Who's a Turkey?

I got to go home this weekend! My family even re-staged Thanksgiving for me on Friday evening. Complete with torturing the dogs by turning them into Napkin Pilgrims and everything.

This picture is actually from brunch yesterday... Just in case you were wondering. Which I'm totally sure you were.

I'll Tofurkey You!

Happy Thanksgiving!!

As I'm still on nights, I actually got to welcome Thanksgiving in at midnight this year. You're totally jealous, aren't you?

Yeah... I know that you're not. Sigh. I'm just trying to make myself feel better.

I only have one night left after tonight, though! Yes, it does happen to be Thanksgiving night. Which means that I will be actually sleeping through the bulk of Thanksgiving proper. But, eh. Whatcha gonna do? Maybe it will save my gastronomic health - i.e. maybe I won't gorge myself to the point of incapacity.

Who am I kidding. Of course I'll stuff myself. I'll find food somewhere, and I'll eat too much of it. My own little way of thanking the universe for the gift of excess.

Night Float (or Swim) has been an interesting experience. The nights have generally been hot or cold - running around all night or sitting catching up on Desperate Housewives on abc.com and knitting.

There are some things I like about the night - lack of having to round for one. Lack of pimping by attendings for another. It is very self-directed. We admit the patients, decide what their initial management should be, and take care of any difficulties that happen on the ward overnight. Being relatively alone (with one other resident) really forces me to make a decision. Which, you know, doctors are supposed to be able to do. So that's good.

BUT. Let me tell you. The MOST exciting thing that happened in these past two weeks occurred during sign-out one day. In a side tangential discussion, the subject of the Midwest came up. At which point I piped in that I was from the Midwest (I claim backgrounds in the Midwest, Northwest or North Carolina as the mood suits). And then another intern also informed the room at large that he had gone to college in Minnesota. A small college. Called St. Olaf. At which point I shrieked, "No you didn't!" Mostly out of shock, but also because I didn't recognize him. But he did! He graduated from St. Olaf two years after I did.

But here - get this: He is an intern in the Family Medicine program at the Air Force Base near Sacramento. Normally there is one AFB intern on the service, but this month there happen to be two of them. The other one, a girl, ALSO WENT TO ST. OLAF. She graduated a year after me. I think I was her orgo lab TA. I totally thought she looked familiar, but I didn't make the Olaf connection.

There are currently THREE St. Olaf grads on the Pediatric Ward service. Is that not one of the weirdest coincidences ever???

We've celebrated with a couple of rousing renditions of Um Ya Ya, our fight song. Trust a Midwestern school known for their music program to have a fight song called "Um Ya Ya." Watch out or we'll Um Ya Ya you!

Eat a lot of turkey for me today. And save me some leftovers for tomorrow, when I'll be back among the Living In The Day!

Night Swimming

Hark!

You know that REM song, "Nightswimming?" It's totally in my head right now. Well. The first two lines are anyway. I don't know the rest of the lines.

Why is it in my head? And, perhaps more importantly, why am I blogging at 5 am when all normal, sane and happy people (aka Not-Residents) are sleeping?

I am on Night Float. It's an actual rotation name. One that most residents/young MD's would be familiar with.

I'm not really sure why it's called "Float" though. Maybe because we 'float' through all the services?

Basically, we come in during the night, watch over all the pediatric patients that are on the general, heme-onc, pulm or renal services and admit any new patients that come in.

Floating implies easiness.

And... it's not hard per se. But it ain't 'floating', that's for sure. Night 'floating' makes me think of evenings in the deep south, sitting out by the lake with my mint julep as the sun dips below the horizon and fireflies start their lazy path across the night sky.

There are no lakes here. Or mint juleps. Or fireflies.

So, I think that I will refer to this particular rotation as "Night Swim." That implies a bit more work, but not as much work as "Day Swim." Because at night you need to swim a little slower so you don't swim into rocks or crocodiles.

Plus, with "Night Swim" as a rotation, you get a great theme song.

Last side note: My brain function appears to be limited after a night on. So... if this post doesn't make sense, I can't be held accountable.

Side note to the side note: I may be incomprehensible, but I can totally take care of your sick kid. Trust me. I'm a doctor.

These Boots Are Made For...

...Sitting on my butt with my feet propped up, while I read Jane Austen and possibly eat pomegranates.

This morning I woke up and thought to myself, "Hmm. I only have clinic today. Plus, it is Wednesday, the Day of Tyra Banks and America's Next Top Model. If I wear cute (though uncomfortable) shoes, I can practice my 'model walk' all day long. Perhaps I shall wear my cute (though uncomfortable) boots. Yes! I shall!" So I did. They were only One Beer Shoes,* but my feet still hurt. Thus I whine.

*One Beer Shoes: Shoes that are uncomfortable, but the pain is able to be dulled by consuming about one beer. Alternately: shoes that can be worn if I am going to spend most of the day on my hiney. Antonym: Birkenstocks. See Hard Liquor Shoes**

**Hard Liquor Shoes: Those that I shouldn't even look at without a straight shot of tequila. I don't wear those often...

Jump on the Brenna Train, my friend, and let me carry you to an entirely different topic.

We had our Intern Retreat last week (to which I wore Coffee Shoes - aka Everyday shoes aka those that I will put on after I've had at least one cup of coffee).

Quick - word association game. I'll give you a word, and you tell me the first thing that comes to mind. Ready? Here is the word: RETREAT.

You totally pictured cabin in the woods with questionable restroom facilities and campfires and sleeping bags, right? Or perhaps a battlefield where one side is deciding to run for their lives?

Well, you're totally wrong.

We were lucky enough to retreat at the Christian Brothers Retreat and Conference Center in Napa. Yes. That Napa. It is somehow associated with monks. I think. I didn't see any there.


We did retreat-y things, like talking. And more talking. And then between the talking, we did some more. In all, the talking part was totally painless.

But, more importantly, we had fun!

We sampled some wine:


Of course... straight from the vine isn't quite as good as, you know, actual wine. As Sarah, Ryan and Monique demonstrated.

(Though I'm not quite sure why Monique looks quite so crazy)

We also took in some fine art.

Wherein a fellow resident showed that you can take the pediatrician away from the children, but you can't take the child out of the pediatrician. This particular installment was called "Melting Stone."

After the wine and art, we did some more talky-talking, and eating - did I mention eating? We ate like queens. And/or kings. So much food, and all of it delicious. Better, at least, than the bagels and beef jerky that I tend to live off of. Just kidding. Kind of.

After dinner we played Mafia. Hours and hours of Mafia. For those of you not familiar with the game, it involves lots of mock murder, lynching and lying through your teeth. Its great fun! Incidentally, Susan's residency program also played mafia on their retreat. Must be a pediatrician thing (I didn't even suggest the game!).

Finally, we did retreat (hee!) to bed. Because the building was originally something to do with monks and not a retreat center, the rooms were of varying sizes. Guess which one I got? The room is definitely in contention for the Smallest Room Ever:



(but we all remember that honor belongs to the two person suite in New York)

The small monk-like room was totally worth the view, though:


So, there you go. I've been retreated. I guess our next retreat will be at the Marriott. FYI, the Marriott is located smack dab between the hospital, the building where the peds offices are, and the building where we have peds clinics. I'll totally wear my tequila shoes to that one!

Existential Crisis

So, I've not been all that productive lately. And by 'not all that productive,' I do, in fact, mean that I have been spending the majority of my time knitting, watching TV and playing Minesweeper. Part of that goes along with the rotation that I'm on. And part if it is just my general Lack of Motivation.

I've decided that I'm having an existential crisis. Doesn't that sound romantic?!

Ah, but wherein lies the root if this crisis? And, more importantly, how do I get out of it so that I can do important things like Study for Step 3 of the Boards, or Exercise or Get Off My Butt and Make Some Friends Already?

There is this sense that I (and others - I do talk to people still) have in residency. The "I Deserve It Because I Work Hard" sense. It is really just an excuse to do whatever the hell I feel like doing. Because, heck. I work hard. Yet, even in these times when I'm not working hard (i.e. on an Advocacy rotation), I continue to do whatever the heck I feel like doing. Like I'm a Pleasure Camel. Hmm. That sounds kind of dirty. I just mean that it is as if I'm trying to build up a stock of Relaxed Time to get me through the more difficult months I know are coming.

But that ain't gonna work, sister. I may have a hump, and people may call be Sally. But I'm no camel.

Actually, I don't have a hump, and no one has ever called me Sally.

Still not a camel, though.

The flip side of the "I Deserve It Because I Work Hard" coin is the "I Deserve It Because I Do Good Things For People." And here is where I think I start to get into trouble. Because I don't honestly think I'm doing all that much Good right now. Big Good, I mean. Sure I do little good - getting a toddler through an exam without torturing them, calming parents down about antibiotics, etcetera. And I'm definitely doing more good than I was as a medical student, where the good was solely and completely theoretical, and sometimes consisted of doing bad so that the patient knew the difference.

But Good? In the big, life-changing, world-altering sense? Or even in the Being A Good Person Most of the Time sense? I don't know. I'm lazy. I watch too much TV. I don't study enough. Somehow the "I Deserve It" part of that coin has taken over, and I justify my deserving it without actually doing anything to earn it.

Granted I'm not out doing drugs, soliciting sex or knocking over kids' sand castles at the beach or anything.

But I'm not out... I don't know... finding the cure for AIDS, either. Or the cure for the common cold, which would help my patients even more at this point.

