Never Ending Story

A few months back, I declared the saga of the (MM)PWHM to be at an end. Once third year ended, I really thought it was so. It was quite thrilling to be free from the drama that surrounded all of that nastiness.

Shortly after the end of third year, however, I got a note in my box from one of the (MM)PWHM. And, oh how angry I got. How dare he disrupt my new-found peace and calm, thought I. I stewed in my own anger and resentment for a few days, and wrote a very mature (if I do say so myself) response. Basically, I said, it was bad and hard and I got over it and moved on.

Then... I felt some satisfaction, but also some... disappointment I guess is the right word. That was when it really felt over to me. I'd closed the door on what had once been a very good friendship.

Well, it turns out that someone's foot was in that door. Over the last few weeks, I've found myself in the company of the letter-writing (MM)PWHM. And what was most unusual was not only the fact that I didn't get nauseated or break out into hives in his presence, but also that it almost felt normal. But there was still that underlying thread of tension. See, I still thought that he hated me, or at least had at some point thought terrible things of me.

So, times passes on, and people gain courage and resolve, and suddenly I found myself in the park yesterday afternoon, having a real conversation with (MM)PWHM. And, it turns out he doesn't actually hate me. At all. Never did. He's a (MM)PWDAHM - that's (Mysteriously Missing) Person Who Doesn't Actually Hate Me.

And what does that all mean? I guess we're going to try to be friends. It just baffles me, really, as had this whole process. I am consciously entering into this. Both my eyes are open, and my feet are firmly planted on solid ground. I fear that I will end up back in the same place I was before, but I have faith that I know myself better now. So, even though it may not be the best decision, I am letting my heart beat out my reason on this one.

I just hope that I don't come to regret it.

(I don't think I will...)

Oompa-Loompacide

The saying "kids are not just little adults" is one maxim that we hear repeated a lot in the hospital. After a few months of pediatric medicine, I find myself needing to re-learn the opposite: Adults are not just big kids.

One thing that is relatively uniqe to adult medicine is the phenomenon of making fun of the patient. Well... maybe "making fun of" isn't the correct term. But with adults that have tons of comorbid conditions - the heart patients with COPD and liver disease, for instance - there is the underlying knowledge that they contributed to their own condition. And so many adults are non-compliant with their therapies that it is not uncommon to have a relative level of cynicism when treating them.

Which leads to comments like the one made by an intern to another this morning: "Something fishy's going on. Her glucose is still 400-something and she's on enough insulin to kill an Oompa Loompa."

Love it.

Day By Day

I was thinking about what I'd write in my blog all day today, and now that I'm sitting here, I just don't care! Not about you. I love all of you, my semi-anonymous blog-reading crowd.

No, I just am not terribly enthused about the ICU. It doesn't lend itself to epic odes. Neither does it lead to ranting tirades. So instead of either, let me just tell you what I did today. If you really care. Actually, your time would be much better spent handing out stuffed animals to orphans wandering the streets. Or eating zucchini or cultivating a resistance to Iocane powder.

Brenna's Wednesday
5:15-ish - Get up.
6:00-6:45 - Rounds with the CT surgery team (during which I function as a third year since those punks are on vacation)
6:45-7:45 - Anesthesia Grand Rounds (Perioperative Management of Cardiac blah-de-blah)
8:00-9:00 - CT Surgery Conference (Boring boring boring)*
9:00-11:00 - Rounds with the ICU team and Pharmacist
11:00-12:00 - Anesthesia lecture (Asthma)
12:00-1:00 - Lunch
1:00-4:00 - Excrutiating Boredom
4:00-4:40 - Rounds with CT Surgery fellow and ICU team

Ugh. We don't always have quite so many lectures, but we do Round like it is going out of style. Oh, and did I mention that we have four patients. Four. We spent TWO hours rounding on FOUR patients. I totally forgot that adult rounds get like this. But I am learning, so that is good. So they say...

*Somewhat related mini-rant: The CTS conference was about some sort of new-fangled radiology techniques. Fancy X-rays. Such a sweat stain. There was one guy - a salesman I'm sure - had this terribly annoying booming voice. And he kept saying "facile." Repeatedly. But he used it in this bizarre manner that I don't think was correct. Actually, I'm fairly certain it wasn't correct. Example: "I will sit down with you and make you facile with the buttonology." Buttonology. Facile. I was so annoyed my brain exploded.

Paint by Numbers: A Life

I finally got my board scores today (yay!) and while I'm not displeased with the results, I am struck anew how much importance people place on all these 'numbers' in our lives: IQ, salary, weight, GPA, test scores, class rank, etc. As if they define us. And yet, we all hide them, as if people will judge us. "NO! I can't tell you what I got - it will make me stupid or possibly arrogant!" Well, as we all know (or at least strongly suspect) I am both stupid(ish) and arrogant. So why not bare all. An existential streaking, if you will.

Here, then, is my life, in numbers:

SAT Verbal - 770
SAT Math - 740
HS GPA - 3.98
MCAT Biological Sciences - 9
MCAT Verbal - 11
MCAT Physical Sciences - 11
MCAT writing - can't remember...
College GPA - 3.85
USMLE Step 1 - 215
Med School Class Rank (years 1-2) - 46 of 104
USMLE Step 2 205
Med School Class Rank (year 3) - 71 of 98
Salary - yeah, right
Weight - yeah, right (okay, so one number still makes me cringe)

There you go. Feel like you know my any better? Didn't think so.

Some numbers that really matter:
2 - number of sisters I have
2 - number of parents I have
Innumerate - number of friends I have
2 - number of working eyes I have (or four depending on your maturity level)
About 30 - number of times I laughed today
Infinite - my possibilities (gag me! how cheesy!)

Now I'm off to get my 5-6 hours of sleep!

Personal Manifesto

For all y'all that have been clamoring for it (okay, so it was just my mom...), here is the famous "Personal Statement" that the residency programs will be receiving from yours truly.

In my dream life, I am a world renowned actress, have several best-selling novels under my belt, and spend my free time doing good deeds. I can also sing like an angel and am as graceful as a swan. In reality, I can’t act, haven’t the wherewithal to complete a novel, and sing more like an android than an angel. Plus, I am a bit of a klutz.

I realized early in life that I may not progress terribly far with a singing and acting career, so I focused on “doing good deeds.” By the age of twelve, I knew I’d be a pediatrician. Why? Because, as the regular neighborhood babysitter/game inventor, I knew that I liked kids, and I knew that doctors did good things. It sounded logical to my concrete brain.

Fast forward a few years to college where I joined the masses of pre-med students, striving to make myself a good applicant. The only problem was that my motivation had not changed since I was a junior high student: I liked kids and I wanted to do good. I had developed abstract thinking skills since I was twelve, but the reasoning behind my ultimate goal was still very concrete.

And then medical school started.

And it was everything I expected it to be, and nothing at all like I expected it to be. Everything was new – the people, the language, even the smells were completely foreign. It was all overwhelming at first, but I slowly began to see that saying “I want to go into medicine” was just as vague as saying “I want to do good.” This realization forced me to finally apply abstract reasoning to my decisions.

It was during third year that I was really able to put my motivation into actual words, and at the same time moved beyond liking pediatrics just because I like kids. While I enjoyed learning about diseases and treatments on a pathophysiologic basis, I found that I was even more drawn to the patients’ histories, trying to identify ways in which we could have prevented the disease in the first place. I found myself getting frustrated when I met patients suffering from avoidable illnesses.

Pediatrics to me, has come to mean more than simply diagnosing and treating sick children. It requires caring for entire families, and teaching them how to raise healthy children. I think anticipatory guidance is just as important, if not more so, than choosing the correct antibiotic to treat a sinus infection. It is the ultimate form of preventative medicine. While I do want to learn how to more accurately diagnose and treat children, I also plan on getting a Masters in Public Health at some point to better equip myself in promoting children’s health and welfare. I look forward to being a strong advocate for my patients.

My personality is ideally suited for both pediatrics and preventative medicine. In my third year rotations, I excelled in the categories involving rapport with others - patients and peers. I listen well, and am generally able to get my own message across without being condescending or mean. Working with children and families requires patience, creativity and a good sense of humor, attributes which I believe I can use to my benefit.

I can think of nothing more fulfilling than to spend my life helping and teaching children. They are full of surprises and joy and promise. How could any day be boring when there is a four year old in it? Is there anything more challenging than trying to get a fourteen year old girl to open up? Unless perhaps it is trying to look in the ears of an uncooperative eighteen month old?

I am no longer the concrete-thinking child who wants to be a pediatrician simply to “do good.” I have learned and grown a lot both in life and in medical school, but in the end what it boils down to is this: I like kids and I want to do good.

The twelve year old inside me is very happy.

