I'm generally a pretty mellow, laid-back person. And before members of my family or old friends scratch their heads and wonder if they've unwittingly stumbled across a blog written by someone who is obviously not Brenna, I should qualify that statement: Compared to a lot of other residents/medical people, I am generally pretty mellow and laid back at work.
Three admissions in the ED? A chance to multi-task! Another RSV bronchiolitis patient? At least that will be a fast one! Present a patient I barely know at morning report? Why not! Call twenty billion consults on one patient? A chance to learn more! Work 19 of 20 days? At least I got that one off! Three pages in ten minutes about the same asinine issue? Obviously I didn't explain myself well in the first place!
But there comes a time every month or so - one might call it cyclical if one were so inclined, where I'm less... patient. And much more annoyed. With everything.
At the beginning of residency the fates were so kind as to allow that 'period' to occur at the start of a rotation. Because at the beginning of a rotation, I'm nervous, scared and unlikely to 'rock the boat,' as it were. These feelings outweigh my general annoyance with the world, so I maintain my cool. But, thanks to the vagaries of time and hormones, it happens that my annoyance grows at the end of a rotation. When I'm more confident with what is going on. And sooo-o-o much less willing to put up with... well, much of anything.
I was on call on Friday night. We had seven admissions between 5pm and midnight. Five of them arrived within half an hour of each other. At least one of them I deemed totally unnecessary. The pediatric floor is completely full, so the keep admitting patients all over the hospital. Plus I had to cover for all the patients that were already on the floor. And there are some new nurses that page a lot. In the middle of the night. With questions that could be handled at a time other than 3 am. And, to top it all off, there was a radiothon going on to raise money for the hospital. Which is totally cool and a wonderful cause, but they were all over the peds floor and just basically getting in my way.
And I was so sick of the RSV bronchiolitis and acute gastroenteritis and complicated MR/CP kids with 20,000 issues that I could spit.
On a normal day (or night), I would have been fine with all of the above. But this particular call night, I was not in the mood to deal.
I feel particularly bad for the upper level resident that was forced to work with the contentious me that night...
Ah, well. There's not much I can do about it now. I've got my last week on the wards coming up. Although, then I start two weeks of night float. Which is like the wards without the daylight. So... that's exciting. And then I do two weeks of Pulmonary. Which is like the wards without the interesting cases.
There appears to be no real point to this blog. Hmm. That's too bad. I guess you'll just have to deal.
Me? I'm off to get a pedicure - I'm working on the theory that I can handle things better with pretty toenails.
Feb 25, 2007
Jan 15, 2007
State of the Residency
In Honor of: 1) The new year, 2) The annual 'state of the union' address that is rapidly approaching, 3) The fact that my intern year is more than halfway over (not to mention the fact that I haven't posted in almost two months) and 4) The part of the dead animal that is in my parking spot...*
...*Okay, so maybe the part of the dead animal isn't really related. I just wanted to point out to y'all that there is part of a dead animal in my parking spot. The hindquarters part...
I Proudly Present: The State of the Residency Address. Because, yes, my life is that important. After all, you're reading about it, right?
Lacking an adequate structure involving things like The Judiciary Branch, The Legislative Branch and The Executive Branch, I will choose to return to my good ol' college days and present the State of the Residency in the structure of Maslow's Hierarchy of Needs. I'm obviously referring to the Psychology part of undergrad, not the chemistry part. Stoichiometry doesn't lend itself easily to descriptive analyses. But look! I do have visual aids - well, visual aid, anyway:
Some time ago, I passed the crucial halfway mark of my first year of residency. Not crucial in any appreciable way, other than the fact that I am technically on the down slope. Of this year, anyway.
In Maslow's Hierarchy, you can only move up to the next level of the pyramid if all of the needs on the level below are being met. So, how am I faring? What has my life become?
First, in the Phsyiological Needs part of my life:
1. Breathing - check.
2. Food - check. Actually, check-check. I am getting plenty of mighty fine eating this year. I must say Sacramento's edibles are superior to Winston-Salem's.
3. Water - check. Though not as much as I should. Again, I say: if I were a patient and monitoring my own urine output (but, eww, why would I?), I'd probably immediately start IV fluids and consider starting Lasix.