I think on some level, I'm starting to resent the patients - or at least the practice of medicine. It takes away so much of my life. Think of what I'd be doing if I hadn't spent the last 10 years of my life figuring out how to get into medical school, studying, volunteering, making myself a better candidate for residency, etcetera, etcetera. I could be married! I could have kids! I could have been on a reality TV show!!

And my way of retaliating is to waste time. Time that could - and, as a resident, really should - be used to make myself a better doctor.

Sigh. I don't know what the answer is. It is a crisis, after all, right? An existential crisis? I don't think crises are supposed to have easy answers.

I do know that most days, especially ones where I've worked really hard, I feel more fulfilled than I could possibly imagine in any other job. I know the thought of working in a field outside of medicine (and peds specifically) seems utterly ridiculous. I know that I'd rather work hard than watch TV all day long.

So, for now, I think I'll keep plodding along. Like a Pleasure Camel.

Watch out, though. I spit.



(Come on, you've gotta get that movie reference... which leads to a Theme Park Reference, and from there, to the more obsure 80's TV sitcom reference)

Geronimo!

My cat just fell off the window sill.

Here she is, looking all non-chalant, "Who me? Fall off a window sill? I don't think so."

Only I would have a cat that is a klutz.

(after this she jumped back up, hit her head, and fell down again)

To School Brenna Wore Her New Skirt vs. Homoscedasticity

One of the things that drew me towards pediatrics in general, and my particular program... particularly... is the general focus on advocacy. Kids are little and need someone to stand up for them, right? Well, I have two good legs and at least two good feet, so... go me!

And I now currently find myself on my Advocacy rotation (refer back to choosing this program particularly). Many residents (peds ones even!) find the advocacy rotation to be... less than useful. And I'll admit that it is no great strain on my intellectual capabilities (hee! see how smart I am with my big words?!), but despite - perhaps even because of that, I dig it. And I can talk myself into a big fiery ball when I start thinking about how kids in general are treated/dealt with in society. But I don't like to play with balls of fire (even great ones), so I won't go there today.

All this was to explain why I found myself sitting in with a sixth grade class this morning. I love sixth grade classes. I saw some Vocab, some Reading Comprehension, and then something about sentence structure. Maybe that was what it was called: Sentence Structure. Probably not. There's probably a more 'official' word for it.

Anyway, the teacher put up a projector sheet (I love projector sheets!) with some funky sentences on them for the students to correct. And one of them? One of them HAD MY NAME! In PRINT. On the OVERHEAD PROJECTOR. It was thrilling. And it was totally about me. This was the sentence:

To school Brenna wore her new skirt.

See? That was so obviously written by some stalker who has been following my life. And not studying sentence structure. Because I have totally worn a new skirt to school before. In fact, I would bet that I've done that at least once or twice a year!

That was fun.

And after Sentence Structure they had Math. They did fractions. I love fractions. I get fractions. I totally know how many pumpkins are ripe if you tell me that two thirds of the 60 pumpkins are ripe. I can even do it in my head.

Which is very exciting, but does not help me in my preparation for the Journal Club I get to help lead on Monday. For Journal Club, I am looking up words like homoscedasticity. Yeah.

I'm thinking to sixth grade maybe back I should go.

And I'll take my stalker with me.

My New Passion

Hey, guess what? I like yarn.

Okay, okay. No big surprise from the person who learned how to spin yarn, has been to two (two!) Animal Fiber Fairs, drove twenty miles out of her way to go to a Yarn/Antique shop in Kansas and hoardes yarn like she's saving up for a worldwide yarn shortage.

I have a new yarn-using hobby now, though! And it is TAKING OVER MY LIFE.

I'm making toys! With yarn!

Yes, I fully acknowledge that I am 28 years old, and well above the age where one should be playing with stuffed animals, and in fact, the mere act of admitting that I still know what a stuffed animal is brings me nigh on being one of THOSE people -- you know - the stuffed animal people -- but... but... it's fun! And you can make some really crazy creatures. That are cute! And make me smile! So shut up with all your "Oh, Brenna must be one of those people" nonsense. Because, well. Maybe I am.

But here is my latest work in progress:

It isn't really anything in particular. But it fills me with happiness and insufflation!

Well. Maybe not insufflation, as that really means something like 'the act of filling with air.' But it sounds like it should mean 'the act of filling with joy and a sense of accomplishment.'

But who expects one of those people to use words correctly?

Jelly Beans and Masochists

There is something unnatural about being awake at 4:36 in the morning. I understand staying up until four - and have often done so for various reasons including (but not limited to) enthralling books, last minute crafty gifts, and extended alcohol consumption/sobering up before letting myself go to sleep thereby decreasing hangover risk (the previous statement is hereby made invisible to anyone calling themselves "mom"). Alternately, I understand getting up at five - generally for things like plane flights and NICU shifts.

But it is this 4-5 hour that really strikes me as odd.

And exhausting.

Which brings me to my main topic: The Masochistic Tendencies displayed by People In Medicine.

Because, seriously? Who in their right minds would choose a career where you work pretty horrendous hours, are guaranteed to get yelled at by the people you're working for as well as the people you're working with, and are bound to spend many years (and many dollars) finding out that you - yes you! - are a bona fide idiot and will never be smart enough.

Not only do People In Medicine (PIM) do this voluntarily - and pay big bucks for it - they also BEG to get in!

Crazy, I tell you!

Not that I'd change any of it.

I guess you have to be one of the PIM to really understand.

....says the spiritual/emotional/intellectual masochist.

Sigh.

I really have nothing to say about jelly beans. I just liked the way it sounded paired up with "Masochists."

And I had some with my lunch.

Which I ate at 2. In the morning.

Brenna, the Movie!

Another meme from Susan.

IF YOUR LIFE WAS A MOVIE, WHAT WOULD THE SOUNDTRACK BE?
So, here’s how it works:
1. Open your library (iTunes, Winamp, Media Player, iPod, etc)
2. Put it on shuffle
3. Press play
4. For every question, type the song that’s playing
5. When you go to a new question, press the next button

Opening Credits:
"The Child is Gone" by Fiona Apple

Waking Up:
"Hollywood" by The Cranberries

First Day Of School:
"Raining on Our Love" by Shania Twain

Falling In Love:
"Because the Night" by 10,000 Maniacs

Fight Song:
"When You're Hot You're Hot" by Jerry Reed

Breaking Up:
"Why Should the Fire Die?" by Nickel Creek

Prom:
"It Takes All Kinds" by Aimee Mann

Life’s OK:
"Trains" by Jill Sobule

Mental Breakdown:
"Gone" by Kelly Clarkson

Driving:
"Leave" by Barenaked Ladies

Flashback:
"Soldier, Soldier" by Natalie Merchant

Getting Back Together:
"The Hardest Button to Button" by The White Stripes

Wedding:
"Sad Songs and Waltzes" by Cake

Birth of Child:
"Driving Rain" by Paul McCartney

Final Battle:
"Sinking Feeling" by Roisin Murphy

Death Scene:
"Happiness" by The Weepies.

Funeral Song:
"Particle Man" by They Might Be Giants

This exercise taught me that there are a lot of songs on my computer that I haven't listened to for YEARS!

Brenna: A Map

I can't get to sleep tonight, so I'm playing with Google Image search.

I really wish I understood what this map was about. Cause it's crazy awesome. Like the cannon ball with antlers? I would totally have included that in a map of my psyche. Scary, man.

Another Enthralling Adventure

There are those who think I haven't been prolific enough of late.

To those, I say:

Well, honestly, I don't really have all that much to say. Other than: you probably wouldn't want to read about my life these days anyway!

Point in fact -- following is the story of the most exciting thing that happened to me today.

I am on my Emergency Department rotation now. This afternoon, I was scheduled for the Urgent Care clinic. Colds, rashes, yada, yada (not unexciting to me, but not worth much discussion.) The last patient of the day was like the textbook definition of The Patient You Don't Want To Pick Up Last In A Pediatrics Urgent Care Clinic. Seriuosly, picture the patient that you would like to see last in the day, and then picture a patient that is diametrically opposed to that.

(I always love the chance to use the word 'diametrically')

Anyway. That's not the Story of the Most Exciting Thing That Happened to Me Today. That's just the set up for why I didn't get out until 7:30, and why I was tired and distracted on the drive home.

Because today, for the first time ever, I spaced out and totally missed my exit. Actually, that's a lie. I didn't totally miss it - I un-spaced out about a quarter mile before I needed to exit, but I was in the wrong lane. I could have risked life and limb to make it, but my father's teaching came into my head at that moment. The driver's education I got from my dad, boiled down, consisted of "Don't be an idiot."

Or, translated into Oregon-speak: "Don't drive like a Californian."

And applied specifically to this occasion, meant "don't swerve across traffic to get your exit."

So, I got off at the next exit, turned around, and then got home.

Where I proceeded to sit on my butt and do zippo.

So there. The Most Exciting Thing That Happened to Me Today. It would have been better had the story culminated with me stopping a fleeing band of bank robbers while rescuing a bag of kittens that had fallen from the back of a very rich man's limo as he was on his way to reunite with his estranged grand-daughter, thus earning both a reward from the bank and the undying gratitude of the rich guy, who thanks me by paying for weekly pedicures for the rest of my life, and then writes me into his will.

But it didn't culminate that way.

It never does, darn it.

Which is why I have not been prolific. Of late.

