Monthly Archives: August 2006

my favorite things (of the moment)

In no particular order:
1. Diet root beer

2. Savannah Bee Company Magnolia hand cream.

3. 400 thread-count sheets

4. Scrubs (the TV show, not the garments, which are comfy but not quite a favorite).

5. My Mom

6. Macaroni and cheese (which I can’t have right now because my son is allergic to milk. But the minute he stops being allergic or stops breastfeeding, I plan to hunker down with a case of Kraft’s and not emerge for at least a week.)

7. My son’s smile.

8. Good red wine.

9.  Getting a sick patient to laugh.

10. ABBA’s “GOLD” album.

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Reality check

Today was one of those up and down days, when you can’t quite figure out how to feel. I had a classmate compliment me on my clinical skills, which was totally unexpected and really nice to hear. Especially since she and some of my other classmates had been talking about how I always seem to know what I’m talking about. (In my head, I’m thinking “Me? they think I know what I’m talking about? HA!”) So that put me in a pretty good mood, gave me a little (much needed) boost of confidence as I went about my various tasks.

Then, one of the nurses taking care of one of my patients asked when my baby was due. Yes, it actually happened, I stood there for a minute just totally frozen, hoping I didn’t actually hear those words. I sucked in my gut and answered “I’m not pregnant. I just had a baby three months ago”. She didn’t even seem that embarassed, and launched into asking me questions about my son, wanting to see pictures, the whole nine. I suspect she was terribly embarassed (she should have been, anyways!) and was trying to cover it up. But inside I was just dying. I’m only 12 pounds over my pre-pregnancy weight, which doesn’t seem like that big a number. I think it’s the fact that these pounds seem to be mostly congregated in my belly, where I’ve never had a problem with extra weight before. I’m very sensitive about it, as you might imagine. I’d love to say I love my body because it bore a child, blah blah blah. And I’m proud of the things my body has accomplished in the last year. It doesn’t mean I’m going to walk around in a bathing suit anytime soon.

On top of that, I have a very unpleasant patient. Cocaine user admitted for chest pain and shortness of breath. (Hello, you weigh 350 pounds, smoke crack, and don’t show up for dialysis, of course you don’t feel good!) His chief complaint this morning was that he was starving. He refused to let us draw his blood because he was hungry. I’m not sure how being hungry and having blood drawn are related, but apparently there is some connection. He refused to go to dialysis unless he ate something. We tried to get him home with a follow-up stress test but he decided to stay in the hospital overnight to get the test. Even thought he tried to tell me the test was too dangerous for him. This was after he argued that keeping him without food was bad for his heart. (Um yeah, you are so thin and frail you’ll just die without a meal. Grr).

The day ended on a high note, when I found out my class rank for 3rd year was good enough to put me in the top quarter of my class. That was a nice feeling. A little bit of validation to cap off a somewhat trying day. I’m settling into my routing, but I still have no confidence in my ability to be an intern, I’m terrified (like full on panic mode) I’m going to harm a patient. I need to get over it, but I think the only way to do that is time. I’m going to ask my resident tomorrow what I’m doing right and wrong. That way I’ll have something concrete to work with instead of guessing. Sometimes having high standards for yourself is nothing but a pain.

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Amen sister!

“Because women’s work is never done and is underpaid or unpaid or boring or repetitious and we’re the first to get fired and what we look like is more important than what we do and if we get raped it’s our fault and if we get beaten we must have provoked it and if we raise our voices we’re nagging bitches and if we enjoy sex we’re nymphos and if we don’t we’re frigid and if we love women it’s because we can’t get a “real” man and if we ask our doctor too many questions we’re neurotic and/or pushy and if we expect childcare we’re selfish and if we stand up for our rights we’re aggressive and ‘unfeminine’ and if we don’t we’re typical weak females and if we want to get married we’re out to trap a man and if we don’t we’re unnatural and because we still can’t get an adequate safe contraceptive but men can walk on the moon and if we can’t cope or don’t want a pregnancy we’re made to feel guilty about abortion and…for lots of other reasons we are part of the women’s liberation movement.”

~Author unknown, quoted in The Torch, 14 September, 1987.

I just found this quote and was blown away. I don’t consider myself a radical feminist but this is so right on. I feel very lucky that the field to which I believe I was called, medicine, used to be totally male dominated. Now, medical schools nationally are 50:50 men and women, and there are some specialities in which women are heavily represented (Ob/Gyn and Pediatrics, for example). I have heard more examples than I would like of sexism and blatant sexual harassment at my hospital, directed towards medical students. I personally have not seen this, although there are some attendings, mostly older, who are a little patronizing. I don’t think it is done in a malicious fashion, I think many of them feel a little protective of us “young women” and want to make sure we’re taken care of. I find it a little charming, to tell you the truth, and I appreciate any help I can get. That said, I still work my backside off and I know I’m just as smart and capable (if not more so) than any of my male colleagues. And in the last year and a bit, I think that my abilities have been recognized in their own right. I have tremendous admiration for our older female attendings, who faced a lot more opposition to their presence then I have. And I am so glad to live in a time when my children can enter the profession of their choice, without regard to their gender.

