 GMT

The other day I donned some khaki pants. I forget why. I so rarely wear khakis. I think I was going to some semi-nice restaurant where jeans or shorts wouldn't cut it.

Pretty much all the pants I own I bought in high school, and I've never replaced them. Resultantly, many are threadbare or have holes. But hey, I figured so long as I fit into them, why buy new ones?

Apparently it's been quite some time since I've worn anything besides my one pair of comfy jeans and my scrubs. The khaki waist was rather tight.

Tight. My pants are tight. Behold, my first step into the "apple" body habitus of which I despise in my own patients, all the more so when I have to operate on them

Everything will always be alright when we go shopping

Sat, 03 May 2008 20:04:33 GMT

The past several weeks have been hard for me, emotionally and physically draining.

I suppose most guys, when anxious, stressed, or depressed, do something to release their pent-up frustrations. Perhaps they go for a run, or lift weights, or have sex.

I do none of the above. Instead, I go shopping.

It's odd. I despise shopping. I once knew a girl(s) who would go shopping whenever she was having a bad day. The momentary high of purchasing an expensive (or a good-bargain) item was quickly washed out by the reality of a difficult situation necessitating her attention.

Nevertheless, I've noticed my credit card bill skyrocket in the past few weeks, corresponding to my general ill temper and foul moods.

What have I bought? Oh, the usual guy toys -- sporty, expensive, manly items which may or may not receive action that I think they will.

Oh well. At least they're not clothes. That would be super girly.

Hmm...well, actually...

The unflattering profile of scrubs

Tue, 29 Apr 2008 23:54:26 GMT

I love scrubs. I wear them during the day, during the night, on call, in the OR, in bed, lancing boils, stapling gut, cooking spaghetti, all the time and everywhere. I even went to today's Ben & Jerry's Free Cone Day in my scrubs.

I think I actually look pretty good in scrubs. It's arrogant, I know, but they sort of give me a tall, sleek look. Or perhaps it's just faulty logic of my narcissistic imagination. (I.e., I want to look tall and sleek, and I like scrubs, ergo, scrubs make me look tall and sleek.)

A mostly unrelated point: There has been a little wave of babies being born to various doctors and nurses in the hospital. I suppose babies are being born all the time, but I just happen to notice now that I'm beginning to finally recognize and remember people in the hospital. Usually it happens that I notice a female doctor or nurse come back after a 3-month hiatus -- oh, she just had a baby. Well, actually, she had the baby three months ago, and I just happened to figure it out now. Consequentially, I've been trying to be more aware of ongoing pregnancies and imminent births, if only to strike up a conversation whilst awaiting an operation to begin.

The thing about scrubs is that -- on some people -- it makes them look pregnant. I'm not sure what it is -- the cut of the pants, or the bagginess of the shirt, or the knot in the drawstring. At any rate, there are quite a number of women who look rather pregnant in their scrubs. The obvious problem is that I'm not sure if they're really pregnant or if the scrubs just don't fit them well. On the one hand, I don't want to seem like an oblivious oaf who doesn't even care to inquire about an expected leave of absence for an anticipatorily happy occasion. On the other hand...well, nobody wants to be that guy who makes that mistake.

It seems then that I've started to receive the reputation of being an oblivious oaf. I guess I'll just have to live with it. But henceforth let it be known that my oft quietness is not due to timidity, fear, or rudeness, but merely the security of erring on the opposite side of humiliation.

I heart Charlie Brown

Sun, 27 Apr 2008 13:25:22 GMT

EMR

Fri, 25 Apr 2008 20:22:39 GMT

Four days ago, my hospital went to an electronic medical record. The death of paper charts had arrived -- everything is now on the computer.

Now in theory, I think EMR is the wave of the future. No more figuring out doctor's scribbles or nursing check-marks: everything will be typed out in crystal clear Times New Roman font. Orders are processed immediately, transfers occur instantaneously, discharge paperwork is condensed and computerized.

In reality, my life sucks. I want to pull my hair out and take a bullet to as many computers as I can. Dozens of people with "EMR Staff" shirts walk around the hospital, pretending to be helpful but ultimately knowing less about the computer system than I do. For every order I place, I get three phone calls saying I placed the order wrong in the computer. For every prescription I write, I get six phone calls telling me likewise.

I know it will eventually be good. I know it will eventually be good. I know it will eventually be good. I know...

But right now, it's a disaster, a mine field, more frustratingly complex than the International Space Station.

Return of the med studs

Tue, 22 Apr 2008 23:32:54 GMT

Fresh third-year medical students started on service today.

Fresh.

I remember what it was like on my first day of third year. I was clueless. Excited, nervous, eager to please, glad to be done with my obligatory two years of lectures and textbook. And I was completely, absolutely clueless.

I tried my best to keep my med student in the know. I tried to make him feel welcome, involved, interactive.

OK, so tomorrow you can follow up on Mr. Hasting's EGD and ERCP, see if GI did a CBD stent and an EUS, and follow up the path from the FNA. You should also probably round on Ms. Turner, see if she ruled out for MI, trend the trops and the myoglobin. Check to see if her urine output has picked and what her creatinine is doing.

I stopped and turned around. My med student was furiously scribbling in a small notebook. I realized that he probably had no idea what I said.