100% of Me Wants to Go Home

According to the NBME site, my boards scores were mailed on Wednesday, which means that I expected to receive them today. No such luck! Susan got hers (whines Brenna), but my mailbox contained merely a survey from the NBME asking questions about the testing experience.

Sigh.

I get my scores sent to me at school, which means that I won't get them before Monday now. Today is my last day of Peds Neuro and Monday I start in the Cardiothoracic Surgery ICU on Monday. Interestingly, I got my Step 1 scores while I was in the CCU (coronary care unit) which is somewhat similar to the CTS ICU. I like the synchronicity of that.

I also like the word 'synchronicity.' Come on - say it with me: synch-ron-i-city. Now, was that not the most satisfying thing that has come out of your mouth today? The most satisfying thing that has gone in to my mouth today was a bowl of peanut butter cup ice cream. Mmm. That was good.

There is still a slight chance that when I leave clinic this afternoon my scores will have arrived. In fact, 57.8% of me is hoping that they still will. But the remaining 42.8% just wants to enjoy the weekend without the burden of knowing.

99% of me wants more ice cream...

Oh, Y!

Anyone who has been around me for a good length of time knows that I love the YMCA. It is like an oasis away from regular life where people go and get all sweaty and look nasty and no one can think bad of them because they're working out. Fantastic.

Another reason that I particularly love my particular Y is that there is a full work-out area in the women's locker room. Which means that, if I'm feeling particulary icky or girlish, I can get my sweat on away from prying male eyes. And there's a sauna and a hot tub and a swimming pool! Okay, the swimming pool isn't in the locker room, but you can get to it from there.

One thing I always did in the women's area was running on the treadmill. It is mostly because I turn a very distinctive shade of fuchsia. Plus I'm not the most graceful runner (I've been known to throw my CD player flying many a time). But one day a few weeks ago, I ended up on a treadmill next to a girl who inspired me to move to the treadmill in the upstairs, co-ed area.

I first came across this girl in the weight room. She spent half an hour - HALF an HOUR on a machine I was waiting for. It struck me at the time that she looked like a girl I'd gone to elementary school with. Except an evil version. Evil Elementary School Girl. She seems to live at the Y, too. I see her there a lot - always scowling.

So, back to the treadmill incident. I was innocently running my merry little way on the treadmill when EESG came up and started zipping away next to me. After a while, I noticed that she kept looking over at me. I generally tend to look around me as I run, too, so I thought nothing of it at first. But she KEPT doing it. Then I started to get angry. How dare the little punk judge me? At least I was trying! So what if I wasn't good. But, I finally realized she wasn't looking at me. She was looking at her ass in the mirror (yes I just used the word ass - it just seemed appropriate here). Stupid EESG was so fascinated with her own ass that she had to stare at it the whole time she was running. Who was she trying to impress? The 50 year old woman on the other treadmill?

Anyway. That annoyed me so greatly, that I graduated to the Big Girl treadmills. Which is nice, because it is a lot less hot and humid working out in an area where there is no sauna!

Survival of the Fittest?

I know I've blogged about PMS in the past, but... when you find a good topic, stick to it...

There are many lists of PMS symptoms out there, but none of them mention things like: back pimples. Or paranoia (that's Susan's) or over-analyzing everything (that's mine). I knew I was PMS-y today, when I had cake batter for dinner. Yes, cake batter. Pink cake batter to be specific. (and it was good. E. coli be darned!)

That's all beside the point, though. The point being that I have a theory as to why females that live/work in close proximity tend to cycle together. This phenomenon is known in research circles as 'menstrual synchrony' (look at me pretending to be involved in 'research circles!' haha!) There are some theories that it was an evolutionary development to prevent packs of wild animals from detecting bleeding females all the time so they'd only have to be prepared for attack, oh say 20-24 days a month. (huh?!? Caveman: "Uh-oh, women bleed, get sharp stick! Ugg!")

I have a new theory - also involving evolution. It is this: females living/working in close proximity need to be PMSing at the same time. That way we can all retreat to our paranoid/over-analyzing/teary corners, poke at our back pimples and eat cake batter at the same time. If we weren't PMSing at the same time, one PMSer could easily take out a few chipper girls in one bad day.

I think my theory is sound. Perhaps I will write it up for publication?

"My Daughter-In-Law Has it Worse Than You"

There is a woman working in the pediatrics neurology clinic who is... less than fully socially adept, I'll say. You know the type - if you make eye contact with them, they'll launch into their whole, long, drawn-out, tragic history (Granted, this particular woman really did experience a tragedy) while you sit there squirming, thinking 'Wait? Am I supposed to know you?' and 'How do I gracefully exit the room without looking like a jerk.'

After several such situations with this woman, it appears that we're on friendly terms now. She has now progressed to accidentally insulting me! Yesterday, I had the beginning of a conversation I have, oh, probably once or twice a month:

Other person (usually older woman): Is your hair naturally curly? (alternately: Is that your real hair?)
Me [humbly brushing hair out of face, and scowling on the inside]: Yes.

This is usually followed by a comment along the lines of: it's beautiful / you're very lucky / do you know how much people pay to get hair like that / etc. To which I generally reply: thanks / I know / Haha! All while thinking - jeez people, it's only hair!

Yesterday, however, as I was preparing to pretend to not be annoyed, I was surprised to hear Neuro Lady say: "My daughter-in-law has it even worse than you!"

Even worse than me?! I didn't have a response to that. Which was, as it turned out, okay, as Neuro Lady launched into several ways I could attpempt to straighten my hair. I just smiled and nodded...

No one has ever made me appreciate my curly hair as much as she did!

Sorry, Lindsay

I used to make fun of Lindsay for saying that mint made her sneeze. But then I realized that it makes me sneeze, too.

I still think she's weird for saying white chocolate give her hiccups, though.

Class Rank

One unfortunate aspect of medical school is the fact that we have to be graded. Along with the grading, goes the ranking. Class ranking. It is a hateful way to determine who is the best, and who is the... not so best.

At the end of first and second years of school, I was ranked at 46 (I think? 40-something anyway) of 104. I was totally okay with that. Not thrilled - we all want to be number one, right? - but not at all bothered.

Today, we just got our ranks for third year. I did okay during third year. I passed everything. No honors, no low passes. I did almost always get honors in the sub-categories "Health Care team rapport," "Patient rapport/Professionalism," and "Motivation/Attitude toward learning." (See - I'm nice and I'm interested. Not always the brightest bulb in the package, but at least people like having me around.) I don't know what I was expecting my new rank to be, but I find myself a tad disappointed. My rank is now 71 of 98. Again - not horrible (not in the bottom quartile anyway...barely) - but this time, I am... not happy.

Though, I did just go back and look and saw that this was JUST my third year rank, so hopefully the 46 of 104 will bring me back up a little bit in the ranks. Not that residency programs see that, though. They'll see the 71.

In the end, though, I am more proud of the things that I do excel in. I'd rather have my patients like me than have the correct answer 100% of the time. I am less likely to get sued that way for one; plus it will just be a better experience overall. And as far as residencies go - I just have to get my foot in the door and get an interview. Once I get that far, I should be fine.

On a separate, scary note - I will apparently be getting my Step 2 scores any day now. Keep your fingers crossed for me!

Money Money Money

One thing that apparently goes along with any final year at a private school is the official Asking for Money. It really does get a tad annoying, when I just received my latest loan installment. Yes, I will be close to 200,000 dollars in debt by the time I graduate. That is a lot of money. I can't even comprehend how much money that is. And now they're asking me to donate some to the school? What money is this that I'm supposed to be donating, may I ask?

I do actually make piddly donations (we're talking five bucks) to my undergrad. The only reason I do it is so that they can say a certain percentage of my class gives back to the school - it makes the school look better on those ranking lists when alumni give back. I had even been planning on giving a paltry amount to my med school this year, too - again, just to add to the percentage.

But today, I got a letter from them asking for money - and my NAME WAS SPELLED WRONG.

Sorry guys. No money from "Breanna."

The Worst Secret

Every day at 4:30, the peds neuro on-call pager is handed off to the night team. So any page that comes after 3:30 or so is a HUGE hassle. Which was why the page last Friday at 4:00 pm made us all roll our eyes and groan loudly. Very loudly. Like person-passing-by-in-the-hall-does-a-double-take loudly.

That particular page was about a young baby who had just been brought in with non-accidental head trauma and seizures. For those of you not in the know, 'non-accidental' is a legalistic euphemism for 'child abuse.' Babies don't really do all that much. They eat, they sleep, and they cry. Unfortunately, that crying can lead to frustration and anger, and a phenomenon known as Shaken Baby Syndrome. This particular child has it about as bad as it gets. This is a person that has no chance at all of being normal - that is if they even survive.

