Thursday Born

The everyday life of a psychiatry resident (who was born on a Thursday).

Archive for September 2011

Breakfast and Bunnies

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This is what happens when it takes me too long to get out of bed in the morning and I don’t have time to eat breakfast. I pack fruity pebbles in a tupperware and milk in a water bottle and steal some time between pre-rounding and rounding to eat. Fruity pebbles are an old guilty pleasure of mine, and I’m sad to admit they’ve begun to lose their appeal. I think this will be my last box for at least a year or two, probably longer.

Today was grey and rainy so I spent my down time indoors. Yesterday was beautiful, but I was busy all day until the end, when I sat outside to eat my dinner of yogurt and cheetos (…don’t judge), and saw at least four or five rabbits. They’re everywhere in this city! They’re also adorable, and probably delicious, except thanks to medical school, I know all about tularemia, so there will be no catching and eating of wild city rabbits for me. Not that I would catch and eat one anyway, mostly because I don’t know the first thing about catching a wild animal or about turning it into food, and it sounds like a lot of work to go through when grocery stores exist. I don’t cook meat very often either, so when it comes to home cooked meals, I’m mostly pescetarian.

Gratuitous second shot of bunnies! It’s hard to get close-ups of them.

Written by Aba

September 22, 2011 at 8:39 pm

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Denial

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I refuse to believe it’s Fall already. Now don’t get me wrong, fall is a nice season, as far as seasons go ( I grew up with just two: Rainy, or Dry. I sort of understand being attached to this whole four seasons business, but it’s still rather foreign to me), it’s just… what happened to summer? How did it pass by so quickly already?

I’m doing what I can to squeeze the most out of the good weather before winter sets in, so today, while waiting to be paged for a consult, I found myself cozying up to Blueprints Neurology in the beautiful little park area outside the hospital.

Have I mentioned before that I love socks? I’ve been rocking argyle and thick stripes for the most part, and there are several fun designs on this page that I think I’ll be splurging on soon. It’s been months since I’ve treated myself to some nifty new socks!

Written by Aba

September 20, 2011 at 8:36 pm

Longing for a sense of Belonging.

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Third year medical students are a bit like nomads, or refugees. I guess fourth year medical students are too, but I think by that point you’ve embraced your situation. During first and second year, we lots of dedicated, comfortable, official space. Third years? We have whatever space we can stake a claim to, always ready for a Resident or Attending or Nurse, someone who actually needs the computer or desk space for patient care, to displace us. Sometimes we return to the first and second year carrels, because we don’t know where else to go, or we head to the library.

What’s starting to actually get to me though, is the switching teams every 2 to 4 weeks. Sometimes you have a team of Residents and Attendings that you become really fond of, and then next thing you know, you’re working with a whole new group of doctors, and a whole new patient population. And sometimes it’s as small and simple as today, where I spent a half day in a Multiple Sclerosis specialist’s clinic, and at the end of the day she said I was welcome back anytime and that she enjoyed having me around, and I really liked her and really would love to spend more time with her, but I’m not going to, because it doesn’t really work with my schedule. This makes me kind of sad.

Also today, one of my Attendings from my PM&R rotation walked by us in the hallway, and he’s another person I really enjoyed working with (and I got a glowing end of rotation evaluation from him). I’m half-considering doing another PM&R rotation during my fourth year, just because I had such a good experience, even though I don’t think that field is for me. And I worry a tiny bit about letting down one of the ENT Attendings I got official feedback from, who asked me if I knew what I wanted to do yet, and said that if I end up considering ENT, I should let him know.

I can’t do every specialty. I’m going to have to pick someday. And for some reason it bothers me in a tiny but not entirely insignificant way that I won’t be doing what most of the Attendings and Residents I’ll work with and like are doing.