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love is all you need

My attending had our team (resident, interns, and I plus spouses and kids) over for dinner at his house. He has five daughters, the middle three of whom are triplets. TRIPLETS! Their children were born so close together that when their youngest daughter was born they had five children under the age of three. I thought his wife had to be a saint to manage all those kids, and when we met her it turns out I wasn’t far off. She was lovely, and their family was so welcoming. Very inspiring to me, who is just in the beginning stages of figuring out my family and professional life.

While we were there, our attending (Dr. A) thanked all of us for all of our work. This is remarkable, because I have never heard an attending acknowledge the fact that residents hit the floor running in the morning and don’t stop until they go to bed. I think this is a measure of Dr. A’s character that he remembers what it was like to be a resident. He went on to say that we took such good care of our patients, even though they weren’t all pretty, and they weren’t all clean. I thought about some of our less fortunate patients, and the fact that many of them are that way because of mental illness, addiction, poverty, and little to no support system. Some of these patients have no one to take care of them at home, and so cycle in and out of the hospital until they qualify for a nursing home. They have no one to provide their most basic physical needs, and I doubt they have no one to provide their emotional needs either. I think that to me, one of my roles as a care-giver in the hospital is to not only make sure my patients are taken care of physically, but to ensure they are treated respectfully, with dignity, and even with love.
Being in the hospital is a humbling and uncomfortable experience. Patients’ bodies are exposed to total strangers on a regular basis. And their lives outside the hospital are examined for clues to their illnesses and their ability to go home safely. It must feel humiliating at times. I try to be mindful of these things in the face of a patient who refuses treatment, or who is rude and disrespectful to me and my colleagues. It can be hard, but I think it’s harder still to be dependent on others for your health. Kindness can be a rare commodity in the hospital, you’re either sick or overworked if you are there for very long. I’m working hard to get into the habit of kindness with my patients, of not judging their social situations, of loving them for their humanity and not hating them for their mistakes. I think it makes a difference to my patients, at least I hope it does. I have so much love in my life that it spills over to the people I take care of. I wish all doctors had enough love in their life that they could spare some for their patients, it might make the hospital a nicer place to be.

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Perfection.

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bathtime

I took a bath with my son last night. He has a cold, his first one, and his nose is full of goop. I thought a warm bath might help calm him down and clear his nose out a little. So I got him undressed, wrapped him in his ducky bath towel, got myself undressed, and filled the tub up almost to the top. I put him in his bouncy seat next to the tub while I stepped in, and then reached over and lifted him out of his towel. He slid into the water easily, his skin slippery against my belly. He wriggled happily against me, waving his hands manically and kicking his feet against my legs. I rolled him over onto his back, supporting his head and shoulders while letting him float freely. He relaxed into the water, making tiny waving motions with his hands. I whispered to him about how it felt to have him swimming in my belly, the flutterings and floatings of his growing, his spinning and stretching. I marveled at how he ever could have been contained within my own body, he has grown so long now that it is hard to imagine him curled in my womb.

I wonder if he still remembers his life before he was born or if he has forgotten the dark wet warmth where he grew. He is still soothed by rocking, I remember before he was born he would often stop moving when I was walking around. I always thought he had gone to sleep, now I believe I was right. And when he sleeps in bed with me, he nuzzles his way up against my body, pressing his face against my breast and sighing as he relaxes. When I close my eyes I remember sleeping just the same way when I was pregnant, the two of us curled up together. I hope he finds the same comfort in closeness that I do, and that he knows he’ll always find that comfort in me.

When we were done with our bath, I wrapped him back up in the ducky towel and carried him to our bedroom. We laid down together, damp and warm and close, and I sang him to sleep. I know now that even if he doesn’t remember his life inside my body, that he knows we belong together. Somehow we never forget that.

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day one

Today was my first day back at the hospital on a “real” rotation. I spent the last month on dermatology, which was interesting and at the same time not very strenuous. There were a lot of half days, which was wonderful. It was a nice way to ease myself back into the pace of medicine. Now I’ve started my acting internship in medicine and the vacation is over! I know this is going to be a challenging month in terms of time commitment BUT it is really nice to be doing real medicine. I only picked up one patient today but it was so satisfying to have someone to take care of. And what’s even better, I am the go-to person for my patient instead of being the one assigned all the scut work without the responsibility (aka a third year medical student). It’s a nice feeling to be able to give consults my pager number, and to be considered a resident with the respect that comes with that. I think this month is really going to whet my appetite for internal medicine.

I started really looking at some residency program information today, and I was surprised to see how programs line up and which characteristics are really important to me. I would love to find a program with reasonable work hours, good benefits, and a good reputation. I have always said that it wasn’t important to me to go to a “big name”, but I have to admit that on some level it would be really satisfying to get into Yale. I’ve gone to excellent schools and I am very proud of my education, but there is something about that Ivy League name that is attractive. Maybe it’s my ego coming out a little bit, but it’s been dormant for a while so I guess it is time to accept it.

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