I've seen several cases of shaken babies, along with other forms of child abuse during my few months on peds rotations. The thing that is striking me about this case is that they still don't know who did it. In my (albeit limited) experience, they've known, or at least had a really good idea, who the culprit was. No one is breaking down in this case though. We suspect it was one of the parents. But we don't know which one. And, as awful as I feel for the baby, I can't help hurting for the parent that is hiding such a dark and painful secret inside.

How to make a Brenna

Ingredients: 5 parts success 3 parts brilliance 3 parts empathy

Method: Add to a cocktail shaker and mix vigorously. Add emotion to taste! Do not overindulge!

Username:

Personality cocktail
From Go-Quiz.com

Boredom Reigns

There is no peds neuro clinic on Thursdays. My first reaction was "Yay! Free day!" But now... I'm bored. Sigh... So bored. I'm waiting for the attending (who is a fantastic and wonderful person - I'm not actually complaining about him) to decide to round on our one patient. I know that if I go home - where I can always find ways to entertain myself - I will be immediately paged back here. So, I've just been wandering around since 9:30 this morning. I've run out of things to do.

I must admit, it is kind of fun to just meander around the hospital. I keep running into fellow fourth year students, and we'll stand and chit-chat for a while (I'm up to ten chit-chats already today) and then continue on. Meandering.

The most interesting thing I've learned today is that the national Human Genome Research Institute has announced that it will sequence the genome of the bushbaby. The bushbaby? Seriously? They announced 12 other animals that they're going to sequence, as well, but I really can't get the image of a bunch of dorky researchers sitting around in a conference room going "Dude! We totally need to sequence the bushbaby!" And then breaking out into riotous laughter. Because that's the kind of thing that dorky researchers do.

Or perhaps they're trying to figure out the gene sequence that leads to those huge freaking bushbaby eyes in an attempt to bring those Japanese anime characters to life.

That Girl

Yesterday was the day that all the little first years started their orientation at our school. I love love love seeing them all come in, all bright-eyed and well hair-cutted. This is before girls get catty and guys get ratty. Haha! That's a little poem I just wrote. I guarantee you that by four months from now, there will be at least one guy with a full on beard and one guy who gave up cutting his hair entirely. And there will be at least one girl that everyone hates. But right now, they are all on a level playing field. And perky! Yesterday, I had to give them all a short (like three minute) presentation to them on one of the groups I'm in. Such power - me and a microphone in front of 100+ perky smart people.

Tonight, as one co-editor in chief of the yearbook, it was my privilege/duty to attend the first years' Dean's Dessert Reception thingy. The first years get all dressed up and mingle and try to impress each other and the deans. And I was there, camera in hand. It was pretty cool. I felt absolutely no compulsion to do any mingling. I only actually met one first year. The rest of the time, I'd point my camera, snap a shot and then scurry on my merry little way. And I had some cake.

The weirdest thing, though: there are at least three people in the incoming class that I taught Verbal and Writing to in Kaplan MCAT classes. I couldn't figure out how I knew this one girl until she reminded me. Weird! They were my students! They were ones that I remember had good essays, though, so that's good. I am amused that these three students have now seen me: teaching Kaplan, representing one student group, and taking pictures for yearbook. They must think I'm 'that girl' - you know the one who does everything. The thing is... I guess I am! But at least I'm not the girl that everyone hates!

If I'd Only Known Three Years Ago...

As I continue to plug away at my ERAS residency application, I am doing more research on pediatric residency programs across the US. Probably something I should have done earlier, but I really do procrastinate well. Actually, the fact that I've done everything on my ERAS app but the personal statement (and letters of recommendation) is really quite an accomplishment for me.

Anyway. I have fallen in love with Rainbow Babies. It may just be the name. What a fantastic name for a children's hospital! So much better than naming it after a rich person who donated a bunch of money who has a really hard to pronounce name. You know, that's just cruel to those poor, sick children. Rainbow babies makes me think of... butterflies and books and things that make me happy.

Plus, it is one of the top ranked programs in the US. Here, too. I would love to learn pediatrics at Rainbow Babies - the program itself looks fantastic with an okay call schedule and 4 weeks of vacation. I think it would be perfect!

Which all means: I should have studied harder.

Sigh. No reason I can't apply to one "wildest fantasies" school, though, right?

Wedding Report

The wedding last night was lovely. It was probably the smallest wedding I've ever been to (not that I've been to tons - most of my closer friends are taking their sweet time to approach marriage, much like me). There were probably 60-70 people there in total.

The ceremony was outside. It was hot. I don't recommend an outdoor wedding in the middle of the summer in North Carolina. It was lovely, though. Another thing: if you do have an outdoor wedding, find a way for the bridesmaids (and bride!) to not have to walk on grass in heels. I was really worried that they'd fall flat on their faces. I can't imagine how worried they were!

After all that spatula talk, I didn't end up getting them anything even remotely spatula-like. I didn't make it to Williams-Sonoma until about two hours before the wedding (after spending an hour straightening my hair...not sure why I did it...) There were only a few things left on the list, and it took three employees to help me find the Baker's Peel. You didn't know it was called that, did you? No one did. I feel like I bought them a paddle. Part of me is very happy to know that every time they move, and have to find a spot in a box to fit that freaking thing, they will think of me. Hahahaha!

Anyway, the wedding was lovely, and the food (heavy hors d'oeuvres) was great. And they had a completely open bar - maybe I should have spent a little more on a present after all!

Paul and Lauren took waltz lessons in the week before the wedding. It was very cute. 

The ceremony was outside in the "White Garden." Thankfully (as it was freaking hot), they passed out fans as we signed the guest book. Of course, you can't give me a fan and not expect me to stick it on my head. That's just the way it is... 

I think this may be a preview of the expressions of the bride and groom when they open my gift. Except that they WERE the ones that registered for it. 

The cake: obviously the most important part of the reception. (It was delicious) 

Spatulas!

I am going to a wedding tomorrow night of two of my classmates. There are several couples that formed within our class, and this is the first of the couples actually getting hitched.

Seeing as they are two medical students, I suspect that a large number of the guests at the wedding will be fellow medical students, or prior classmates of the bride and/or groom. Which puts the median and mode of the attendees at around 24-26 years old. (Not the mean, however - that gets skewed by grandparents and other elderly relatives) Okay, I am admittedly no statistician, but my guess would be that the average salary (mean) of the majority of the guests will be... let's just say not that high.

Does it seem petty of me then, to question why the cheapest thing I can find on any of their registries is a seven dollar spatula? I have a spatula. Three, in fact. They came in one package that cost me about a buck, if I remember correctly. Granted, mine doesn't withstand heat up to 500 degrees. But then again, my oven doesn't get that hot.

According to The Knot and Kohl's, you should apparently never spend less than $50 on a gift for the happy couple. (Quick math: $50 = 7 spatulas) Hmm. The Knot also recommends taking those college pals into consideration when you do register. I guess I should be happy there are spatulas on there at all. And THEY should be happy receiving a set of spatulas from me.

Hi, My Name is Brenna...

...and I'm a Target addict.

Let me tell you about my secret, super-amazing ability, though. If you give me an hour and a good clearance at Target, I can - without fail - fill my basket with almost exactly $60 worth of merchandise. Without even trying to add the prices in my head. Without even really having an idea of what is still in the basket, and what has been relegated back to the shelf in a fit of Brenna-shopping.*

Tonight, I went to get various sundry good-smelling things (conditioner, deodorant, hair gel, air refreshener refills to cover the summer scent of Mold that has permeated my bathroom, and the like) and ended up spending $60.58. The socks were on clearance! And ALL of the purses. You can't fault me for spending $3.24 on a cute, funky purse, can you? Sigh... I know, I know. I have a problem. Still, though - most of that sixty bucks was on the smelly stuff. So I don't feel too bad.



*Brenna-shopping: Picking up something in one area of Target, finding something else in another area of Target and exchanging the second for the first. Kind of mean to the employees, but Target employees rock, so I think they enjoy my little game. Well, actually they probably don't. But they still rock.

Two Fifty Four

Once, in my on-call internet wanderings, I came across a blog where the guy titled each post with a number. One, two, three and so on. Like they were chapters or something. It worked, because the guy was only on post twelve or so. I wonder if he is still blogging. Will he continue it on to... say, two thousand thirty three? It wasn't the most interesting blog, so I didn't ever go back to it. I guess I'll never know!

After a month away from the hospital, I was pretty worried about getting back into the swing of things, as I think I mentioned previously. I always harbor this fear that I'll come back, start seeing patients again and have this horrible realization that I absolutely despise what I'm doing. Thankfully, I'm finding the opposite is true, and am happy to report that I actually missed seeing patients during my month's absence. Hindsight, right?