On the one hand, I think this is a great sign, that I get fairly easily attached to the sorts of people I’m going to be spending so much of my future career with. On the other hand, I’m really looking forward to finding my niche, my people, and “settling down” a bit. You still rotate around a lot as a Resident, but there’s a somewhat smaller core of people that you belong to.

Having a sense of belonging is very important to me, apparently. I’m not sure why.

Written by Aba

September 19, 2011 at 8:40 pm

The Ones That Persist

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I’m starting to collect patients in my head, people who I don’t think I’ll ever entirely forget. Their names will fade – most have already slipped away – but enough salient features will remain to distinguish them from the hundreds of others that will blur together.

One night on Orthopedic Trauma call, we were consulted to see a patient in the ICU. Nineteen or twenty year old male. In a coma after a very simple accident that could happen to anyone. Probably would never recover. He was so young, and more striking, he just looked like he was sleeping, but he was essentially dead. I wish I remembered his name because I meant to check if he did die, but I’ll never know for sure.

Then just recently, my Neurology team was consulted on a patient for something a little silly, but we all went to check up on her the next day when we were rounding. Near the end of the physical exam, her age came to light, and we were all shocked. 78! And so healthy! There are people her age who can end up in the hospital but be fine? Who can tandem walk and balance on their toes and heels and otherwise complete a full neuro exam? It was a little sad how shocked my entire team was, from us two medical students all the way up to our Attending. Seventy-eight, and many years ahead of her, barring any surprises.

I try to shy away from talking specifically about patients here, because HIPAA is very serious business, but I think every now and then I’ll share a little bit about these patients, the ones I won’t forget, and the ones I don’t want to forget.

Written by Aba

September 18, 2011 at 1:26 pm

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The Surgery Rotation Diet

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After studying for the Step 1 and doing little other than sitting at a desk all day and forgetting that the sun exists, I had gained about 8 pounds. After 12 weeks of surgery rotations? I lost about 12lbs, and am now down to my pre-Med School weight (which was the lowest my weight has been in the past… ten years or so; my heaviest ever is twenty pounds higher than where I am now, but that was back when I was sixteen). I don’t mind my current weight, but I think I’d like to re-stabilize at two or three pounds higher than this.

Mostly, I need to be better about making sure I always have food in my backpack or my white coat pockets. Graham crackers swiped from the hospital pantries really shouldn’t be quite so substantial a part of my diet, but I’m so, so grateful for their existence! And the little packets of peanut butter. And the juice! Love the grape juice. Perfect pick me up after a long surgery.


 

See? Even my parrot Chu agrees that the grape juice cups are delicious! (Parrots have similar tastes in food to people. He loves sweet things, and he loves carbs. And nuts/seeds. Basically, just like with humans, high calorie content = delicious).

Written by Aba

September 15, 2011 at 9:05 pm

Otolaryngologists hate Fridays

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That’s the only way I can explain how on my ENT rotation, Fridays have always been my longest days, and two of them have been my longest days in the hospital (on a day I wasn’t on call). Seventeen hour days are a serious test of endurance, but twelve and fifteen hour long surgeries probably go by a lot faster when you have more to do than watch and help retract. I did get to make the final cut that took out a tumor yesterday though, and was even allowed (under Attending guidance) to wield one of the electric cauterization tools for a few minutes while the resident scrubbed back in. So much fun! I was really disappointed when the resident came back and took over. :(

But mostly, my job is to help close the case. Put in a few of the more superficial sutures, cut the tails for the deeper sutures, and staple the main incision closed (which is a two person job; one person to hold the stapler, another to use tweezers to hold the skin together). The second year resident and I were complimented on the beautiful job we did with the stapling! She had really good technique; I don’t think anyone’s ever guided my stapling that specifically, and it wasn’t annoying at all.

