Medical School

So, I've been busy. My boyfriend and I are moving in together, and we have spent the last bazillion weekends or so looking for a place to live that suits us both. FINALLY we found a great one that is hugenormous with almost hilarious ammounts of storage. Good thing, too, because the other night I organized ALL my yarn (even the stuff lurking in corners) and found that I have a LOT. Here is the picture of my closet. The brightly colored buckets (orange, pink, turquoise and purple in the upper right corner) are all yarn. Then there are two small clear ones that are yarn and equipment (needles, etc). Beneath those are two large clear buckets that are yet more yarn. The darker purple and green bins on the right are NOT yarn. The bag that says "thanks" is an almost finished Lace Leaf Sweater that I think I'll finish tonight. I have as much yarn as some small stores that I have been to. Next year, NO NEW YARN. Yeah, right.

Honey, if you are looking at this web page, just remember that our new place has 3 bedrooms and YOU PROMISED I COULD USE ONE FOR YARN.

Another thing that was a big deal around here was the youngest sibling in my family graduating from college! Congratulations Baby Brother. As you can see, Baby Brother is, not unlike my new apartment, hugenormous. He is such a loveable guy, and he got the biggest cheer during graduation of anyone in his class. It was great.

I'm almost done with my 12 week internal medicine rotation, THANK GOD. I'm almost done with Third Year, which is also a nice thing to think about. I'm tired. This has been a long year. Medicine was exhausting and hard, but ultimately very rewarding. I'm ready for fourth year, which everyone says is very, very fun.

Before I started, I was concerned that I actually hated adult medicine and only cared about pregnant ladies and kiddos as patients. But I was wrong. What I've learned about myself is that I really love almost every patient that I've had. Sure, there are some nutcases, like the lady whose husband wanted us to give her all her pain medication in pill form to take home...I think he was selling it on the street. And then there was the middle aged guy who did nothing but lay in bed at his parent's house and drink vodka. Let me tell you, your liver is not happy when that is all you do. But for the most part my patients have been amazing, and I have learned far more than I thought possible simply by showing up every day and talking to the attending physicians. I also did lots of reading, of course, but the learning that has happened has mostly been on the go, which is the kind that really sticks with me.

I'm working on some things, and will update the sidebar with pictures soon. Sorry about my epic absence. I missed the comments that I get, even though I don't really get that many!

So I made this kick-ass sweater for my boyfriend's 30th birthday, and of COURSE, I was so stressed out about starting my Medicine rotation, and about whether the sweater would fit him, that I don't have a single picture of it!!  I have this picture of the yarn, Bartlett 2-ply color Bronze, but not even one shot of it knitted up.  

Fortunately, my bf's mom took a picture of him wearing it, I'll have to get her to email it to me. It fits PERFECTLY (after an aggressive blocking to stretch what were originally too short sleeves), it looks really nice, and best of all he loves it.  He said that it was amazing, very warm, and taht he was very impressed with my skills. 

Things around here are changing! First of all, I bought this book: Happy Hooker and it turns out, I kinda like crochet! Maybe it is Debbie Stoller that I like. After all, Stitch and Bitch the original was what turned me from someone who liked knitting a lot to someone who thinks about knitting while I'm sleeping! I don't have great pictures yet, but I'm thinking of using my ridiculous Lamb's Pride stash to make some kind of granny square throw, or maybe a cute flowery scarf, or maybe both! I like the way crochet LOOKS more than I like actually crocheting, but it is something that I think I'll work on. My mom is trying to remember her old skills in crochet, so over my spring break my plans are to go home, hang with the folks and crochet with my mom! Yay.

In true me fashion I have actually come to really like Psych! I hope I'm not disappointing all of you medical type supporters who wrote in and told me that you hated it too! Maybe it is because my attending is WONDERFUL. He is so kind to the patients, and is very reasonable in his treatment plans and what he is willing or not willing to do to these fragile patients. He also has that amazing ability to joke around in a way that is stress-relieving and funny, but not at the expense of our patients. We laugh more at the ridiculousness of the situations that we see on a daily basis. It is a protective measure, because although the locked ward has grown on me, it is still a difficult place to be.