The one sore spot (literally) in being back is being back on my feet for so many hours in the day. My feet are trying to rebel - they got very used to being spoiled by sandals and fresh air and sitting. Now they're back in socks and shoes that start out as comfortable-ish and end up feeling like they're made of concrete. Ah, well. I shall overcome and my feet will be beat back into submission. I feel I must send out an ethereal apology to my grandpa, the former podiatrist, for such blatant foot-abuse.

Do you know how close September first is? It really isn't that far away. That is the date that we can start to turn in our residency applications. Which means that I need to get it done ASAP. Susan and I did start our personal statements last night, which is generally the hardest part. I just need to keep up my momentum. I cannot believe it is already time to write another personal statement! Ugh. I feel like I just did this, but I guess it was four years ago. Pbbblt. I'll save you all the agony of reading what I did write last night. I may post it when I have a draft that doesn't make my want to vomit.

You know what bugs me? When almost every sentence in a paragraph starts with the word "I." I guess I need to read a little more Anthem.

Back to the Grind Stone

It was so nice to have a full month away from the hospital. I almost broke out into hives last night thinking about coming back. I guess I'm still too new at all of this to be able to comfortably slip in and out of "semi-doctor" mode.

Today is Day One of Pediatric Neurology. I thought I'd give it a chance, what with my love of both pediatrics and neurology. The only problem - if I do like it - is that you can't do a peds residency followed by a neuro fellowship (like you can for peds cardiology, hem/onc, allergy/immunology, neonatology...) It is an entirely separate residency program. So! I guess I hope I don't like it too much, or that I absolutely love it.

My first impression: it is FREAKING HOT. I guess I hadn't noticed that summer was in full swing, as I've spent most of the last month shuttling back and forth between air-conditioned places in my air-conditioned truck. The five minute walk to school this morning (at 8am!) left me drenched in sweat. Ick.

As far as the actual peds neuro goes... I'll let you know once I actually see a patient. I met the resident, and she told me that last Thursday was a busy day: they saw three patients. So, yeah. I don't think I'll be stressing too majorly this month.

Gives me more time to get started on residency applications (!)

For Better or...

...for Worse...

Well, the test is over - no problems in actually taking it today. Other than the fact that it kicked by butt. I'm holding off a celebratory "yay, I'm done taking tests as a student" blog for oh, about 6 weeks - until I get my score report back. I'm not guaranteeing a pass on this one.

I AM, however, going to purchase a season of Sex and the City at Costco, and maybe swing by Banana Republic to get this shirt I've been wanting. I need to reward myself a little for seven hours of testing hell today, right?!

If It Wasn't Screwed On...

So, this morning went pretty well. I woke up, showered, put on my cute little Test-Taking outfit and got on the road with plenty of time to make it to the testing center.

I pulled in right behind another classmate of mine (who is incidentally, one of the sweetest, nicest, kindest people I've ever met). I mentioned to her on the way in that I had never confirmed the date of my test, and jokingly said "I hope I wasn't supposed to be here yesterday!" We laughed, and took the elevator up.

I walked in and confidently handed my ugly orange testing sheet (which I've been guarding with my life for months now) and my ID. The Kindly Gentleman took my ID and scanned the list. Once. Twice. Three times. There was no Brenna on the list, you see.

I started some deep, relaxing breathing, and my friend started saying all those things you say at times like this ("I'm sure it's okay. Worst case, you have to re-schedule, you'll be fine" etc.) while Kindly Gentleman stepped in to the other room.

See? My test? Is scheduled for TOMORROW.

Good grief.

I was so filled with relief to discover that I was a day early, instead of a day late, that I just burst out laughing. Actually, I am still laughing. It is pretty funny, after all. BUT! I have to go through it all again tomorrow!

And now I really don't know what to do with myself today...

Hold on to that luck and send it my way tomorrow!

T-minus Twenty Hours

Well... That's it. I'm officially done studying for Step 2. I believe that is the scariest part about studying for a huge test: stopping. I was going to attempt to finish all 1500-some Kaplan questions, but I'm calling it quits with 200 to go. I do feel a bit of free-floating anxiety about that, but I told myself that if I did well on the practice questions the USMLE provides, I'd be done. I got a freaking 85% overall! I qualify that as good. Freak occurence, perhaps, but good nonetheless.

Now comes the question of what to do with the rest of my time. I live to study. Everything else I've done this last month has merely been... study break. Soooo... No more studying (no matter how tempted I am to just run through the Cram Pages of First Aid just one more time).

Maybe I'll go to the mall.... Mmmm. Mall....

I was planning on getting a hotel room closer to the testing center, like I did last year, but it would have cost nigh on $120. What am I? Made of money? So, alas, no Drury Inn this year. It means an even worse night of sleep, but at least I'll have that $120 to... spend at the mall... Mmmm. Mall....

Wish me luck!

This is a picture of anal warts. I just wanted to share with you all the image that appeared on my screen as I do Kaplan questions at Panera. I sometimes forget that the entire world is not used to seeing things like this... I hope I didn't ruin anyone at Panera's appetite. Y'all's I don't care about so much. 

Beans, Lots of Beans, Lots of Beans, Lots of Beans

I wish my brain thought up stuff like this.

Since it does not, I shall continue studying... Blech.

The Clinical Skills exam was entirely unremarkable. I was there with Meg, and there were actually two other people from our class there (and twenty complete strangers). I will say that I found it extremely annoying to be ushered around by the proctors going "Doctors! This way, please, doctors!"

I don't know what I found so annoying about it. Perhaps because once you're out of elementary school, people tend to stop referring to groups of people as a collective noun. "Lawyers! Please smile for the camera now, lawyers." "Okay, shoe salesmen, we are going to go here next." Anyway. It was annoying.

The rest of the day was... eh. Pretty uneventful. We are warned not to speak of the actual test, on threat of expulsion from the Medical Licensing thingy. It would be a "Testing Irregularity" if I was to say too much. So I shan't! The lunch they provided was good, though.

Rush hour in Tlanta is icky.

One week until the next Harry Potter! Can you taste the excitement!!!

Yeah, yeah, yeah, the cow is back!

O Mylanta!

I's in Atlanta! Or, as I call it (in my head only) Tlanta. I'm not sure why my brain decided to call it that. It's more fun. Try it. Go on: Tlanta. Not many English words use the letters T and L in juxtaposition that way. Well. I guess there is "battle" and "nettle" and... "wattle" (as in wattle and daub) but they're not quite the same, are they. No. They're not.

Why am I in Tlanta? Ah, yes, those of you with longer memories will remember that a few weeks ago I mentioned that I had to venture to this great city to take an English test. Well, tomorrow is the day!

I am joined in my adventure of insanity by a fellow student (who, sadly, does not have a blog I can link to). We hit the road in mediocre spirits this late morning and drove drove drove. Along the way, we:

1. Came across some really rude people at a Panera outside Charlotte
2. Drove through a monster storm
3. Pulled over for refuge from the storm into an "Adult Entertainment" type store's parking lot.
4.

Okay, that was really all that happened, which, in the end, is a good thing. Uneventful cartrips are good when you actually need to arrive at your destination relatively unscathed and on time.

We met up with another fellow student (and alas, another non-blogger) who has been chillin' in Tlanta while she studies. We went to Eclipse di Luna for a dinner of tapas and sangria. It was PHENOMENAL. I highly recommend it to future (and current!) visitors to Atlanta. Mmm-mmm-mmm. Tapas and sangria. Definitely worth the 5.5 hour drive.

As for the test? Blah-blah-blah. Test-test-test. We'll take it, then we'll be done. We'll most likely pass and then get to drive back up to home sweet home.

Where I fully intend to start messin' with some wattle and daub.

Portland, Schmortland

I graduated from college in 2000. I started med school in 2002. There is a two year gap in there, which I commonly tell people was because I 'couldn't get into med school.' That's only half true. I applied to several different schools over three different years, that is true. I interviewed a total of six times over those three years, at three separate schools. I got into medical school two of those three years, into two of those three schools. Why do I present those two years as a failure then? Because I could not get into the school that I wanted to go to. My home-state school (Oregon) does not like me.

The rejection letter I got from them on my second try (the year I didn't get in anywhere) actually included a comment along the lines of "maybe medicine isn't actually the field for you." Yeah. That's a nice thing to say to a rejected med school applicant.

Despite that, I still do want to go home, and as there is only one med school and only one Pediatrics program in the state of Oregon, I have to set my sights on them.

But, the thing is, I got ANOTHER rejection letter from them today. Preventive tactics on their part? Nah. I had applied to do a fourth year rotation there - commonly known as an "externship" or "interview" (I hate that second phrase - it is four weeks! That ain't no interview) Apparently, the illustrious OHSU is all full. No space for me to come spend a few weeks making sure that they're not all mightier-than-thou full-of-themselves jerks.