Also, neck dissections? Pretty cool at the end! If you’ve taken a human cadaver dissection class, you might be thinking “Huh, a neck dissection? I’m sure it’s not actually what it sounds like to me.” Except it is! ENT doctors do neck dissections when someone has a head and neck cancer and they need to take out lymph nodes to look for metastases. This involves meticulously dissecting out the neck anatomy, because you can’t just haphazardly cut into the neck without damaging a large number of important nerves and vessels, so you need to clean and identify all the structures you care about before you can take out the nodes you want. At the end of the neck dissection, it looks a lot like a cadaver dissection, except it’s alive and oozing some blood, and things are intact because surgeons have far more skill than first year medical students.

Written by Aba

September 3, 2011 at 8:41 am

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Almost done!

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I wonder how much more I would like surgery if the schedule was better. Now that I have a much better idea of my role as a medical student on the team, I’ve been enjoying my time on these rotations a lot more. But the schedule! Ugh, these hours aren’t conducive to really living.

Last weekend I finally got a glimpse of one of the other Farmer’s Marke’s in town. I can’t believe I’ve never been before! (except, of course I can believe it; I’ve been too busy) It’s so cute! We were at that park for the International Food Festival though, so we just took a quick look and then walked all the very long way to the other side of the park for the festival. I went with two of my friends, Joe and Amrita, and their ridiculously adorable dog Mila who got compliments the entire time we were there.

So pretty! She’s the sweetest, spazziest little puppy ever.

To further compensate for all the random little things I’m missing out on, I’ve been doing things like (semi) impulse buying a bike. There’s a wonderful charity of sorts here called Bicycle Works, and I almost bought a bike from them my first year, but I was a bit overwhelemed by how many people were there, and one of my friends gave me the impression that it was a bit expensive. Now I’m kicking myself because their bikes are really well priced and it’s a great cause to support. Unfortunately for me, now that I was really ready, they’d just moved locations and are closed for who knows how long (they said two weeks, but it’s already been two weeks and they’re still closed).

So after the festival, I ended up paying quite a bit more to buy a new bike, because I’d spent a few weeks watching craigslist and I kept missing out on the bikes I wanted (one which was just a slightly older model of the bike I ended up buying, plus it was red! I really wanted a red bike) and I was getting impatient.

It’s pink/purple, which I guess is close to red? and I’m becoming rapidly fond of it. Right after I bought it, I rode it 2.5 miles home, and it was rather exhilarating. I had a bike as a kid but nowhere except around my driveway to ride it, and the last time I’d ridden a bike was when I was ten or eleven and went on a long ride with a friend and her family while I was visiting them. Today I finally started riding it to the hospital, and it is such a nicer commute to ride than to walk! (Or even walking plus riding the metro). I plan to someday finish adding to it, so it can be properly practical. I love the look of a handlebar basket, so I plan to get one someday, but mostly I want baskets on the back for groceries and picking up my packages from my new leasing office, which is a bit too far to walk. Lights and a place for a water bottle would be nice too someday, and maybe a kickstand. I plan to move with this bike once I leave for residency, so I don’t mind putting a bit of money into it, and I’m going to be riding it almost every day.

I really hope I end up somewhere I can keep riding my bike as a useful thing for errands. I love living in areas with safe and convenient places to walk and bike to. Saint Louis was quite a change for me in that regard, though it does at least have some areas (like where I just moved to) that are a bit more my style. Maybe once I finish learning how to drive and get a car, I’ll feel less like having to drive around is a hassle, but I think at heart it will always be my preference to rely on greener ways to get around.

 

It is really hard to take a picture of yourself and your bike on your phone!

One of the next times my boyfriend Ahmet is in town, we’re borrowing an extra bike from a friend and riding back down to that park to properly check out that Farmer’s Market. Or maybe I’ll just go by myself some random weekend. I miss doing things like that, exploring on my own. It’s fun in a very peaceful and quietly exciting way. But enough lamenting my schedule. Surgery is almost over, and I have just a week left to study for my first shelf exam!

 

 

Written by Aba

September 1, 2011 at 8:18 pm

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