I have been knitting a lot, but most of it on a secret project that can't be displayed here just yet. I finally finished the bottom of Eris, but can't seem to get motivated to knit the sleeves! I'm working on this pattern in this yarn, and LOVE both. Pictures soon, I promise.

I have been planning for next year a lot, and electives are starting to fall into place.

I hate to say it, but today while at OUTPATIENT Psych, I found myself yearning for the fun times of the locked ward.  I don't like my outpatient doc too much.  He was one hour late, did not give reason or apology for said lateness, and AGAIN answered his cell phone while in the middle of a patient interview.  NOT COOL.  It actually makes me so mad that I had a hard time concentrating on other things.  During the day I get more and more angry, and start to think about throwing things and hurting people.  Psych is giving me psychiatric disorders.  I came home sad and angry, so my roomate's boyfriend made me drink bourbon and dance around their room with him.  It helped!  

I have been dreading psychiatry. I get nervous around aggressive, unstable people, and for some unkown reason I often attract more than my fair share of attention from people like that. They can smell my fear, I guess. Today was my first day at my outpatient site, a locked ward in a small hospital. I walked into the ward, and it smelled like piss and some lady was screaming, "Help me" over and over again. Then, I was assigned to my first patient. Guess what his deal is???

He's been punching people.

Some advice from my attending: "He's slowly getting better. He has not punched anyone in the last few days. You can tell when he gets mad, he gets a dark look in his eyes. Watch out for that look. Also, don't go within arms length of him. And if you wear glasses, take them off so if he punches you, he won't hit them and break them. And take your keys off from around your neck."

Guess which future doctor career I WON'T be choosing?!?!?!

Yesterday was better, I got to scrub in on a C-section and got to deliver the placenta.  Now, I read Kristin's blog, and someone commented about how you don't "deliver" the placenta, you help the mom do it.  Normally, I totally agree with that, but C-sections are not the most physiologic things on earth.  In fact, they disrupt the benefits of birth.  NOW, don't get me wrong, my mommy had me by C-section, thank GOD, so I have a deep admiration and appreciation for the women who go through this freaky procedure.  

But, having said all that, I do think it is fair to say that I delivered the placenta yesterday, since I stuck my whole hand inside the lady's uterus and "swept" the placenta out with my hand.  Very weird, very cool.  So far, I'm liking OB a lot.  The one thing that really bums me out is that once the munchkins are born, I don't really get to pay a lot of attention to them.  I wish I could HOLD them, they are SO freaking cute.

one more thing: one of my patients is on bed rest until she delivers, which we hope is NOT soon, her baby needs to cook a little bit more.  I went in yesterday afternoon and she was knitting a pink baby blanket!  After rounding with the attending, I came back to help her figure out her pattern.  She was picking up knitting after 20 years of not knitting, so she didn't know what YO and K2Tog means.  I'm excited to see her progress today. 

Next entry: the Fall line up!!

Today was the first real day of my Obstetrics and Gynecology rotation. OB/GYN is something that is high on my list of potential careers, so I am very excited about the next 6 weeks.

I am starting with 2 weeks (well, more like 1.5) on High-risk obstetrics, which as I learned today, could also be called "Sadder OB." The moms and/or babies have more issues, and as a result, you don't always end up with the result that we all imagine when we think of delivering babies. Happy mom, teary eyed dad, rosy fat baby bundled up like a little burrito in the bassinete.

I saw a stillborn baby today. This baby was a twin. The other was healthy, this one was known to have an abnormality that is often fatal immediately after birth. The first baby came out yelling and turned a happy baby color right away. This kiddo was angelically perfect in every way. The room feels alert and energetic when a happy, yelling, healthy baby comes into the world. There is a buzz, and even the tough attendings will coo and sigh.