Do you think Jane Austen would have kept a blog if the internet had existed in days of yore?

On Stockholm and Eighty Hour Weeks

In 1973 a group of people were taken hostage in Stockholm, Sweden. They were captive for six days, and at the end of it, they were actually defending their captors. This phenomenon - the victim identifying with their victimizer - has come to be known as "Stockholm Syndrome."

Today was my last day in the NICU... and it seems that for all intents and purposes, I may just as well have been holed up in a bank in Stockholm. Because, despite the torture and the long hours and the frustration - I had a hard time leaving! I never thought I'd feel that way. The NICU is a small microcosm of the world - and I have basically lived there for the past month. Or been held captive, depending on your point of view.

In all, I ended up working 299.5 hours these past four weeks - 89 of those hours within the last seven days. That averages out to almost 75 hours a week. Which means that I could have legally worked another 20.5 hours this past month.

And... I almost wish I had. I'm not referring to Stockholm Syndrome here, either (okay, maybe I am) - I just mean that I missed 20 hours worth of learning. I've always been in favor of the Eighty Hour Work Week for residents. I think it is dangerous to the welfare of others - patients, family members, spouses, pedestrians, grocery store cashiers, etc. for residents to work much more than that.

But, had I not worked 74 (point eight-seven-five) hours a week in the NICU, there is no way that I could be feeling any semblence of competence in managing NICU babies. Not that I'm an expert by any stretch of the imagination. (excuse me while I laugh uproariously at the thought!) I figure that my almost three hundred hours expanded my knowledge base by almost three hundred percent.

But since I started with a NICU knowledge base of about 0.01%, that means I know about, oh... 3% of neonatology.

So, anyway. In the end, after some stressful days, some restless nights, and several of rambly, rant-y blogs, the NICU actually ended up being a lot of fun. Though I haven't actually described any of the fun parts here...

Maybe that's part of the Stockholm Syndrome.

Whinge

In Britain, the word 'whine' has a G in it.

I don't know why.

But to add a sense of Occasion and Properness and Grandeur to this blog I'm about to commence writing, I'll say that I'm 'whinging.'

I'm tired. And though I had a fun clinic today, it was the sort of fun that involved attempting to keep a GIGANTIC toddler from ruining every piece of equipment in the room, getting a parent to focus on actually telling me a story in a comprehensive manner that didn't skip from one symptom to another, and topped off with two grade school twins determined to out-do their sib. Fun, yes. Exhausting, you bet your bottom. Dollar. Bet your bottom dollar. Hey! That phrase actually makes sense -- assuming you keep your money in some sort of semi-vertical stack say like in your pocket. Or pennies in a jar buried under your grandmother's porch. My wallet is organized more horizontally, though.

Anyway. Clinic. Fun. Exhausting.

And only a precursor to my Penultimate Call.

Hi, my name is Brenna, and I have an unhealthy obsession with the word "penultimate."

Call tonight. Busy. Crazy. Patients getting transferred from all over kingdom come and arriving ALL AT THE SAME TIME crazy. Nurses demanding (though nicely) admission orders post haste on the five patients that arrived within two hours of each other crazy. Not eating dinner until 11 pm crazy. Doing 10 pm rounds at 1 am crazy.

I'm exhausted. And I'm sick of the NICU babies. And... I want to go to sleep. And I don't want to have to get up and be HERE again tomorrow morning. And round. And then go home, fall asleep, and do it all over again the next day.

You know... I don't think adding a G to 'whine' makes it any less appealing to listen to. Or read.

I think I'll go to bed now.

(Oh, yes. And two-and-a-half points to the person who gets tonight's post's movie reference.)

Boffo!

I'm going to bring back the word "Boffo." (Was it ever really a word?) You know, as in "You passed the test? Boffo!" Or, "I was on call again last night, and it was totally boffo." Only one of those statements is true.

Don't worry, I didn't fail a test - that statement was just hypothetical.

But I was on call last night, and well, it was kinda boffo. Not I've-found-my-purpose-in-life-and-only-want-to-see-tiny-sick-babies-for-the-rest-of-my-life boffo. More like I-actually-had-half-or-even-three-quarters-of-a-clue-of-what-was-going-on boffo.

I have this tendency... If someone has a strong personality trait, I find myself doing the polar opposite. I'm around a talkative person, and I get quiet - I'm around a quiet person and I can't quit gabbing. My own little way of balancing out the universe, I guess.

Last week, the fellow on call with me was laid back, chill - cooooool, even. We're talking Fonzi cool. Unflappable. Which I didn't need to react oppositely to (is oppositely a word?) as I was already in semi-panic mode all day.

But last night was another story altogether. The fellow on was... well. Flappable. She wore a long yellow gown over her scrubs and just kind of flew around everywhere talking to herself. It was quite amazing. Very smart person, but very... hectic. And any time she'd talk to me, I think she started whatever she was going to say in her head (despite the consistent talking to herself out loud), thus only delivering 2/3 of the message to me. Her: "...so give 2 cc IV push now." Me: "Okay, but. Um. Of what? On who?"

Anyway, combining her strong personality trait, which we'll call "Flustered-ness" and my tendency to go anti-other-person's-trait, I was remarkably calm, cool and collected last night. Anti-flustered, if you will. Which is, overall, a much better way to manage a call night.

Boffo, man.

Never Fear, Grasshopper.

My second NICU call was worlds better. It helps to actually know the patients that you're supposed to be taking care of. And to know where the rooms are. And how to use the Vocera. And when you load up with jelly beans instead of dinner and you and the nurses order some of the best sushi ever made.

That didn't stop me from breaking out into hives (quite literally) when the Attending this morning said that he wanted to "talk to me" before I left.

Side note: I seem to have developed some sort of chronic neck hives as a response to stress. Or perhaps some strange rheumatologic disease that will henceforth be known as Brenna Bumps. They've been a-flaring up lately, let me tell you, though. Itch, itch, itch.

What did the attending say to me?? Well, today was his last day, so he wanted to give me feedback on my performance this past week. And... he said I'm doing great! HUGE sighs of relief that promptly deflated the hives and made all the babies all acidotic-like by increasing their CO2. Maybe not that big. But big.

One week down, three to go. Total hours this week? 82.5. Not counting the couple of hours of paperwork I've done at home. Oops.

Super Star

I think she likes having the run of the place while I'm gone on call.

What's The Worst That Could Happen?

In our lives, we are privileged to have a certain number of Memorable Days - days which will stand out in our memories for the rest of our lives. (Or until we get all old and senile) And if you're lucky enough to be a resident working on call, you have the unique opportunity of having one of those Memorable Days co-incide with a Call Day, meaning it will last for a full thirty hours. Unfortunately, some of these Memorable Days stand out for the sheer horrible-ness-osity of them.

I had my first NICU call on Tuesday.

Here is some background on the NICU set-up: The team consists of three residents - one first year (me!), a second year and a third year. There is also a NICU fellow and the attending. For some reasons the rooms aren't numbered - they're labeled with names. Animal names, to be exact. So we have the Bunny, Bear, Deer, Elephant, Lion, Koala, Giraffe and Zebra rooms. The area is actually quite huge, so we wear walkie-talkie thingies (called Vocera).

Not surprisingly, I don't know all that much about taking care of babies in general - not to mention premature babies that weigh 860 grams (for comparison's sake - a loaf of bread weighs 680 grams). So I was happy to know that all those people would be there to teach me, and guide me and basically save my butt.

Except... On Monday, my 'orientation' consisted of "Here's the Vocera. Rounds start at nine." That was pretty much it. I knew a little about the four patients I was picking up from the last intern. I knew that there were a bunch of calculations I was supposed to do - not what or how, though. I winged my way through on Monday, but amid a crisis (not related to my patients) and other hullaballoo, I really didn't get any more instruction. And then I had to leave for clinic.

So, Tuesday morning felt as new to me as Monday did. And the third year had the day off, so we had to cross-cover her patients. Meaning, I had to round on eleven babies - still not really knowing the babies or the calculations or even what room was what.

The second year resident was post call, so we rounded on her patients first so she could get out by noon. Which left me to round with the attending and fellow by myself.

I think I mentioned that the attending on service is the Head of Pediatrics? Did I mention that he's from the East Coast? And, quite stereotypically, is very smart, very picky, and very not afraid to reprimand dumb interns during their presentations. And, unfortunately, he very much didn't know that it was only my second day.

It just went on and on. Me presenting, him yelling at me, me presenting while trying to not burst into tears. And, then? In the middle of all of it? My period started. Early. So I wasn't prepared. So. Add to the yelling, and fighting back tears, the worry that I was going to bleed through my scrubs and be on display to all the nurses and parents of these tiny babies. (Thankfully, I didn't bleed through - until Wednesday morning, that is.)

Rounds didn't end until 12:55, and we had a discharge planning meeting at 1:00. So, I did get lunch! And then I got to go over the disposition of all 30+ babies on the service with the social workers. Did I mention that it was my second day? I DON'T KNOW WHEN THE BABIES ARE LEAVING. Thankfully, the (very nice) fellow helped me with that.

After the meeting, I started working on a new admission. The fellow was supposed to help me, but... he disappeared. He left with a ground transport team to go pick up a sick baby at a different hospital.

Wait.

He left.

My back-up.

The person who knew the patients.

And how to manage NICU babies.

Left me alone.

The attending was still there. But... He scares me!