4. Sex - well... in the sense that I have a sex (aka I check the female box when given the option)
5. Sleep - I'll give this a half check.
6. Homeostasis - i.e. staying warm or cool. Check. But I'm always cool, babe.
7. Excretion - i.e. pooping and peeing. Check and half check (refer to the water need)
Total Physiologic Needs: 6.5/8 plus one extra for food.
Next we turn to Safety Needs:
1. Body - check. The foil hat keeps the alien mind probes at bay. And I do have a lovely apartment, though I am considering taking on a roommate next year. Actually, I'd be taken on - I may move in with a fellow intern.
2. Employment - big fat 60-80 hour a week check. For the next 2.5 years, anyway.
3. Resources - ummmmm.... negative check. Or maybe a dashed check. I have adequate resources now. But in the aforementioned 2.5 years, the check will plummet to the depths of $200,000+ debt. HAHAHAHAHA! That's a big number.
4. Morality - goodness. Check, I think. I hope!
5. Family - check. Though my baby sister just left for Spain *sniff* Those Spaniards better not mess with her!
6. Health - check as far as I know. And I firmly and decisively ignore anything that might suggest otherwise.
7. Property - check. Except for the part-of-a dead-animal under my truck. Perhaps it is emitting some truck-eroding part-of-dead-animal fumes.
Total Safety Needs: 6/7 plus one dash
And now onto the Love/Belonging Needs:
1. Friendship - this would be a slowly growing check. I'm finding the work load to be less than conducive to easy friendship-forming. The old ones are going strong though. They are gold, after all. Or are they the silver ones??
2. Family - definite check. Though they are 598.01 miles away.
3. Sexual Intimacy - sigh. No check.
Total Love/Belonging Needs: 2/3. Still over 50%, so I still think I can move up a tier.
Next to Esteem Needs:
1. Self-Esteem: Check. About half the time anyway. Maybe a third. A quarter?
2. Confidence: Check. Or... maybe I don't deserve a check. Should I check with another resident? How about an attending? I should be able to make up my own mind, right? So... check. Maybe?
3. Achievement: Check. Depending on the patient, the attending, the day and the color of my socks (when they match, that's an achievement)
4. Respect of others: Absolutely check. I respect, admire and otherwise idolize many people in my life.
5. Respect by others: to my face? Check. Behind my back? No clue!
Total Esteem Needs: 0-5/5
And, lastly, the big Kahuna, the thing we all strive for; the tier that many never acheive, and that those who do, rarely live there for long: Self-Actualization Needs. These include Morality, Creativity, Spontaneity, Problem Solving, Lack of Prejudice, and Acceptance of Facts.
Actually, other than my obvious prejudice against dead animals (or parts thereof), I think I spend a good amount of time being Self-Actualized. I think my overall enjoyment - yes, enjoyment - of my job supercedes some of the shortcomings in the lower tiers.
Hmm. That makes me sound like a Career Woman. Like in the 50s, after the War, when there were women and there were Career Women. I don't know that I'm cool with that. But I guess that is what I've signed up for for the next 2.5 (not 3 anymore!) years. Thankfully, it does look as if I am getting most of my needs met.
And if I could just get that part-of-dead-animal moved, I'd be Self-Actualizing all over the place.
...*Okay, so maybe the part of the dead animal isn't really related. I just wanted to point out to y'all that there is part of a dead animal in my parking spot. The hindquarters part...
I Proudly Present: The State of the Residency Address. Because, yes, my life is that important. After all, you're reading about it, right?
Lacking an adequate structure involving things like The Judiciary Branch, The Legislative Branch and The Executive Branch, I will choose to return to my good ol' college days and present the State of the Residency in the structure of Maslow's Hierarchy of Needs. I'm obviously referring to the Psychology part of undergrad, not the chemistry part. Stoichiometry doesn't lend itself easily to descriptive analyses. But look! I do have visual aids - well, visual aid, anyway:
Some time ago, I passed the crucial halfway mark of my first year of residency. Not crucial in any appreciable way, other than the fact that I am technically on the down slope. Of this year, anyway.
In Maslow's Hierarchy, you can only move up to the next level of the pyramid if all of the needs on the level below are being met. So, how am I faring? What has my life become?