The vibe totally changed for the next little munchkin, a silence fell over all of the doctors, residents and med students as they pulled the much smaller twin out. The fourth year med student valiantly suctioned, and we all were silent, as if willing this tiny creature to do something to break our hush. Almost reluctantly, the attending broke the silence to talk to the mom, telling her that the things we saw on ultrasound before the baby was born were visible on the baby now. She told her that she wasn't sure about a heart beat. The mom and dad began to cry. Although they were prepared, they were hoping that their baby would live for a few hours so that they could spend some family time together. Looking back on the fetal tracings, we realized that what were seen as two baby hearts beating was just the one, and that the little, sick twin was probably not alive when the mom came to the hospital today.

Was it worse for the family this way, or easier to lose something you never saw and only felt moving? Would an aggresive monitoring have caused little baby to be born alive? Would it matter? I wish I could have spent more time with them, as a fly on the wall, to see how they managed their grief at the loss of one, but joy at the health of another baby.

I'm closing in on the home stretch with my surgery clerkship! I had my oral exam yesterday, which caused me some worry and nightmares (typical for me when I'm stressed), but was pretty straightforward. All the reading and thinking and staying up all night evaluating surgery consults in the Emergency room has paid off--I can think like a doctor now! At least for some things. I know how to make a differential diagnosis (list of what may be wrong), and what tests and studies I need to order for my patient. Of course, I'm best at the surgical cases, and I'm looking forward to learning about the same things from different perspectives.

I was on call last night, which was very busy and exciting, and then this morning I went over to see a surgery on a newborn. I was tired, but it is not something you see every day. I can sleep later...right? Baby is doing well.

So I'm doing Pediatric surgery right now, and it is a lot of work, just like all the other surgery rotations. I'm the only student on a service that usually has two, so I'm there extra early in the morning to write down all my little patients' vitals, med lists, etc. Here's a secret that is not so secret: I LOVE KIDS. I think they are hilarious and awesome most of the time. I'm having a lot of fun talking with these little guys in the clinic either on their way to a surgery, or recovering from a surgery. I also really like checking in on them, making sure things are fine, etc. I tend to worry about them when I'm not around, and I get really happy when they are doing well. Most of the time, their parents pick up on the fact that I'm in love with their kids. Some of the parents we see, however, are so ridiculous that it would horrify you all. Example: a kid came in to clinic after an operation last week. He was looking and feeling rotten, and we were pretty sure he had some kind of infection/abscess going on. He needed to be admitted (for serious antibiotics) and get a CT scan. When I first went into the room, his mom was really annoyed with me, and kept pointing out that he was feeling really bad. I agreed readily, and thought she was just very upset. THEN, when we told her that our plan was to admit him, take him to CT and find out what was wrong, she heaved a big old sigh and said, "You mean we have to wait around here again?!" Um, lady, your kid is SICK! You just TOLD me that! I care that he's sick! I want to fix it and make him feel BETTER!

This weekend I'm off to a wedding 5 hours away!  Sad thing is that I'll probably spend more time driving to it than actually with the bride, one of my best friends who is on a leave of absence from my med school.  My poor boyfriend hates weddings, but he's being a real trooper and coming with me.  I'm planning on sneaking in lots of study time between my bridesmaidenly duties!  Next week we have a big practical exam where we evaluate fake patients, then a written exam that is allegedly insanely hard.  50% is passing grade nationally.  Yikes. 

Finally, socks are sooo close to being done. Can't wait to not be working on them. I like the yarn, I like the pattern, I like the IDEA of making them for someone else, I just don't like that I can't put them down to start something else because they are due...today!!

So, vascular surgery is over, and I'm actually sad about it. They really liked me a lot, and on Sunday after morning rounds, one of the attendings called me into his office. He started out by telling me that I did a great job, and then he told me that surgery is my destiny, and that I'm so good at it that not doing it would deprive the world of my surgical skills. On the one hand, this is a really wonderful thing to hear from someone who is clearly very quick to judge students. Hearing that I'm smart and hard working and talented is always really wonderful, and I'm glad that my work and studying have paid off.

I went to my boyfriend's house later that day, and told him about what the doctor had said. He thinks it is great that they liked me so much too, but he asked me, "Are you sure THAT is your destiny? What about other things?" He's referring to the fact that I'm the kind of person who has always known that I want to get married
and have children. I would like those things to happen sooner
rather than later, I want to be young enough to really enjoy my
kiddos, and although I'm sure child care will be a part of my life, I want to be around enough to watch my babies grow. I thought it was funny that my boyfriend, who hates thinking about babies and weddings, was the one reminding me of this!