That makes FOUR rejections from one place. Am I crazy? Is someone, somewhere trying to tell me something? I feel less and less enthusiastic about applying for residency there. Darn them all.

Well. At least they didn't cash my application check this time.

On a completely unrelated note, in case you were wondering I am worth $1,871,000 on HumanForSale.com

Happy Birthday, America.

Rock on with your bad self. Let's celebrate by crashing a space probe onto a comet 83 million miles away! Sounds like fun, ya? It will totally be like galactic fireworks.

Man, I wish I had wanted to be an astronaut when I grew up. Someone should have warned me...

[hazy edges around your eyes indicate that this is either a flashback or a dream]
Generic adult: Little girl, what do you want to be when you grow up?
Little Brenna: A doctor!
Generic adult: Oh, no, no, no. If you do that, you'll have to study all the time, even on the Fourth of July. You don't want to study on America's birthday, do you?
Little Brenna: That sounds horrific! (little Brenna has a big vocabulary) Maybe I should be an astronaut...?
Generic adult: That sounds much better. You don't get motion sick do you?
[fade to black, indicating the end of the dreamy flashback.]

Alas, poor little Brenna didn't know any better. So big Brenna finds herself studying the day away. Independence day my gluteus maximus.

It is nice to see that I did learn something over the last year or so, though. When I studied for Step 1, it took a long, long time to get my overall average on the Kaplan Q-bank up to 65% (the rumored average you need to get to pass the boards) Right now, I'm at a comfortable 69%, and still have another week of studying to go. In high school or college, 69% is abysmal. Now, though, it is cause for celebrating (bring out the comet probes!) - it means that I have remembered almost 70% of EVERYTHING that has been crammed into our heads over the last three years. Imagine taking a test in your senior year of college about what you learned in freshman philosophy. Sounds more impressive when you put it that way, huh? Or, maybe I'm just trying to make myself feel better...

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Thank You, Chloe

I've never been much of a concert-goer, generally preferring theater to over-priced, eardrum-bursting crazy fests. But even I could not resist the lure of going to an outdoor Dave Matthews Band concert, and that was where I would have been found last night.

As a side note, when I told my sister that I was going, her first comment was "Heh. There is going to be so much pot." which caused me to have a dream about me and Susan having to go to the emergency room, and they did a drug test on Susan, and it came back positive for cannabinoids, and I was trying to get someone to believe me that it was all because we'd been exposed to second hand pot smoke. I woke up before any dream doctors believed me...

Back to the concert. We left with plenty of time to get there by the time Dave should have been on the stage. We didn't account for the fact, however, that the ENTIRE WORLD was going to be driving down the same road at the same time. We got within probably a mile of the venue, and it took us OVER AN HOUR - nigh on an hour and a HALF, even - before we actually got to park. At one point during this adventure of static insanity, a young girl appeared at my window, as if by magic.

Girl: Are you guys waiting in line for Dave Matthews?
Us: We think so...
Girl: So are we. I can't believe this. I'm getting really pissed off!
Us: Ha, yeah, so are we.
Girl [smiles brightly]: I'm Chloe!
Us: Hi... We're Brenna and Susan.

Then she left, and I noticed a gigantic flower painted over her shoulder. I wished I'd thought to paint a gigantic flower on my shoulder...

After another thirty minutes or so, during which time we realized that the parking lot was FULL, a cop finally told us to "just park on the sidewalk up there." She looked quite defeated and exasperated.

Finally, finally, we made it into the Verizon Wireless Amphitheater and saw Dave and band rockin' away. Susan and I wended our way to a spot with an okay view and stood bopping around for a while.

Then, as if by magic, Chloe appeared! (There were like 5 BILLION people there, yet there was Chloe) She informed us that she was in a better spot and took us there. And better it was! In the center, as far forward as you could get with the cheap tickets. Very, very nice. Thank you, Chloe! Granted, this did put us in pot central, but at least everyone was really happy, and neither Susan nor I did, in fact, have to go to the emergency room or undergo random drug testing.

The one last note I have to make is this: I'm getting old. There were definitely people at the concert (not in pot-central) that were older than me, but not all that many. And I spent the whole concert with at least 25% of my brain watching everyone around me making sure that they weren't lighting each other on fire (almost happened), getting alcohol poisoning (almost happened), or breaking bones (almost happened repeatedly) as I knew that Susan and I would be the ones that would have to take control and save the day.

I guess I have a new reason to not go to concerts...!

Blame Susan

This is officially the first Baby of a Friend of my life. How incredibly adorable is she?
 

Regimental

I realized that I haven't written a post in a while, so I decided that I should write something. Then I realized how boring my life has been for the past couple of days! This whole studying thing has taken all the drama out of my life. I suppose that is good, as long as it is only for a few weeks.

This is how my days have been going lately:

8:30 - Get up, cook (!) breakfast (eggs and toast)
9:00-12:00 - Study at home (interspersed with numerous games of Minesweeper)
12:00-1:00 - Lunch, while watching an episode of Faerie Tale Theatre - unbelievably, there were ones I didn't see as a child!
1:00-3:00 - Work out and shower (notice that I spent the morning all dirty and nasty - thus the studying at home)
3:00-6:00 - Study away from home (Barnes and Noble, Panera, Library, etc.)
6:00-7:00 - Dinner
7:00 and on - watch TV, re-re-read Harry Potter (in preparation for July 16th!)

Same thing, day in, day out. How monotonous. And today was only the fourth day of it! I am quite proud that I have kept to my schedule so well. I don't tend to stick terribly well to schedules... I guess because things like this happen - having absolutely NOTHING interesting to say. Isn't it horrible?

Maybe tomorrow I'll throw caution to the wind and... get up at 9! See, but then I'd miss my episode of A Different World during breakfast. What's a girl to do?

In other news, all this working out has made me EXTREMELY sore. Today, instead of going to the Y, I thought I'd take it easy, and merely did a 7 mile jaunt around Salem Lake. Idjit. I can barely move now. Except to type, of course... and to turn pages in my study books (darn it!)

And finally, "Meanwhile Back on the Farm" has TRUE meaning to me after 27 years of existence, now that my "Permanent Address" has changed officially today to my parent's new FARM! They are, as I type, moving out of our home of some 17 years to a new home. It is a mere 6.5 miles away in distance, but it will truly be a new life. My poor mother is stuck for an indeterminate amount of time without Internet OR Television (for some reason the Green Acres theme pops into my mind)... Send her happy thoughts, people.

Deja Vu, Is That You?

Moving beyond my utter shock to find myself already in the third month of fourth year, I have to face that daunting task of again studying for the boards.

Adoring Crowd: But... I thought you took those last year?
World-Weary Brenna: I did.
AC: And I thought you passed.
WWB: I did.
AC [bewilderedly]: Then why...?
WWB: Ahh, you see: last year was only one step in a three-step testing process. Some liken these tests to 'hoops' that must be 'jumped through.' I am currently studying for the second hoo - I mean test. Another long test day awaits me at the end of the month - nine hours this time, instead of eight. Plus, I get the added excitement of driving five hours to Atlanta to take an English test. Officially, it is known as the "Clinical Skills" portion of the exam where we talk to actors (aka standardized patients) to prove that we can 1) Speak English and 2) Know where to place our stethoscope. All for the bargain price of $1420...

Anyway. I do get a full four weeks off to study for Step 2. It is kind of nice to return to my roots, as it were. This is comfort zone, after all. I may not know much about taking care of patients, but I know how to study, my friends.

Winding Down

I am nearing the end of my Pediatrics Acting Internship. Waaay back in first year, when I learned that we had to do two "AIs," the thought was absolutely terrifying. It wasn't until well into third year that I realized that it was not something fully beyond my capabilities. I enjoyed my third year rotation in peds, but it was not my favorite. I was actually a bit disappointed that I didn't absolutely love it. So, at the beginning of this rotation, I felt confident in my abilities, but worried that I'd feel the same way about inpatient peds as I did back in February.

I am happy to report that this rotation has probably been my best ever as a student. I still have a LOT to learn before I can be a confident intern. A lot lot lot to learn. But, in a mere four weeks, I've seen enough in myself to know that I'll be able to do it when the time comes. Even better than all that, though, is the fact that I did not dread coming into the hospital even once this whole month. Unlike all my other rotations where I would cling desperately to those last minutes of sleep wishing that I would wake up to discover that it was actually a day off. I wasn't all gung-ho, get to the hospital at 5 am or anything. But I actually looked forward to certain aspects of it all.