They did call in another fellow to help out. But she was ABSOLUTELY USELESS. She read articles. And she didn't put on her walkie-talkie. So everyone called me with the issues. Baby isn't peeing. Baby has a distended stomach. Baby's temperature is down. Baby's glucose is 35. Baby's CO2 is up to 75...

These are things that a week from now, I will know how to handle. But not on my first real day.

It was so awful.

I wasn't so successful at holding back the tears for a few hours there. I didn't know it was possible to be on the verge of tears for hours on end - and still run around writing orders and filling out paperwork. But it is.

The night fellow came in around five - so I was really only alone for three hours, but man it felt like longer.

The night fellow was a great person - very smart and on top of things and relaxed. But I am used to working with other residents - working as a team, checking in a lot with the other person. It's not quite the same with a fellow.

I did get to put in an umbilical vein catheter, which was cool. (And so easy!) But most of the night, I felt totally lost and stressed.

I finally crashed around 2 am. I couldn't stay awake any longer. I actually ended up getting over two hours of sleep. By Wednesday morning, I felt much better. Except for the diarrhea. But I won't go there.

I was doing okay getting vitals and numbers on Wednesay, feeling much more in control (it was, after all, my third day!). But then, six am came and went, and the third year resident didn't (the second year had the day off). About 6:15, I started to get worried. Around 6:20, I started panicking. What would I do if the only other resident didn't come? I paged her. No answer. I was about to call the chief resident, when the third year finally arrived. I almost burst into tears again, but this time out of relief.

Writing it all out here, it doesn't sound as bad as it all felt! I think it was all made worse by the fact that I barely got to sit down. Through the whole 30 hours, all I got to drink was one bottle of water, a Diet Pepsi and a cup of coffee. That's about ten times as much liquid as I give my baby that weighs less than two pounds. I don't weigh ten times that baby.

The whole day I felt lost and confused and just plain stupid. And there was no one there for me to complain to!

You know - it probably could have been worse. The patients were relatively stable, no one died, I did get sleep - and I even got out at noon on my post-call day. Plus, I'm off today! I just hope that I never again have a work day as bad as that! I get to do it all again on Saturday, so wish me luck.

"That Was Fun!"

Eventually, I'll get around to writing about this past week (which included, for one, my ten year high school reunion!)

But first -

I started the NICU today. I won't even begin to talk about how utterly clueless I am. They're so small, you wouldn't think they'd be all that scary. But they are. Terrifying. Especially when the Peds Department Chair is the attending, and both chiefs and the program director decide to join you on rounds on your first morning when you don't know the patients or how to calculate all the crazy calculations or how to even touch an 800 gram baby without feeling like you're going to break them into ten million pieces.

But. Anyway. I had clinic this afternoon. Two of my patients were siblings, just in for their regular check-ups. I did my normal schpiel with them, and as I walked out, the older sibling said to the mother, "That was fun!"

Fun! The kid had fun! At the doctor's office! And I was the doctor!

It's nice to know that I'm not completely hopeless.

In other news. I'm on call tomorrow night. In the NICU. Alone. Me. The doctor. Taking care of thirty babies who are very, very sick. And being the doc to go to deliveries where they expect the baby to do poorly. Ha. Haha. HAHAHAHA.

Okay, so... There is a fellow on, which is SO SO SO nice to know. But not all the fellows are terribly helpful. I hope they're nice to me.

The Great Equalizer

I got to go back to the DMV today. As you may remember, I went a while ago to get my driver's license. I was on top of that because my Oregon license expired on my birthday in June. The registration part, I've been putting off - mostly because, well... I've been working. Officially, though, you have ten days - ten - to register your vehicle in California when you move here. Most states give you thirty days.

Regardless, I've exceeded that time period. And, me being me, I was honest about it. Darn you scruples!!

Anyway. Let me tell you about the registration process in the lovely state of California. Aren't you just filled with excitement?!

First, you need a car. Haha! Duh.

Then, you need to take the car to get emissions tested. Your options are: a test only site, a test and repair site, or a something-something certified site. You might think that a certified site seems appropriate. Wrong. Then, a test and repair site obviously seems like the right choice. Also wrong. You need a "Test Only" smog testing site. Duh. It costs $50 for the test, and another $10 for the certificate saying you got the test. (Why not just charge $60?? Like anyone is going to get tested just for the heck of it.)

Then, the DMV needs to verify your VIN. This part, thankfully, is free. Plus you get to watch someone fail a motorcycle driver's test and give props to a 16-year-old who just passed her behind-the-wheel test.

Then comes the Great Equalizer: the DMV waiting area. What a fantastic cross-section of Culture. Everyone has to go to the DMV at some point. Unless you're so rich that you never even bother getting a license, I guess, counting on a chauffeur to take you everywhere. I wonder, too, if Tom Cruise or Paris Hilton, etc. have to _wait_ at the DMV. Maybe there's a special "Stars Only DMV."

But I digress. Thoughts do tend to wander far and non in the DMV waiting area, though.

So, when your number is finally called, you go to the window with: the registration form, VIN verification, Smog certificate, old registration, vehicle title, driver's license and proof of registration.

I had it all! I was SO set. I even remembered my checkbook, since the California DMV only takes cash or check. (Actually, they do take debit cards now, but that is a fairly new development)

But, guess what? IT WASN'T ENOUGH. Apparently, Mother California considers pick-up trucks - ALL pick-up trucks - to be 'commercial' vehicles. Never mind that they may be driven by a girly pediatrics resident. Nope. Commercial. Meaning: I need to go to a TRUCK STOP to have my Commercial vehicle WEIGHED.

They did let me pay the $212 to register, though (including the $23 late registration penalty.)

Now I get to go get my truck weighed - who knows how much that costs. Then I get to GO BACK, wait some more, to pay for license plates and tags. Another $50-70.

Goodness.

I'm going to need to start using my truck commercially to pay for all of this!

The best part of all of this? I'm leaving town tomorrow (for my ten year high school reunion!!!!!), so I'll have to take care of the truck stop issue when I get back. While I'm in the NICU. Which is the rotation notorious for consistently exceeding the 80 hour work week regulations.

Sigh. What can you do?

Did you read this whole post? Crazy person. It's about the DMV. Let me get your opinion, then... Personalized plates or no? I can get the "Kids" plate with either a heart, star, handprint or plus sign. What would it say, though?

Gimme a Shot!

Once upon a time, I caught a little bug, which I dubbed the "Reality Television Virus" - RTVV. The main symptoms are watching - and enjoying - reality TV. Associated symptoms include getting 'attached' to the contestants, talking about the shows with other people, recording the shows and possibly re-watching them, and actually wanting to either audition for a show or to attend a post-show performance tour. Differential diagnosis includes General Television Addiction, Thinking You're Better Than Those TV Freaks and Frank Insanity. Treatment at this point is mostly supportive.

Shows that have supported my Illness (this is probably not an all-inclusive list):
Survivor
Big Brother
American Idol
Amazing Race
So You Think You Can Dance
How To Get the Guy
America's Next Top Model
Project Runway
Made
My Super Sweet 16

And now, there is a new addition to my list. Possibly the most egregious sign of RTVV's hold on me yet. Are you ready for it?? It is called Who Want's To Be A Superhero? And it, my friends, is awe-some. Inspiring of awe. It is on the Sci-Fi channel. The concept is that Stan Lee, of comic book fame (I hadn't heard of him either, but he's apparently super-famous) - has gathered together 12 superhero wannabes - including Monkey Woman, Fat Mama, Cell Phone Girl, Feedback, Major Victory, The Iron Enforcer and more! - and puts them through challenges to see who possesses the most super-hero qualities. It is so fantastically staged that I can't even begin to express the wonderful-ness of it. One of the characters is actually a spy; one gets recruited to be a super-villain - and that's just the beginning. It's reality TV at its best - some people obviously placed by the producers to fill a certain role, others in it just for the fame that being on TV will bring them with no actual passion for comic books, and a couple gung-ho-Stan-Lee-loving-actually-thing-they're-superhero people. It's the kind of group that makes you feel good about yourself as a person. And after all, isn't that the point of Reality TV - to make you, as the viewer, feel superior?

Except for a few people on a few shows - specifically this season of So You Think You Can Dance. I cannot express how in love I am with all of the finalists. They are just Good People as far as I can tell. Takes away from the Superiority Complex aspect of the show, but definitely adds in spades to the Tugging On The Heartstrings aspect.

Hmm. Methinks I should do a whole breakdown of the Reality TV Virus and It's Appeal.

Despite my love of the shows, I realize that the RTVV is Not Healthy. I'm on vacation from work right now, and I think I should use some of this time to develop an anti-RTVV vaccine. I just read an article about a new anti-Rotavirus vaccine (rotavirus causes nasty diarrhea in kids). I think it can give me some clues as to where to get started with the anti-RTVV. Specifically this sentence:

"The parent bovine rotavirus strain Wistar Calf 3 (WC3) was isolated from a calf with diarrhea in Chester County, Pennsylvania, in 1981 and was passaged 12 times in African green monkey kidney cells (79)."

Hmm. Okay, maybe not. Hopefully RTVV is a self-limited illness that will eventually run its course. In the meantime, I'll just continue to watch.

Clarification:

When I write orders for patients on the floor, a lot of times... well... I mess up - get a dose wrong or forget to specify that the patient with a G-tube should get their G-tube feeds in the G-tube. When I do that, I have to come back and write a 'clarification' order.