I DO like surgery, perhaps vascular in particular because the patients have very complex medical histories that need to be taken into consideration when planning for major operations. But do I LOVE surgery enough for it to be my life--more so than family? During our conversation, the attending mentioned another female surgeon at our school who I really like. She's tough but fair, is great at teaching med students, and really nice to her patients. She is 42 and just had her kids, by IVF. This is not how I dream of my future. I'm trying to keep my options open, and I have many other rotations to come. We'll see...

In sock pal news, I've been scrambling to catch up after not knitting for the first 6 weeks of my clerkship. I made it this far:

And then realized that I was totally delusional, and that the sock would only fit a midget. OOPS! Frogged that one and started again with this, one size up on the needles (2 instead of 1):

Gotta stay focused on this, I can't ask for an extension, can I??

Here I was thinking Vascular Surgery was going to be all tough. Well, it IS tought--get there at 4:30 am, don't leave until 8:30 most nights, stay post-call and do 5 hours of surgery. I've only been really yelled at once by the big head honcho, but everything he said was true, and now I don't do those things as much. Plus, I've learned SO much about being a better presenter of my patients, knowing many things about them and being definite with my "Plan" for that particular day of hospital life. I almost think that the two main docs LIKE me!! I'm interested and hard working, and they appreciate that. Still, at the end of next weekend I'm switching to anesthesia, which is like a mini-vacation of kindness and relative abundance of sleep!

Last night, though, was awful. I was on call, and things were moving along smoothly, until my friend and I got emergency "get your asses down here" kinds of pages from the resident on call. There were 5 simultaneous traumas coming in to the ER. A drunk driver smashed into a family of drove them off the road, where their car rolled twice. The mom and dad were in the main trauma bay, the kids were okay enough to be in the pediatric ER, which is kinder and less scary than the trauma bay. The driver was also there in the trauma bay, so we were running three traumas at once! I've never seen so much organized chaos, and so many people. The drunk driver was pretty much just fine, the dad was not so bad, but the mom not so much. 

The thing about trauma is that you don't have time to feel stressed or upset or angry or grossed out. You just do whatever the trauma chief tells you--in my case I was in charge of recording the physical exam for the drunk--they yell out things rapid fire about his eyes, ears, spine, legs, and I write them all down. It is a good job for med students because it is hugely important, but doesn't require us to know exactly how to manage a bleeding head wound, for example.

I was fine with all of this until I started to realize what was going on: the dude I was working on was the one who caused all of this chaos!! One of the chief residents, John, put me in charge of getting him to X-ray and then to the CT scanner. While he was getting some x-rays, I looked down the hall and saw the two kiddos sitting in one of the hospital crib things. The poor things were hanging on to the toys they give you for dear life, with vacant expressions in their eyes. Then their aunt and uncle came, which perked them up a bit, but they were still very focused on where mommy and daddy were.  For the FIRST TIME yet during this clerkship I almost lost it. I really thought I was going to cry.

My friend came over to ask if my patient was done in X-ray, and I looked at him and said, "I don't care!" I wanted to leave the patient in the middle of the hall and walk away. Of course, I didn't, but this morning after 1.5 hours of uncomfortable rest, I still couldn't get that feeling out of my head.

Thank goodness then, for packages in the mail!

My SP is the coolest! It all came wrapped in green tissue paper: Barbara Walker's "Treasury of Knitting Patterns," a big yummy bar of dark chocolate, some sour Altoids, a pretty card with a very nice note, and two bracelets from Working Assets and The One. Oh, and a really lovely lacey knitted bookmark that I think she made herself-IN GREEN! Oh the abundance of goodness, and how it soothes my sorrowed soul. Thanks SP, you ROCK!

Then some stuff from Knit Pixie. I've not bought yarn for about a month, and had a yearning the other day. Some was on sale! And I think I had a hunch that I'd need some yarn love.