What a relief. There is nothing worse than questioning why I am here. I mean, I question it every day ("I really want to be a doctor? Seriously? Why?!? ") but every day, I get a little more foundation and a little more evidence that this is a good thing.

Plus, I can always retire early and become the film critic I know I was born to be!

Very Disturbing

Okay, like any good 20's-something female (27 now, post-birthday!), I am expert at 'googling' people. Being extra-savvy, I also google myself occasionally, just to see what sort of info people are getting on me. Up to this point, it has mostly been college stuff - with a couple of pretty bad college group pictures that are fun to look at and laugh. But TODAY, when I googled my pretty little self, I find the last entry on the page is a link to SEXY PORN PICRURES

The last time I checked, I was not in any sexy porn pictures. That photo of me from analytical chem lab is anything but sexy. (Unless you're really into goggles, I guess...eew.)

Also disturbing and just plain odd is the entry before the sexy porn pics: it is a link to people with my surname. Included on the list is someone named 'Vagina.' Vagina?!? Hi, nice to meet you, my name is Vagina, but people call me Vag... I guarantee that child didn't find any of those pre-printed pens/keychains etc. with their name on it.

If you are looking for other things to do with Google there are a few fun things. I suppose they are better than e-stalking, too...you never know when you'll end up in porn photos...

Sweat Stain Sunday

I'm on call again... In just over a year, it will really be no big deal when I'm on call. I'll be more likely to be saying 'not on call today.' Which, when I think about it, isn't ANY more exciting to the general populace than me informing them (you) that I am on call. Why did you just read that sentence? Have you no sense? Really, people.

There are all these weirdly sick kids in today. Like the kid whose bicarb is 5 and is just in their room chillin' like a villain. If your bicarb was 5, you'd probably be in the ICU. Odd, huh? One kid herniated their brain last night, so that one is in the ICU. Another kid is this close to possibly going into acute renal failure on top of the dilantin hypersensitivity that is already wreaking havoc on their liver.

Still, with all of this, I find myself yawning and going "Hmm. What a sweat stain of a day." Then I laugh, because I still think that I'm just the funniest thing since sliced bread. But then I remember that sliced bread really isn't all that funny, and in fact, can be quite tragic if the person doing the slicing is a klutz and cuts off a finger or something. Then I start crying because it is sad when people lose fingers. Unless they do it to themselves to get out of going to war by shooting off their trigger finger, which is a stupid thing to do to a perfectly good finger. Those shot-off-finger people must have a hard time doing things like dialing the phone or using a pincer grasp, which would probably get pretty sweat stainy after a while. Ha! Sweat stain... I am funny.

Good grief. I'm tired. Please disregard this entire post.

New Slang

Okay, it is only the middle of my call, and I've already 'personally' (I use the quotes because I am, after all, still a student and still need an actual resident to follow behind me) accepted three patients. That is because we as a team have admitted nine patients. It isn't even midnight, people. STAY HOME!!!

I am taking a quick breather before the next two cases get here (a sickle cell kid and a child abuse case are on there way as I type) and I remembered the BURST of INSPIRATION I had the other day on my walk home.

I have come up with a new slang term. One that is SURE to SWEEP the nation with its brilliantosity. Ready? Okay, instead of saying that someone, or something is boring, we will now refer to that occasion/person as a "sweat stain." Get it? (Probably not, I was kind of tired that day.) No - listen! It is because sweat is body odor - B.O., right? And it makes a ring on people's shirts? Get it? B.O.-ring?

Ack! There goes the pager...

Spread the word people. Call is SUCH a sweat stain.

TV for Geeks

Ahhh... it is summertime. Time for the beach babes and surfer dudes to head out to perfect their tans. And times for geeks like me to retreat to the air-conditioned indoors because the sun hurts my eyes and the summer air frizzes my hair. (Plus the 50+ hours a week I'm spending at work not lending themselves to daylight)

This is the time of year when I really get some good for-fun reading done. I do like the sunshine, I just prefer to be sitting in it indoors with a fan and a Diet Pepsi most of the time.

I also get more reading done, though, because there is nothing on television! Television is really the bane of my existence, and I wish I didn't watch it at all, but that is totally and completely beside the point.

Point being that there are two new shows that appeal to my total geek-ness. It is fantastic! Though I fear it will interfere with my summer reading...

The first: Beauty and the Geek. I fully acknowledge that this is a show executive produced by Ashton Kutcher, of all people AND that it is a show that plays horribly to outdated stereotypes of the dumb bombshell and too-geeky-to-function guy... But it is just so funny! These guys are like... well, like me, really. Pasty white skin and all. Granted I have a tad more social skills than they do, but I still understand them. Them's my people.

The second show: The Scholar which I fully acknowledge is being at least partially funded by Wal-Mart (whose book section is abysmal and whose actual motivation towards 'education' I seriously doubt) But, again, these is my people. These are high schoolers competing neck-and-neck in competitions that are made to make you feel smart! Like the three switches-three light bulbs problem. There are three switches (1, 2, 3) that turn on three lights (A, B, C) on the other side of a wall. With only one trip to the other side, how can you determine which switch controls which light. Think about it... Feel that warm little lightbulb of discovery pop above your head yet? This show is great, because it takes me back to high school, and I'm actually all like "IN YOUR FACE KID!" when I know the answer to a literature question that they don't. Of course, I am 26, but still... I knew Call of the Wild as a high school grad, too!

My geeky heart is all atwitter with the television shows that have been granted to me this summer. Sigh... I'll have to put off reading the rest of the Douglas Adams series for a few weeks...

Music Survey Thing-a-ma-bob

Amount of music on your computer?
After suffering two major computer crashes (before which I had a couple thousand songs), I don't trust my laptop to keep any music. I have probably about 20 somgs on there right now, consisting of the free songs that you can get from iTunes every week... I'd say I like about half of them, which means I have about 10 usable songs on my computer. Rock on!

Currently listening to?
The Tonys! I've been obsessed with the song Hide and Seek by Imogen Heap lately. Who, incidentally, is the lead singer of Frou Frou.

Five songs that mean a lot to you?
This is one of the most impossible questions to answer. Ever. In the history of questions.

1. Cecilia by Simon and Garfunkel. For reasons unbeknownst (good grief! how do you spell that?) to me, I ended up roaming the halls of an empty dorm with the rest of my res life staff a couple of days before the freshmen arrived during my junior year of college. It is just such a happy song, and makes me think of all the good times I had in college. Cheesy, no?

2. Beautiful Savior is a song that will always make me cry. The St. Olaf choir would sing it at the end of every performance they did. I wasn't actually in the choir, having a voice resembling... well, not someone who'd sing in a choir anyway. Christmas Fest every year ended with the whole gymnasium (because God forbid they actually get a performance hall at a school renowned for its music a performance hall) would just resonate with this song. So, look, it is another college song! I should have included Um Ya Ya on the list...but I won't...

3. Jem's They is a song that I could listen to all day on repeat. It just has an infectious rhythm and tune and the lyrics are somewhat political, which is cool. Everyone should have a little social rebellion in their songs, no? This is also a song that was introduced to my by a great friend at a time when I really needed good friends, so it, of course, reminds me of her.

4. The Origin of Love from Hedwig and the Angry Inch is remarkable if only for the fact that it puts Plato in rhyme, adds some music and is then sung by East German transvestite. The first time I saw Hedwig was in Alaska while I was there in AmeriCorps, so this is one of my Alaska songs.

5. Man, I'm on the last already? No fair. In deference to all the songs I've forgotten, I'll leave this one open. I could mention Moondance, Son of a Preacher Man, Happy Birthday, Daisy, Stop in the Name of Love, 5000 Miles, Edelweiss, Pines of Rome... plus more songs that all have memories attached to them. You expect me to choose one memory above the others? Impossible.

Top five albums?
Rarities, B Sides and Other Stuff by Sarah McLachlan.
Lost and Gone Forever by Guster.
Rent by the Cast of Rent.
House Carpenter's Daughter by Natalie Merchant.
One by the Beatles.

Of course, these are just the ones that come immediately to mind. I reserve the right to rescind and or replace any of these at any time.

Last album bought?
The OC mix, volume 2. Tee-hee! It is actually quite smashing and I heart it greatly.

Recent discoveries?
Imogen Heap, Finger Eleven... other stuff...

And the baton goes to:
Melissa Jo
and
My mother, who should get off her butt and start her own blog, already.

Enjoy the Ride

I'm on call tonight. I'll probably watch this video at least twice more before the night is over. Ain't she just adorable? And I love her necklace...

The HORROR!

I tend to like certain scary movies. Not ones that are just all about gore and making you jump just because they can. Movies like The Shining, though, stick with me.

Which may explain why I got chills as I stood waiting for an elevator, and two little girls with brown hair and wearing identical dresses came up. I half expected to be drenched with blood when the elevator finally did come.