Uhh...ok. Sorry, I know, it's been a weird, busy day. Let me try to slow down. ERCP -- do you know what that is?

He looked up from his notebook blankly. I could tell he was trying to decide whether to admit ignorance or try to save face.

Don't worry about it. Endoscopic retrograde cholangiopancreatography. We'll go over it.

Ah yes -- third year. Twelve months and you can take a civilian and turn him into a doctor. The transformation begins.

A weekend of recovery

Mon, 21 Apr 2008 00:11:55 GMT

How do I deal with a bad, bad week? Easy, the same way I deal with anything else tough in life: I hide under my bedcovers.

After a glorious fourteen hours in bed (by myself, thanks for asking), I woke up remarkably early on Saturday ready to do something fun during my golden weekend. (Early is anytime before 8am -- which clues you in to how early I went to bed on Friday night.)

I called a bunch (like, all four) of my friends in town. Sadly, they were all doing couple-type things (my friends, evidently, coming in even numbers). Therefore, I decided to strike it out by myself and hike to Tomales Point, a hike I've been wanting to do for some time. (The wisdom of hiking in relatively isolated territory by yourself is dubious, but I really wanted to hike.)

Afterwards, I checked out the movie listings and realized that The Forbidden Kingdom had come out. Jet Li and Jackie Chan fighting together -- excellent!

Now, let's face it: the plot itself is a bit flimsy, the dialogue formulaic, and -- worst of all -- the white boy gets the cute Asian girl in the end. (Where's the justice, I say? It's what you'd expect of a marital arts film directed by a white guy.)

However, this is all mitigated by (did I say this already?) Jackie Chan and Jet Li -- fighting!

All in all, it's been a good weekend. My spirit is refreshed. I'm ready for the beat-down.

Criticism

Fri, 18 Apr 2008 00:07:36 GMT

I don't take criticism very well. I really don't know anyone who does, I suppose. I find it demoralizing and depressing.

My month on the surgical GI service would otherwise be a pretty good month -- no in-house call, two golden weekends, plenty of operating -- were it not for the one attending that has made my life miserable.

The criticism starts the moment I step into the OR and doesn't end until the last stitch is sewn.

You're holding it wrong!

No, not that...THAT!

What are you doing?

Do you know nothing?!

You don't know? How do you NOT know?

Why are you doing that? WHY!

You're wrong, you're wrong!

Stop it, just stop it!

I can't stand it. The negativity, the reprimanding, the yelling -- it's like being in kindergarten...in hell. Even the nurses take a cue and start making snide comments at me in the OR. I find myself dreading each day more and more, wishing I could just sleep in till noon and never show up to work. I've been made to feel like an incompetent, unintelligent, maladroit fool.

At first I tried to imagine what sort of comebacks I would say if I had the guts to say it and didn't have a job to preserve. Now I don't even have the energy to play my dream dialogue in my head. I stand physically dejected and mentally paralyzed. I'm like the wild horse who is ridden over and over again by the human until the horse finally stops bucking the rider off. The horse is beaten again and again until finally he gives up and his spirit breaks.

And then, after the horse's spirit is broken, the owner continues to ride him and ride him and ride him.

My cell phone bill

Sun, 13 Apr 2008 19:27:43 GMT

I didn't get a cell phone until I started internship. I started out with a pretty basic package from T-Mobile, something like 600 minutes a month with free nights and weekend. Interestingly, however, I found that I was often going over my daytime minutes. I guess I just talk a lot on the phone? To all my other single, bachelor friends?

So I upgraded to 1000 minutes a month. Now my cell phone bill runs me 10% of my apartment rent. The good part is that I never have to worry about going over my minutes.

But the bad part -- well, for example: I just checked my cell phone bill for the past month. I didn't go over my minutes. In fact, out of the 1000 daytime minutes I had to burn during a one month period, I used 200. That's it. Two hundred minutes. Twenty percent. One-fifth.

Why so little? Three letters: ICU.

Recognition

Sat, 12 Apr 2008 02:12:55 GMT

I walked into the OR the other day and the scrub nurse looked up.

"Hi, anDrew!"

I stopped dead in my tracks. Who called my name out? Who knows who I am? How do they know who I am?

I looked at the scrub nurse. Her face was familiar, but I couldn't place her name. I quickly scanned her attire for her name tag. Oh yes, Maya. Her name was Maya.

"Hi, Maya, how are you?"

I work in one of the busiest operating rooms in my state. There are hundreds of nurses, technicians, mechnicians, and anesthetists that work there. As badly as I would like to remember the names of everyone that I work with in the OR, I have a hard time keeping them all straight. And, until now, no one has cared enough to learn my name, so I figured: why bother?

But now, here was Maya, who had actually learned my name and called me out. I guess it shouldn't surprise me completely: after all, I've been there nearly two years now. But in my head, scrub nurses are still those Nazis of sterility. I have a dormant fear of them. These are same people who reprimanded me repeatedly just a few short years ago when I was a medical student for not holding my forearms in the correct position when gloving and gowning.

And now? Have I become friends with them? Have I finally turned the corner, made the first-name-basis connection? Will they treat me differently, respectfully, nicely?

"Don't stand there! You're too close to the blue towels!"

Oh. Never mind. I'm still just a resident.