Today, I'm clarifying my blog! Though I don't think I've given any orders here. Until now: Send Me All Your Money!!!

Okay, back to topic. So. I just got a comment about my previous tirade about the new Chrysler ads. Turns out that Dr. Z is totally real! He is the bona fide CEO of Daimler Chrysler. I feel a bit bad about slamming an accent that is, in fact, a real one. Oops!

Knowing that, I guess I now _get_ the ads, in the fact that Dr. Z is making fun of himself. I still think the ads are a bit too 'inside joke' for me, though. Or that Dr. Z comes off as too much of a caricature to be believed as the CEO.

And the commercials still bug me.

Thanks for the info, though, "Interested Observer!" Gotta be someone out there keeping me honest.

Otherwise patients may start getting their G-tube feeds in their IV or something.

What Do These People Have In Common?

Annette Bening
Mira Nair
Kim Basinger
Kate Hudson
Jon Bon Jovi
Michelle Rodriguez
Hugh Jackman
Jessica Alba
Danii Minogue
Joan Collins

Any guesses?

Nope. No, again. You're totally wrong.

So what is it? According to MyHeritage's face recognition software these celebrities share certain facial characteristics with yours truly! Meaning... they look like me! What an honor for them. Especially Hugh Jackman.

Who do you look like???

(hint - someone I know looks like Meryl Streep and Naomi Watts... and Elton John.)

Pay Day!!!

They pay me for this!! Seriously!

We finally got our first paychecks today. Which means that I can finally pay for the things I've been buying.

And now that I actually know how much I actually get to take home from my salary, I can actually set up a budget. And I discovered that I can actually afford to go to a movie - or even buy a whole can of soup! - withouth experiencing paroxysms of guilt or breaking out in hives. (Shopping hasn't been too pretty these past few weeks)

Ooh, except that I didn't figure in gasoline yet. Scratch that whole can of soup thing.

Today, at work (for which I get paid), I went to the audiology clinic - that's where they test hearing in kids. They've got these scary automaton bears that bang drums and blow whistles. Kind of like hairy, incredibly scary Small World characters. That's supposed to be the 'reward' when kids look in the right direction when they hear a sound.

Hmmm.

And to once more completely change the topic:

Back in about... junior high I decided that I was so far from being cool that I'd just embrace my dorkiness and go with it. For a few years, I was so far from cool that I purposely went anti-cool -- I wouldn't carry the Espirit bag that everyone else had in sixth grade, I didn't like the guy that everyone liked in seventh grade, and well... I never really had a 'fashion sense.' It was an attitude that served me well.

As a matter of fact, it is an attitude that I still heartily embrace. Minus the purposeful anti-cool part. If I happen to stumble into a 'cool' outfit, I'll continue to wear it now.

But it was this attitude of embracing my inner dork taht led me to spending the weekend attending "Lambtown" (a small-town California celebration of... lambs) and going to see a live stage version of "Seven Brides for Seven Brothers."

What I love is that, where ever I go, I manage to find other people who are totally in tune with their own inner dorks.

And now? I'm a paid dork.

Yes, I Watch Too Much TV

A non-medical post today. Really just some rants about commercials...

First: Chrysler. This Dr. Z character? No. Bad. Bad bad bad. The commercials drive me crazy, and they're always on. I hate hate hate them. If I had been thinking of buying a new car, it would be anything but a Chrysler at this point. Dress a young guy in a bad wig/mustache and make him talk in a bad fake German accent? Who pitched that idea? And who said 'that sounds perfect!' I'd really really hate to see the ideas that they didn't use.

Second: Head-On. Apply directly to the forehead. Head-On. Apply directly to the forehead. Head-On. Apply directly to the forehead. What the??? Does it provide omniscience? Or at least mild ESP? Cause if so, I'll totally buy it.

Hi, Coconut!

Today is the ninth day in a row of 100+ degree weather. But at least the humidity came down to 20%.

You know that whole - 'sure, it's hot, but at least it is a dry heat', thing? Apparently Sacramento is what they're comparing it to. 'At least we're not in Sacramento.' Where there has been about seven hours a day of temperatures less than 90. And those are the hours when I actually let myself turn on the AC. Because I'm trying to conserve energy. Because they're threatening rolling blackouts.

For those of you unfamiliar with The California Energy Crisis: California has Too Many People and Not Enough Power. For the past several years, they've (I guess now it's "we've," since I live here) had to buy extra power from surrounding states - and Canada. Except when those states (and Canada) need power for their own people, Cali is SOL. So they just kind of have to dole out power to different areas at different times. Rolling blackouts.

I've lived in Minnesota, Oregon, Alaska and North Carolina. One thing I've learned about myself: I hate hot weather. Cold weather? Bring it on, baby. Some day, I'll retire to Siberia. Fur muffs and parkas and hot chocolate by the fire... So much better than rolling blackouts.

Anyhow. I'll stop whining now.

Okay. Here I go again -

I started my Behavior and Development rotation today. Except that it should be called... umm... well, something clever that means "really boring and sleep-inducing." This morning we listened in on conference calls with social workers, psychologists and pediatricians deciding whether certain patients still qualified for services for kids with developmental delay. Then, in the afternoon, I sat in a dark room watching through a two-way mirror while a doctor administered a couple of developmental surveys to a four-year-old.

A four-year-old, who incidentally could not identify a picture of an umbrella because he had never seen one before. (It all comes back to the weather!)

During the testing, the kid said "I cooking it!" referring to a glove in a plastic pot. But it did sound for all the world like he said, "Hi Coconut!"

That was the highlight of the day.

Okay. NOW I'm done complaining.

How Many Pediatricians Does It Take To Change A Tire?

Four.

Man, I knew it had been a while since I posted, but I didn't realize quite how long!

Anyway - Friday was my last day on the wards! Which means that this weekend has been a real live "Golden Weekend." A rare delicacy in the medical world, a "Golden Weekend" consists of two whole days off in a row. Normal people call it a "Weekend." But, actually, since I have two weeks of Behavior and Development, followed by two weeks of vacation, I actually have five Goldens in a row!!!

In total, I worked 4 weeks on the ward - 24 days on - about 280 hours total.

How does one celebrate the end of a rotation? By going to an eighties cover band, of course! I went out on Friday night with some fellow residents - a few interns, some third years, a chief and a recent graduate, to be exact. I don't know where the second years were... Anyway, it was really HOT, but much fun. I actually even managed to stay up many hours past my bedtime.

We'd gathered at one intern's house, since she lived walking distance from the club. When we left the club - at around one am, mind you - it was still mid-80s outside. Ridiculous! SO FREAKING HOT. When we got back to our cars, it turned out another intern had sustained a flat tire. Thus the four pediatricians changing a tire. At 1 am. In 80+ degree weather.

So, after a month of residency, do I really condsider myself a doctor? I've met many patients - I've even had two afternoons of clinic where I'm the patients' doctor. As in, "Who is your doctor, random person?" Random person replies, "My doctor is Brenna."

Ah, yes. The name thing. I have yet to actually introduce myself as Dr. Last Name. I will say, "Hi, I'm Brenna Last Name, one of the residents here. I'll be taking care of you when you're in the hospital." Notice that the word 'doctor' never escapes my lips.

And when the nurses call me doctor? Well, first, I don't hear them. They'll call me several times before it enters my skull that they're talking to me (usually to remind me to sign an order!). Then I aske them to call me Brenna. Because, really? That's my name. Though I guess I do need to get in the habit of telling my patients that I am, in fact, a doctor. To instill some sort of confidence or something.

But when I'm out in public? I have a new answer to 'What do you do?' The new answer? I work with children.

A Fresh Perspective

Last week, I had yet another Big Event in my Life as a Resident: the arrival of the medical student!

They came Wednesday morning - So young. So fresh. So... clueless. There are four residents and there were four med students starting, so we each have our own shadow to kind of follow us around. Unintentionally, I'm sure, the students kind of got paired up with residents of similar dispositions. "My" student happens to be a fourth year making up his third year rotation in peds. Which is nice, because it means that I don't have to follow him as much (or rather, he doesn't need to cling to my coat-tails all day).

That first day, I had NO idea what to do with him! I still barely know what I'm doing myself!

Amazingly, however (as I've noticed in the past), if you give me someone to 'teach,' I get a lot more confident in my own opinions and actions. Maybe I'm showing off... But all of a sudden, I'm writing orders, and making decisions and discussing plans with everyone without any (or as much) guidance. I'm also teaching things that I didn't even know I knew. And giving tips on how to give better presentations. Or what questions to ask to get a good birth history. It is SO SO SO weird to be the person in the long coat now.

When I was a third year, I thought interns were so amazing. And now... that's me!

I might have mentioned this before, but some of the best advice I received in medical school seems quite relevant right now. What is that advice, you ask? Well, I'll tell you. It is this: Never compare yourself with people that are ahead of you in their training. If you must compare, look backwards to were you were. Having a med student really shows me that I don't suck.

Something else that is different as a resident: my motivation. As a student, I would see patients, and I'd care about them, but there was still usually a level of dis-connect there. Something upsetting would happen, and I'd care, but I'd also care a lot about whether the patient's problem would keep me from getting home early or not. I worried about it sometimes - could I be a good doctor if I wasn't subverting my own self interests? If I cared more about my hair cut appointment than a patient's MRI results?

Now that I'm the doctor, though, it is totally different. I don't know what made the difference... I guess as a med student I always felt kind of useless. But now... I have to be reminded to eat... I look up patient labs at home. I wake up thinking about whether or not I can get a patient into inpatient rehab that day.