Then, on the elevator (the creepy girls didn't get on, thank goodness) was a barefoot, stringy haired, dentition-challenged (aka missing a few teeth) lady holding the hand of her barefoot, stringy haired little girl. She burst into tears and started going off how she couldn't find her children and something about her husband. I half expected to see a man with a shotgun taking aim at me when I finally got off the elevator.

Good grief. Maybe I watch too many movies... I'm just glad these things didn't happen at night!

An Open Letter to Jo-Jo at Capital One

JO-JO, hon, I'm sorry to break this to you, but people at your work (that being Capital One) don't like you. You know?

You may wonder, dear double-Jo, how I, a stranger from North Carolina, (when you clearly reside in the Midwestern part of the country) should come by this information. The answer is simple: Capital One has apparently, in some new-fangled, reality-TV inspired move gotten rid of 'on hold phone Muzak' in favor of just putting the customers on speakerphone so they can hear the private conversations of employees.

Either that or someone pushed the wrong button.

As another note to you, Jo squared, Capital One used to be friendly and helpful, and they would call me when they saw I'd been charged twice for the same thing. Now, it is apparently MY responsibility, AND I get chastised for not calling the merchant myself (good luck getting anyone at Paramount's Carowinds to care), and THEN they put you on speakerphone for five minutes and let you listen to some angsty teenaged Midwestern chick complain about Jo-Jo and apologize to another angsty teenaged Midwestern guy for ignoring him all day. ("It wasn't my fault, you know? I was in my meeting, then at break and I wasn't up here, you know? So, I wasn't, really, like ignoring you, okay? I just didn't see you, you know?")

I'm sorry to crush your world, Jo-Jo. But you've been warned...

Guess What I Just Did?

Ha! I finally took my emergency medicine test! And let me tell you this: I guarantee that there will be people in our class who cheat on this test. They give us two weeks to take it, on our own computers, anywhere in the hospital. Yeah, right, people won't cheat. Geez. I was tempted, and I haven't done that since second grade, when my friend Kelly had mis-spelled some words on her spelling test, and we were grading each other's and I fixed the mistakes for her so she could get 100% too. But then Kelly yelled at me for doing that (what a good seven year old, huh?!) and I have never been able to stomach the thought of cheating since.

I'm glad I'm done. It wasn't like I spent the whole week studying for the freaking thing. I just crammed for an hour before I took it.

Why am I making such a big deal out of this test? Let me tell you: this was the last - the LAST - test I have to take for school. Ever. Ever ever ever. ED is the only rotation of fourth year that comes with a test, and now I'm done with it! Granted, I do still have the boards to take, but that is for my career, not just some arbitrary little test to try to stratify us into 'good' and 'better' categories.

I don't think I've ever used as many italics in one post as I have today. Hmm.

Call last night went just dandy. I stuck around on the floor, did a couple of slightly doctor-ish things. ("Yes, go ahead and hold that Vanc until the blood is in," "He had a bowel movement? Great!") Then things got really quiet, and I went upstairs, watched John Stewart and went to sleep. I didn't sleep well, but I got a full seven hours in the bed... And then I got to be post-call and start the already long weekend early! Really makes me wish I was doing something more exciting than laundry.

Well, at least I don't have a test hanging over my head any more!!

Call On Me

Tonight is my first night on call as an "Acting Intern" That's AI for short. It is supposed to be a fourth year rotation where you act as an intern. Minus the ability to dictate, give orders or have any say in patient care. So, what it really boils down to is that I'm like a third year, but I don't have to go to lectures. And I'm not on the bottom of the totem pole for pimping - the third year has to field the questions before they get thrown to me.

Actually, it isn't quite as bad as I make it out. Everything in peds is micro-managed from the top down (as well as sideways - nurses are ever vigilant for mistakes... as are pharmacists and unit secretaries). I am given a little more freedom and responsibility as an AI. Not a lot, but some.

I am currently doing my AI in Pediatric Hematology/Oncology. We've got twelve patients in right now - some for routine chemo, some with more complicated problems. I am the only one from my team on call tonight. There are two general peds residents on, and it is generally their duty to cover the hem/onc patients overnight (unless a hem/onc AI is on). Here's my dilemma, though: If there is a problem with one of the patients, I want the nurses to call me! I'm the acting INTERN after all, I should be the first to be called. Problem is, when I went out and said "Hi, I'm Brenna, the AI on tonight, here is my pager number in case you have any problems" they all stared blankly at me and continued reading their magazines or gossiping. So I don't think they're going to call me... Which is in some ways good because I can't do anything anyway.

It could be a long night.

Cardiac Risk Factors

::Warning! Warning!!:: HIPPA Violation coming! Beware!

So, not being a very patient patient, I went ahead and looked up the results of my lipid profile. We're technically not supposed to. Which makes no sense, in my opinion. They ARE my results, after all. Why should I have to call someone to tell me what I can just find myself. I don't want to waste my cell phone minutes, after all.

I'm sure you are all dying to know what they are, right? Well, I know at least you are, Mom. Here you go:

CHOLESTEROL (LL) 174 (normal: 0-200)
TRIGLYCERIDE (LL) 109 (normal: 0-140)
HDL-CHOLESTEROL 56 (normal: 30-90)
LDL-CHOLESTEROL 96 (normal: 0-130)
CHOL/HDL 3.1 L (normal: 3.4-5.0)
VLDL-CALCULATE 22 (normal: 5-40)

Here's the problem, though... I am not quite certain what they mean. If I saw these numbers in a patient that I was seeing, I'd be like - "Hey! That's great!" But we don't tend to see lipid profiles in 26 year olds terribly often. Is 174 too high for me? Hmm. Oh, well. It looks good now, and that's all I care about! If I get it checked every year or so, I'll know, right? Of course, that would require going to the doc every year...

Man, is That One Ugly Head

Somehow, I thought that with age, with education and with patience, I would come to a point in my life where I would procrastinate less. Uh-uh. Ain't happenin'.

I am all done with my Emergency Medicine rotation (and all the people go: yay!) except for the test, which I can take any time between a few days ago and a week from now. In an ideal world, I'd take it today, and be done with it, right?

Unfortunately, I woke up this morning, and there was Mr. Procrastination, rearing his u-g-l-y head again (he ain't got no alibi!). See, I haven't really studied as much as I'd like. And I kind of have a headache. And I'm dizzy. And I have to meet with my fellow yearbook managers today (oh - by the way, I'm co-managing the yearbook for next year). And... I just got Empire of the Sun from Netflix, and Christian Bale is so cute, even as a little boychild, AND I had to watch The OC, which I recorded last night, and I've decided that it is time to read the Harry Potter series again in preparation for July 16th, and I'm almost done with a blanket I've been crocheting, I just need to figure out the border and... I just don't wanna take it.

So... hopefully I'll get my butt in gear by Sunday. I don't want to start my next rotation with this looming over me. Honestly, I don't know why I would even bother studying much more. I'm not an honors student (as I've proven time and time again), and the margin for 'pass' is pretty big. I don't think a few more hours is going to do me much good. Hmm. Maybe I will take it today...

Heal Thyself

As a medical student, I would be hard pressed to call myself a 'normal' twentysomething sort of person. These so-called 'normal' people in their twenties, as far as I can tell, are in the midst of trying to figure everything out. I can hold myself as an expert here since I have spent two whole years out of school... (that's self-directed sarcasm, for those of you who have a hard time with subtext) I think those of us in medical school are forced to deal with the whole free-floating anxiety, God-what-am-I-supposed-to-do-with-my-life-I-feel-like-I'm-play-acting-and-I-forgot-my-lines situations (see Dave Eggers, Chuck Palahniuk, Garden State to name a few) either a)early or b)late (leading to divorce, substance abuse, etc. in our middle ages) There ain't no way we're going to get very far if we admit, "Well, I'm not really sure what I want to do, but I always thought that being a doctor would be pretty cool. So I thought I'd give it a shot." To have the ability to tell other people what is wrong with them, and how you are going to help them, takes a lot of assuredness - both at work and in your mind.

Not sure how I got off on that tangent. The point of the matter is, that there IS one way in which I'm like a typical twentysomething: I avoid going to the doctor like the plague. Ironic, no?

I went today, though. And I'm very proud of myself! I'm not even sick! I just went for a check-up. I want to know what my cholesterol is... I'll keep everyone posted, as I'm sure you're just dying to know.

I must say - even though I'm fairly familiar with the whole doctor's office situation now, I was nervous! It makes me feel more empathy towards the people coming in that have NO clue what to expect. For me, going through my history was just like presenting any other patient, albeit a little more personal.