First, in the Phsyiological Needs part of my life:
1. Breathing - check.
2. Food - check. Actually, check-check. I am getting plenty of mighty fine eating this year. I must say Sacramento's edibles are superior to Winston-Salem's.
3. Water - check. Though not as much as I should. Again, I say: if I were a patient and monitoring my own urine output (but, eww, why would I?), I'd probably immediately start IV fluids and consider starting Lasix.
4. Sex - well... in the sense that I have a sex (aka I check the female box when given the option)
5. Sleep - I'll give this a half check.
6. Homeostasis - i.e. staying warm or cool. Check. But I'm always cool, babe.
7. Excretion - i.e. pooping and peeing. Check and half check (refer to the water need)
Total Physiologic Needs: 6.5/8 plus one extra for food.
Next we turn to Safety Needs:
1. Body - check. The foil hat keeps the alien mind probes at bay. And I do have a lovely apartment, though I am considering taking on a roommate next year. Actually, I'd be taken on - I may move in with a fellow intern.
2. Employment - big fat 60-80 hour a week check. For the next 2.5 years, anyway.
3. Resources - ummmmm.... negative check. Or maybe a dashed check. I have adequate resources now. But in the aforementioned 2.5 years, the check will plummet to the depths of $200,000+ debt. HAHAHAHAHA! That's a big number.
4. Morality - goodness. Check, I think. I hope!
5. Family - check. Though my baby sister just left for Spain *sniff* Those Spaniards better not mess with her!
6. Health - check as far as I know. And I firmly and decisively ignore anything that might suggest otherwise.
7. Property - check. Except for the part-of-a dead-animal under my truck. Perhaps it is emitting some truck-eroding part-of-dead-animal fumes.
Total Safety Needs: 6/7 plus one dash
And now onto the Love/Belonging Needs:
1. Friendship - this would be a slowly growing check. I'm finding the work load to be less than conducive to easy friendship-forming. The old ones are going strong though. They are gold, after all. Or are they the silver ones??
2. Family - definite check. Though they are 598.01 miles away.
3. Sexual Intimacy - sigh. No check.
Total Love/Belonging Needs: 2/3. Still over 50%, so I still think I can move up a tier.
Next to Esteem Needs:
1. Self-Esteem: Check. About half the time anyway. Maybe a third. A quarter?
2. Confidence: Check. Or... maybe I don't deserve a check. Should I check with another resident? How about an attending? I should be able to make up my own mind, right? So... check. Maybe?
3. Achievement: Check. Depending on the patient, the attending, the day and the color of my socks (when they match, that's an achievement)
4. Respect of others: Absolutely check. I respect, admire and otherwise idolize many people in my life.
5. Respect by others: to my face? Check. Behind my back? No clue!
Total Esteem Needs: 0-5/5
And, lastly, the big Kahuna, the thing we all strive for; the tier that many never acheive, and that those who do, rarely live there for long: Self-Actualization Needs. These include Morality, Creativity, Spontaneity, Problem Solving, Lack of Prejudice, and Acceptance of Facts.
Actually, other than my obvious prejudice against dead animals (or parts thereof), I think I spend a good amount of time being Self-Actualized. I think my overall enjoyment - yes, enjoyment - of my job supercedes some of the shortcomings in the lower tiers.
Hmm. That makes me sound like a Career Woman. Like in the 50s, after the War, when there were women and there were Career Women. I don't know that I'm cool with that. But I guess that is what I've signed up for for the next 2.5 (not 3 anymore!) years. Thankfully, it does look as if I am getting most of my needs met.
And if I could just get that part-of-dead-animal moved, I'd be Self-Actualizing all over the place.
Nov 27, 2006
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.
Nov 23, 2006
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!
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!
Nov 14, 2006
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.
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.
Nov 8, 2006
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!
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!
Oct 25, 2006
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)
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)
Oct 23, 2006
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)
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)
Oct 19, 2006
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:
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.
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.
Oct 2, 2006
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?
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.
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.
Sep 27, 2006
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!
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!
Sep 22, 2006
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.
Sep 20, 2006
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?
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?
Sep 16, 2006
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.
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.
Sep 12, 2006
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.)
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.)
Aug 31, 2006
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.
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.
Aug 27, 2006
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.
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.
Aug 24, 2006
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.
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.
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