This afternoon, I was scheduled to take the in-service exam (a four hour test we take each year, so they can make sure we're getting smarter). I spent the morning hastily getting things together (I'm a lot busier this week than I had been), and re-admitting a patient. I checked things out to the people that were staying. But when I finished the test early? I didn't even think about going home. I went back up to the floor to make sure my patients were getting taken care of.

You could say it was because I'm a control freak. You'd probably be right. But I think it is also because I finally care about the people. Which makes things a lot more stressful. But so much more rewarding.

Have I mentioned that I love my job? And that is after putting in 38 hours already this week.

Independence Day!

This morning, I went in as always, and I pre-rounded, and we rounded, and then - then - my upper level said to me, "Do you think you can be ready for check-out at noon?"

And I said, "......Noon?"

And she said, "Well, yes. It is a holiday, so the people who aren't on call can check out when they're done."

At which point, I did a little jig. In my head, though. Gotta keep up appearances and all, you know. The long white coat buys you some respect, but people are still watching. Judging. And doctors don't dance.

Well, except for me, maybe. (Just not with any grace or rhythm)

So today felt like a total vacation day for me. A vacation day where I worked six hours...

And what did I do with my vacation you may be asking yourself? Because I know you are all so terribly fascinated by my every waking moment.

First, I went out to lunch with a fellow intern. A nice, relaxed lunch. Outside of the hospital.

Then I cam home and read a fun book and cleaned a little.

Then I studied.

Yes. Studied.

Darn PALS class on Thursday. THANK goodness for today, though. I don't know if I'd have had the time/patience/awakeness to even make a dent otherwise.

Tomorrow is another exciting Milestone day for me and my doctor-hood: we get medical students! Never mind the fact that, in terms of actual working days, it was only, ummmm.... 10 days ago that I was a student myself. Now, I hold young, impressionable students' minds in my hands. Mwahahahahaha!

I shall impart unto them the wisdom of the ages. Most importantly: when your upper level says to go home or to, say, check out at noon: you GO.

Relish the independence.

Day Off!

It's my first day off as a doctor! I was on call Friday night - overnight call. I know that I spent a whole post describing the night team that comes in to cover the nights, but it turns out that the day team still has to cover the weekend nights - Friday and Saturday.

I got home post-call yesterday around 11 am. Not too bad. In all, I worked about 87 hours this week. If you know much about residency work hours, you'll know that we're restricted to 80 hour work weeks. BUT. It turns out that the 80 hours is averaged over 4 weeks. And, in fact, I'm only on the schedule to work about 57 hours this week. Fifty seven! Awesome. What has life come to when 57 hours sounds like part-time work? Hmm.

My night on call went much like most of my call nights as a med student. The whitest of white clouds possible reigns over my work-load. Even on Friday, when I was on with an upper level that is apparently notorious for Friday night black clouds, we got NO admissions overnight. And the sick kids? Not a peep from them. I got like three pages all night. And one of them was for a kid that wasn't on our service...

A white cloud may sound like a good thing, but I find it quite frustrating. I need to prove - to myself and others (mostly myself) - that I can handle the workload. And I want patients! How am I supposed to learn without them?! I'm hoping that my white cloud will start to absorb some of the smogginess of California and become slightly gray-tinged. I'm not wishing for a black cloud. More like a heather to slate gray.

On my post call day, I was so happy to be home with no 'bed time' that I decided to try to stay up. Yeah. I crashed around 4. I did set my alarm to wake me up at 6. Didn't hear it at all. I finally woke up when Ari called around 8 pm. If Ari hadn't called, I think I would have slept all night (thanks Ari!). As it was, I woke up, ate some dinner, and fell asleep on the couch at 10.

I keep looking at the clock today. I feel like I'm supposed to be at work! I am struggling to keep myself from signing on to the electronic medical record to check on some kids' vitals. Being on the wards is quite a pervasive experience - it takes over every thought. And it has only been a week!

As it is, I don't really get to completely enjoy my day off. I am scheduled to take Pediatric Advanced Life Support (PALS) on Thursday. That's the class where we get taught to save children's lives for real. S.C.A.R.Y. So, I must study today. This is not a med school, "I'll-learn-it-later" type thing. This is me, a doctor, learning how to save lives in emergency situations. I need to know it. Ack!

I am meeting some fellow interns for a movie later, though. So it isn't all work and no play. Just Mostly work. For the next three years anyway. Or 1093 days. However you want to look at it...

Some Thoughts

Throughout medical school, we've always been warned to treat nurses well - 'nurses can make you or break you' - the saying generally goes. As I got closer to actually approaching residency, though, I heard some addendums to that saying. Most often, the addition of "some." As in "some" nurses really know what should be done. You should listen to "some" nurses. How to tell the "some" from the rest? "You'll know," they said ('they' being the amorphous symbol of a generic resident)

As a student, I never really knew which nurses were among the "some." Today, though, I realized that it didn't take me long to identify them. Mostly because I met an anti-"some" today. She really wasn't that bad. She was just driving me crazy. Mostly because, even though I called back right away when she paged me, she never answered the phone (someone would have to find her), and everything she said started with "I'm sorry, but..." It's my job to answer the pages, and my job to deal with annoying little patient issues. I believe that an intern is truly at the bottom of the totem/feeding pool in a hospital. Even med students - powerless as they may be - have the whole med school backing them up and, you know, giving them 'days off' and junk.

Anyway. The nurse wasn't really bugging me that much. She was just freaking out about very small issues.

The nurses at my hospital practice what is called 'primary nursing.' Well, maybe not exactly that. But that's kind of what it is. When a patient comes in to the hospital, a nurse on each shift takes them on as their patient, and if the patient ever gets re-admitted, they'll be the nurse again. Which is totally handy in a teaching hospital, where the doctors rotate on a regular basis. And totally handy when a chronically ill kid comes in - the nurse knows all about the patient's baseline and home meds. It is very helpful!

How boring my blog posts have become. But, I just ran some stats. Maybe this will explain... In the past five days, I have spent about:
48% of my time at work
4% of my time driving to/from work
6% of my time getting ready for work
2% of my time reading stuff for work
3% of my time talking/writing about work
22% of my time sleeping.

Leaving my 15% of my time free. Most of which I spend thinking about work.

Day Three and Counting

I've now officially worked for three days as a 'doctor.' I'm getting better. And worse. I feel more confident, and completely out of my league. I guess these are all good things...!

In the past three days, I've logged about 33 hours of work. Which really isn't saying that much - 12 hour shifts are common these days, especially in medicine. What is impressive, is that the week isn't even half over for me! I'm 'scheduled' to work 52 more hours before Sunday. I have Sunday off. Thank. Goodness.

A little about how our ward service works:
- There are two teams, each with one attending physician, one upper level resident (a second or third year) and two interns.
- There is also a Night Float team - one upper level and one intern.
- The physician work room is called the 'doc box.' I don't know why. Except, you know, we're doctors... and the room is kind of box-shaped. But most rooms are, aren't they?
- Every day one intern and one upper level are on 'late call.' Every one else is on 'short call.'
- At 4, the short call people 'check out' to the long call team. That means we tell them a bit about our patients and let them know if there are any active issues (like... if the patient gets a fever, give Tylenol, or order blood cultures, or what have you). The short call people are supposed to leave by 5.
- At 6:30 pm, the Night Float team comes on.
- When the Night team arrives, the late call people check out the whole service (all of the patients from both teams) to them. The late call people are supposed to leave by 8.
- The Night Float team stays through morning report the next morning - they leave between 8 and 9 am.

I was on late call last night - I got home around 8:30. I ate a small dinner, watched some Little House on the Prairie , read a little, then went to sleep at 9:45. I think I stayed up too late though! I was having a hard time with little things today - like writing my name. And walking...

There was a study done on medical interns not too long ago (I heard about it, I don't have the reference). They put EEG monitors on interns as they went about their daily activities. The results showed that the interns were walking around asleep. Literally.

I've only had three days!! I'm still running on adrenaline, so I'm good. But ask me again after three weeks.

I apologize for rambling. Be glad you don't have to read my patient notes!!

I'm No Superman

A journey into Brenna's head, first day of residency (a la JD in Scrubs, minus the theme music and the ability to wrap up a storyline in less than 30 minutes. And any actual coherence)

4:45 am - Alarm goes off. Oh no. I'm not ready. Today? Really? I'm supposed to start? What would happen if I just... didn't show up...?

5:00 am - Shower. At least I'll be a clean doctor.

5:30 am - Getting ready to go. Stethescope! Doctors carry stethescopes! If I have a stethescope, no one will notice my glaring lack of doctoring ability. Where's my stethescope?!

5:50 am - Lost. Where the hell is the employee parking lot?

6:00 am - Wandering the bowels of the hospital. Davis Tower. Davis Tower. Where is Davis Tower?

6:05 am - "Doc Box" for checkout. Shoot. Wake up, wake up, wake up. You're actually supposed to pay attention to this now that you're a doctor. Listen! Stop talking to yourself!

6:15 am - Getting vitals from computer. I don't know where the weight is! Or what meds were given! What patient is this? Where am I? Why did I choose to do this? I don't want to be a doctor! I'll be a... teacher. Or a lifeguard. Or a morning radio show personality. I don't want to do this. I don't like this. That one girl quit in her first month of residency. Maybe she was smart.