Tonight is my last shift in the ED. Yee-haw! First, I have to finish putting together a presentation on Ludwig's Angina. Factoid: "Angina" comes from the Greek "anchone" which means "strangulation." Nothing to do with chest pain.

Aitch

Today was "Sim Lab" day for the students rotation in Emergency Medicine (i.e. Me) How the emergency room functioned without fourth year med students, I don't know (that is sarcasm, by the way)

I was quite tired most of the day (I blame it on the latest book I've been obsessed with which kept me up until 2am last night). In the middle of our review on causes of PEA - that's pulseless electrical activity, not small green beans - I became inexplicably concerned with how one would spell the letter "H." I know, I know. It makes no sense. WHY do I care how you spell "H?" I don't know.

Now, to something much more exciting: I have only one shift left in the ED. ONE. So very excited. AND, it is in the Peds ED, which means I don't have to talk to any more drug seekers... ever, really. Unless I come across some very precocious children in the future. Or evil parents. Grrr...

The other night in the Peds ED, which was, incidentally the unofficial "Hurt Your Brother and Send Him to the Emergency Room" night, I felt more competent than I have in a long time. This kid came in with a knee laceration (inflicted while his brother dragged him around on a blanket). The attending told me to go ahead and stitch it up. And I did. Alone. NO supervision. And I was good! I didn't fumble around or drop anything. I just... did it. Granted, it was a knee lac, not like a chest tube or anything, but still... It is always good to know that you can talk a young kid through something like that and not freak out the mother by looking like a total clown.

Mmm. I'm hungry. With a capital Aitch.

This picture is the best answer I can give when someone asks the question "How did you end up all the way in NC from Oregon?" I should carry it around with me to point out the injustice of it all. This is actually a schematic of residencies, not med schools. It is also a scary blow to a girl (namely me) who desperately wants to 'Go West, Young Man'  

Some Stories, Not My Own

Grandma Trauma on Graduation Day
This morning, I picked up a "Nose Lac" patient (lac = chance to suture). It was an older woman, and I expected a nursing home patients, of which we see quite a few. Generally the demented/unstable on their feet/not agile with a cane patients that we patch up and send on their merry little way (have I mentioned that I want to be crazy when I'm old?).

Anyway (obviously I don't have what it takes to be a true reporter - get the story all within the first five sentences? Yeah, right), this older lady was very spry - seemed much, much younger than I expected. She'd been at church, had tripped and face-planted a brick column. I was about halfway through my work-up when she asked me if I knew one of the fourth year students. Turns out, she was (is, actually) his grandmother. And today was graduation day! She was in town specifically to see her little baby become a doctor (they're doctors now! SCARY) I promised her we'd get her through as quickly as possible.

Being at the biggest hospital in the area, we get a lot of patients. We also get relatives of attendings as patients - especially kids. They get the royal treatment, usually. They basically just walk right into a room - no waiting - and get everything done very quickly and nicely. It makes sense - they're attendings. They've put in a lot of hard work, and are generally well respected (or feared). I've also seen residents and nurses (especially nurses) get golden glove care. I didn't really know what to expect for relatives of med students... Turns out, they're just as special! Or, at least they are on graduation day. The ENT doc actually came right in when we called him. (Usually it takes...hours)

The point of that whole rambling was that I was happy to see that we med students get some benefit of our time in the trenches. Or, at least our grandmothers do.

Psych Patient Takes Pills, Calls Student
This morning, when I first got to work, I heard a psych resident telling an attending about a suicide attempt patient she had just talked to.

Psych Resident: She kept saying that [name] didn't care because he wasn't here.

This perked up my ears, because we have a [name] in our class, and it isn't the most common of [name]s.

Psych Resident: She said that [name] worked here, but the only one I know of was a medical student that rotated through psych.

Brenna (to herself): Hmmm. Maybe it IS [name]. Fantastic! Mystery time.

[Name]'s good friend was on the day shift with me today, so I told him about it, and he called [name] to find out. (Okay, so it wasn't a hard mystery to solve... I never claimed to be Encyclopedia Brown. Or Harriet the Spy. Or Nancy Drew....)

Apparently, [name] got a call at 3:30 in the morning:

Crazy Patient: [Name], it's me. I'm going to kill myself.

[Name]: {dumbfounded silence}

[Name] got their fiance to call the police, and in an hour long process, the police managed to track Crazy Patient down and brought them into the ED.

Good. God. Can you believe that? Right there is why you should not be nice to crazy people. Especially if you have a name tag on! Crazy Patient looked [name]'s name up in the phone book.

I was not nice to the crazy people. I scowled a lot and sometimes glared. I do not expect to be getting any middle of the night calls.

Student Gets Engaged, E-mails Friends
That's really all there is to that story, but I felt like I should have three stories. It is a nice, complete-feeling number, you know?

Five days left of my ED rotation. Thank goodness.

State of Mind

Saturday morning in the ED is slow. There are only 8 or so patients. I have nothing to say, but I had wanted to blog while in the ED. Just to say that I had. So here I go! Blog blog blog blog.

Ahhh... Satisfaction. (A state of mind, or a Justine Bateman movie?)

I'm going to go read the required article on Dog, Cat and Human bites. For some odd reason, it makes me think of Susan. Why, oh, why could that be?

To Forgive, Divine...

It appears that after all my venting about the ED over the weekend (to anyone and literally everyone who would listen), I don't hate it so bad! Maybe it was an abscess in my mind that I needed to drain... The attendings that are on for the night make a BIG difference. Big. Huge. (I have to go shopping...)

Tonight, in one shift, I tripled the number of rectal exams I've done, managed to not laugh hysterically when one of those patients started yelling "Mama! That lady had her hand in my BUTT!" (this was a full grown woman, not a child), saw the coolest dislocated ankle fracture EVER (the attending whipped out his camera for it) AND I got to do a central line!!!

It was like the heavens opened up and smiled down upon me. Perhaps my cosmic reward for crossing the rectal exam hurdle (it would appear I'm fixating on the rectal exam... Freud would have a field day)

Many a time have I watched a resident place a central line, after which they say some variation of "You should do the next one." Of course, I am never with the same resident twice, so all year, I just kept waiting and waiting. I know the landmarks. I know the technique. I know how to flush the ports, and that we need to get the fancy blue caps. And today I got to do it! So excited was I. AND I got the vein (an IJ) on my first stick. Like butter baby. Awe. Some.

Still not going to go into Emergency Medicine as a field, but at least I'm not getting hives before each shift any more...

You're Going to Feel a Little Pressure in Your Bottom

It's time for me to admit something. It is something that I've kept secret for... well, about a year now. I didn't tell because I was embarassed...ashamed...and secretly quite happy about it. Ready? Until about 2:00 this afternoon, I had never performed a rectal exam. I know, right? A medical student making it ALL the way through third year of medical school (read: The Year of the Scut without uttering the dreaded phrase "Relax, you're going to feel some pressure..." I even did Trauma! Every trauma patient gets a rectal, and all the surgery residents get to do their evil little laughs when they say "Student! Rectal!"

Anyway. I've done one now. That's a relief...

For those of you who have seen me in person in the last few weeks and know how much I despise the Emergency Room (this coming from a girl who has at least kind of liked everything up to this point), I must say: it is MUCH more exciting when there are at least two demented patients, each trying to out-scream the other. (Pt 1: Ahhhh! Pt 2: AHHHHhhh! Pt 1: Uhh-AHHHHHH!) Throw in a third who won't stay in her bed (Pt 3: Hell, hell, hell-hell), and Brenna may just change her tune.

Except that I got some man's nasty trauma blood on my white coat.

Hmm. At least it wasn't nasty fecal matter.

Keep on Swinging...

This week, I'm all about working the swing shift in the ED. That's 'evening' shift to those less into the vernacular. (Heh. Vernacular.)

Last night was my first shift over in the adult ED. I felt totally hopeless. And just when I was starting to feel less than a complete and total idiot (as I usually do during my first day anywhere), the surgeons descended en masse into the ED and started raising a ruckus. It was really quite awful. There were only a couple surgery residents down there (around 10 pm), but my goodness were they rude. Another reason not to go into surgery. A third year surgery resident actually chewed out the ED attending for letting a trauma come to this ED. Uh-uh. Residents don't DO that to attendings. That would be like me telling the resident what to do.

I had to talk to one of the other nasty residents about a burn that had come in. All I did was ask him to go see the patient (his own attending was the one that had okayed the patient's transfer to us) and he about went ballistic.

Ugh. Let's just say that I had a bad taste in my mouth when I left work last night. I'm hoping that tonight will be better...

I did get to help shove a scope up some guy's nose because he'd tried to use a garden hose as a siphon and ended up sucking something into his throat... Another chapter in "Things Not to Stick in Your Mouth."