6:15 - 8:00 am - More vitals, and pre-rounding. Yes, that's it. I'll quit. So what about loans. I'll pay them back eventually. No, wait. I like seeing the patients. No. I hate this. But some parts I like. Except for the things I don't. Do I hate it more than I like it? Yes. Yes, I do. I hate it. I could be a firefighter. They save people. Without stethescopes.

8:00 - 10:00 am - Rounds in the "Doc Box." Listen, listen. Maybe I could do the residency thing, and then quit. That way, I wouldn't be, you know, all embarassed about the quitting thing. I could move to Poland or something. And open a flower shop. Oh, shoot. Present patient now. Try to sound like you're not a third year med student on their first day. I'm smart, I'm confident, I have a stethescope. And a pen!

10:00 - 12:00 - Wandering around the floor, writing orders, seeing patients. Okay. Not so bad. I like talking to families. I like defusing potentially volatile situations. But I can still quit. If I want to.

12:00 - 12:30 - Lunch. How are the other interns doing? Am I worse than them? How much worse? I don't want to be worse. I want to be better. Or at least the same. The same. I like the same.

12:30 - 2:00 - More working on things on the floor. I am wandering around in circles. But at least I know when I'm in the wrong place now. I know how to write orders. That one guy actually called me doctor - and I don't think he even saw the stethescope. I discharged two patients. Go me! They actually left the hospital. I did that! I said they should go, and they did! I said, "Take Aspirin!" and they're going to! I write an order, and I don't need a co-signer. The power! I'm getting tired.

2:00 pm - Getting coffee. Wait a second... I LOVE this! Why would I quit?! It's great! Ha! So take that 'firefighter.'

2:05 - 2:35 - Closed in private room dictating a discharge summary. Hahahahaha! I have NO idea what I'm doing! But I like it! The transcriptionist is going to think I'm crazy. This is probably the worst discharge summary EVER. How wonderful!

2:35 - 4:00 - Accepting PICU transfer. I have a plan for the patient! I'm formulating clinical decisions. Granted, they're nothing earth-shattering, but it is my patient, and I'm formulating a clinical plan, and I'm right, and we're going to follow it!

4:00 - 5:00 pm - Check out in the "Doc Box." I'm listening! I care! I'm not forcing it! I sound like I know what I'm talking about!


So... the first day was extremely emotional (for my inner mind), but not very busy (for my body). I thanked my lucky stars that we started on a Sunday. Things are sure to be busier tomorrow. I know that I will have some bad experiences this month, and this year (and this life), but I'm glad that my first day as a "Doctor" was overall benign. And I'm so not going to quit.

Curriculum Vitae and Some Stats

Today was my first day! Not really a first day day - it was first orientation day.

I am familiar with "First Work-Day" jitters, a subset of the larger heading of "Meeting New People" jitters. I was thinking this morning of all of the times I've started a new job. It has been a lot! I think this is a comprehensive list:

Olan Mills Telemarketer
Mailboxes, Etc.
Mervyns Associate
Cafeteria Worker
Intel pseudo-technician
Chem Lab Assistant
Assisted Living Assistant
Front Desk Receptionist/Supervisor
Arts & Crafts Summer School Teacher
Doctor's Office receptionist
Michael's Craft Store Associate
AmeriCorps Volunteer
Fruit Stand fruit-seller
Kaplan MCAT/LSAT teacher

Plus the jitters of many volunteer jobs, and, of course: new schools.

So. Jitters. Nothing new. But this morning, I realized that this is the first time that I am starting a job that is actually what I want to do!! This is huge! That feeling actually overwhelmed the jitters. But only for a little while.

There are twelve people in my intern class, including me. Two went to med school in New York (but are from California), one went to school in Denver (but was born in California), two went to UC Davis for med school, 6 went to other California schools (see a pattern here??). Only one other person is not from California - she is from Seattle.

Continuing with some stats:

2 guys, 10 girls
4 married
4 dating
4 single
1 with kids
None with dogs
1 with cat (me!)

Everyone seems very nice. But it is so hard to tell on the first day! We sat around having people talk to us, had a tour, a scavenger hunt, and tonight had a barbecue with all the peds residents.

It is hard to not look at everyone trying to figure out who will be my friends, and who will drive me crazy. No one stands out in either direction yet. But I'm sure there will be some of both!

Tomorrow looks like an extremely boring day of HR orientation stuff, but then on Wednesday, we get to go for a hike!

Wednesday is also the first day of summer.

And the first day they're predicting 100 degree weather.

With Family Like This...

...Who needs enemies...?

On Thursday afternoon, I realized that I was really, really bored. And I started worrying about Orientation, which is (finally!) starting on Monday. And then I worried more. And more. And I knew that way lay in front of me was a weekend of worrying. And boredom. Those two feelings are two of the top ones that cause me to do something that I really shouldn't do: shop.

I decided that a better use of my time and money would be to go home for the weekend! I was going to drive - I am an expert at long road trips now, after all - but 20-some hours of driving in one weekend seemed a tad excessive. Miraculously, I discovered that I still had miles on Alaska Airlines (from my year in Alaska - four years ago!), so I was able to get a half-price ticket! Thus, Friday morning found me in Portland - surprising both of my parents.

I do love surprises - an added benefit of going home last-minute. I also got to save a few bucks on shipping for my Father's Day present! Plus, who wouldn't want to spend time with people like this?!?:







My parents recently acquired a portable fire-pit thingy, so last night, we celebrated Father's Day by whipping up some S'mores and singing songs around the campfire. Okay, that's a lie. We didn't sing. We did tell some bad jokes, though.

Take Today, Subtract Ten Years

And you have me, graduating from high school...

Ten years ago today.

Man, I'm old.

4 + 4 + 4 + 4 + 4 + 4 + 4 =

Me!

Yes, I just turned 28. Which is funny, because I think I totally skipped 27. For the last 6 months or so, I've been thinking that I was 28. I guess that means this will be a big year! Or that this is the age that I'll think I am for the next few years - like 22. I thought I was 22 for about four years.

Thank goodness I didn't stay 13 for a lot of years (viewer discretion advised):


I went to San Francisco for the big occasion. I took the train there - Amtrak! I like the train. It adds a whole sense of romance to everything. Especially when you carry a carpet bag and wear your hair in pin curls with a cute hat and pencil skirt. I didn't, but it would have added to the whole experience. That and steam. There should have been some steam.

San Francisco itself was cool - quite literally. It was nice to get away from the heat of the "Valley." I apparently live in a valley now. A hot valley.

I love that I'm so close to San Francisco. I forget how much I enjoy visiting big cities - especially when I can hang with friends that have a familiarity with the city.

My 'vacation' time is winding down. Thank goodness! I am terribly entertaining, but I think Natty Gann is getting sick of me talking to myself. Orientation starts on Monday, and then next Sunday (the 25th), I start off on the inpatient service. Exciting!

Did I say exciting? I totally meant terrifying.

License to Drive

Since I graduated from high school (ten years ago, for those keeping track), I have only lived in Oregon for about one year. I've lived in Minnesota, Alaska, North Carolina and now California. But, until today, I always maintained my Oregon residency, including my Oregon driver's license.

I was going to get an NC license (long story), but I failed the written test. Computer test, actually. I missed one question, and it tells you right away - that threw off my stride. Plus the NC test had lots of violation-specific questions (i.e. what is the fine for driving under the influence) and, well, I tend to stay away from the violations, preferring, instead, to just be a good driver. Ultimately, I decided taht I didn't need an NC license, so I just kept the Oregon one.

But now that I'm a 'doctor' and an 'adult' with a 'real job,' I have to get a new driver's license.

So, I made an appointment online for the Sacramento DMV, and this morning went in to Take the Test. Based on my past failure, I was a tad nervous. (Incidentally, a recent study showed that 1 in 11 drivers would fail a state driving test. how would you do?)

Surprisingly, California still has a paper test, which is hand-graded. I do better with paper tests.
I even got a smile-y face.

So, yay! I passed! They took my picture for a license, but (unlike Oregon) they didn't give it to me today. They apparently mail it to me in a couple of weeks. I don't know if the picture was any good, but it has to be better than this:



After the DMV, which was right by the hospital, I stumbled upon a Trader Joe's. Thrilling! A great grocery store just a few minutes away from my place of employ - on the way home, even. That is exactly what I was looking for.

Natty Gann update: Overnight she figured out how to get into my bed. Which explains why I woke up hanging over the edge of my (queen-sized) bed.


She also found a new place to sleep.

Expando Ray!

The Costco here sells sushi. It's not very good.

Guess what?! I have a satellite dish now! After my TV panic the other day, I realized that Dish Network was not the only satellite TV provider. Unlike Comcast. Grr. Comcast. So, I called DirecTV. And today, the DirecTV guy came, and basically said the same thing that the Dish Network guy did. BUT DirecTV guy was much more willing to stand and listen to me debate with myself the pluses and minuses of mounting the dish. Ultimately, I decided to test it out. The mounting was really easy, actually - just a few screws into a wood post - no real structural damage. I've made bigger holes in my apartment to stabilize a bookshelf.

And now I have TV!!

I signed up for the Total Choice Family Package. Partially because it was the cheapest option, but also because, well... it has the channel I watch the most lately: Disney. I don't get VH1 or MTV, (which I know horrifies Melissa), but I don't care all that much. I may upgrade in the fall so that I can get Bravo - I wouldn't want to miss Project Runway!

I do get tons of religious channels.

AND the NASA channel. I watched it for a few minutes. They had a cartoon on teaching about similar triangles. There was an Expando Ray to make a triangle bigger! Expando Ray!!! Do you think NASA really has an Expando Ray?? I want one.

Natty Gann is settling in well. I have determined that she can't jump (like a white man, I guess...) She gets into my lap by digging her claws into my thigh and climbing. Kinda hurts.


I've given this chair to Natty Gann. She can climb up on it pretty easily, and it isn't my couch. I covered the couch with tin foil so she won't climb on it... Problem is... I can't either. I think she's already got an aversion to the couch by now, though, so I'll remove the foil.

Did you know that 62% of pet owners say they would ignore Disaster Relief orders to evacuate if they were not allowed to bring their pets with them? Here is my PSA of the day: if you're one of those people (I would be...), make sure you have a plan, including a list of hotels outside the evacuation area that will accept pets. Thank you for your time. And attention.

Continuing with a random smattering of topics: I met my chief residents today! I had to go in to the Peds office to do a pre-child-advocacy-rotation interview. The cheifs were there finalizing our rotation schedules. I'm starting on the Wards. Which is totally what I wanted - jumping right on in. It is terrifying, but better for me than putting off the hard stuff. After my first hard month, I have Child Advocacy, then vacation, then I do NICU.

It was fun to start meeting people. They all knew who I was when I walked in. Strange that they know so much about me, and I know nothing about them. The out-going chief was there as well. She told me that she was sending a bunch of her clinic patients to me... Scary! She did it because she remembered my name. The good thing about having a unique, but easy to remember name, I guess.

Natty Gann seemed to do fine during my absence this morning, which is good, because I think I'm going to San Francisco this weekend. And she's not coming...

I'm sure she'll be fine on her chair.

Introducing....

Natty Gann!

Lindsay guessed the name right! That means she gets to be the cat's honorary godmother. Woo-hoo, Lindsay!

Natty Gann is so sweet! I brought her home, showed her the litter box, and gave her some food. The pic above is of her first few minutes in the apartment - she wolfed down the food. She is such a scrawny little thing, she definitely needs it.

After eating, she came over to me and just wanted me to pet her and pet her and pet her. No scratching or biting at all. Thank goodness - that is my biggest cat issue.

She does have this crazy walk, that for some reason makes me think of Voldemort.

I think the poor thing lived in a house once upon a time - she certainly is well-mannered - but was either abandoned or ran away. I don't know when she was injured, but it definitely affected her ability to get food. I don't know if she can really jump much yet. She's tended to stay at her lowest electric state (grounded... that's a really bad chemistry joke...). But she was also sedated today in preparation to get spayed. Turned out she had already been 'altered,' so she didn't need surgery.

So... Realizing I'm turning into Scary Cat Lady by describing every little detail about Natty Gann.

Instead, let me tell you: 1. That I got a new cell phone! If I had more attachments to NC, I could have saved that number like so many people do when they move, but... Well. I don't really want a NC number. So now I have a California number. And a tiny little phone (click on that link to see it, Mom) and 2. That my home phone number spells a word! I've always wanted a number that spells a word!!!

Natty Gann is sitting on the floor in my dark bedroom.

Cats are weird...

(but not as weird as Crazy Cat Ladies)

Coming Soon...

Eek! I'm off to run a few errands, one of which is: getting my cat!

The vet actually called this morning to 'make sure I knew' (I didn't) that the cat has a limp. She thinks that at some point the cat's pelvis was broken, and healed on its own. It shouldn't cause any major problems, but she (the cat, not the vet) will probably have arthritis in later life.

I don't know what to do with that information...

ANYway.

I realized as I showered this morning, that I still didn't have a cat name. I thought and thought and then, suddenly - as happens so often in the shower - inspiration!

I will be naming my cat after a character in one of my favorite childhood movies!

It is a movie I own.
About a scrappy young girl.
Who was abandoned.
And finds her way home...

Any guesses?

Cool!

Here is my new refrigerator! Yippee! I was not at all sad to see the other one go. It was really loud. It's kinda neat to be the very first person to get to use a new appliance in an apartment. No other people's random germs all over it.

Setbacks

This morning, when I got up, I was very excited to post a blog this evening to introduce everyone to two newcomers into my home: a cat and a satellite dish.

Turns out, I get neither.

I spent last night cat-proofing the apartment. And this morning, I put out fresh litter and fresh water in two bowls for the new cat. I went to the animal shelter, got to meet the cat out of the cage, hold her for a while, then give her back. Now, don't worry - I still get the cat. Just not until Tuesday. They have to give her her vaccines, spay her and insert a handy-dandy microchip. So, I guess it isn't that bad that I didn't get her today. But sad. Though, I do still need to think up a good girl cat name...

The cat issue was not all that traumatizing. Though I do need to remember to change the water in the bowls next Tuesday.

What was traumatizing, however, was when the Dish guy came in already shaking his head. Turns out there is a tree and a wall (my wall) in the way of the two available satellites. The only way I can get Dish is if I a)convince my neighbors to get it, and run a wire off of theirs or b)convince the apartment people to cut down the tree. Neither is going to happen.

So, I had to resort to Comcast, even though I was trying to avoid them. I logged on and ordered the Standard Package plus digital video recording for twice the price that it would have been with Dish. TWICE. PLUS an installation feel. PLUS the fact that the cable jack is on the total opposite wall of where I situated my TV, after two hours of furniture re-arranging yesterday.

And then it turns out that I can't get DVR unless I get some fancy digital cable package that costs $60/month. Plus the $10/month for DVR. WHO ARE THESE PEOPLE???? What? They think I'm made of money??? Yes, I will finally be making money. But... I can't afford that. Me and my cat have to eat.

So.

Rabbit ears.

And, I guess I need to go buy a VCR again.

I feel silly making such a huge stink about TV. But... it's all that I have right now.

Until I get the cat, at least.

MeetIn'

A few months ago, I came across this website called MeetIn - the 'largest' friends social group in the world. They didn't have a chapter in Winston-Salem (*gasp*), but they did in Sacramento. So I joined.

And tonight... I actually went to an event!! Are you not SO proud of me? I am! I found myself at Sammy's Astro Club tonight, at "Dive Bar Night." I had so much fun! There were several new people, and lots of regulars. I think tonight was a blow-out attendance night - there were probably 30+ people there. I had no idea what or who to expect, but it turned out that most people were like me - young professionals. Some single, some engaged, and one guy who just broke up with his girlfriend of seven years, but still lives with her... he was depressing.

Who knows if I'll ever be able to go to anything else - Dive Bar Night is only every other week and I don't really know what my schedule will be like. But I'm just glad I went out this one time. Sacramento is like the big city to me now, so I need to take advantage.

And now, as promised: pictures! I can't promise good quality - I had to shrink the file sizes down to get it to actually load...


Here is my bed! I love it. The mattress set is from Costco, the frame from Ikea and the bedding from Overstock.com. Isn't it beautiful? I don't really have any other bedroom furniture yet. Someday I will. Maybe Saturday! (aka Yard Sale Day)


And my couch. I love it, too. Like the curtains? I hung those last night. In the background you can see the dining room and kind of the back of my new monitor... Once that is more organized, I'll put up pictures of that area, too.

Hot Time in the City

I finally got motivated to unpack some boxes today. Helped largely by another trip to Ikea yesterday, where I bought some under-the-bed storage boxes ($12 each!!) and a cheap drawer set for my closet. So! My clothing is 'put away.' Kind of. It is put in the general area of 'away' at least.

As I was unpacking clothes, and hanging up my pictures, I realized that I was getting warm. Hot, even. Really hot. Super freaking HOT. A glance at the thermostat showed that I did, indeed, have it set to 80. The air conditioning was on. And the temperature was reading ninety. Ninety. So... apparently there is something wrong with my air conditioner.

Actually, after a call to the front office, I realized that the breaker for the AC was off, so I remedied that. It is still freaking hot in here, though... But it is down to 87.

Speaking of difficulties cooling things down: my refrigerator is a tad loud. And by a 'tad' I mean 'conversation-interrupting' or 'wake-up-from-sleep-causing' loud. It sounds like a spaceship trying to take off. I informed the management about that when I turned in my little "Is the Apartment in Good Shape"-type checklist. The next day (yesterday), the repair people came, took one look at it and said, "Oh. This is an original. It must be the compressor." Then they asked me how loud it was (real loud), and wrote down that I need a new refrigerator! Yay!! New refrigerator!!

To go with all my lovely new furniture! Speaking of, here are some pics to tide you over (Ari!). I'm only posting two pictures, because, well... everything else is still in major chaos.

Never mind. I lied. I think I'm trying to post at a busy dial up time, so it is being slow. I'll try again later!

In completely other news... I did something very different yesterday. Something I really thought I'd never do. I went to the public animal shelter... and I picked out a cat. A cat! I decided a while ago that I'd like a pet. What I really want is a dog (I looked at the dogs at the shelter too - I wanted all of them), but I am really not in the position to take care of a dog. After a dog, I'd like a kitten. But I don't really think I can take good care of a kitten, either. So, I'm going to get a full grown cat.

I picked one out yesterday, but it was a new arrival, and they need time to let any possible owners come claim it. But on Saturday, if he is still there, he's mine. Or she. I can't remember if it was male or female...

Any ideas for names??? Top of my list right now is "Linus"