Tuesday, February 26, 2013

Adventures in flying...

No matter what anybody says, nothing prepares you for getting up to use the lavatory on the plane, and finding the person in front of you breast feeding. Nothing.

Monday, February 25, 2013

Cores: Done

This past week I completed the last of my core rotations, psychiatry, and my last currently-scheduled rotation at Chicago Hope Hospital. (I will be moving up the street to another hospital for the foreseeable future, Chicago Memorial Hospital). This is a very weird feeling. It feels like only yesterday I walked into the Family Practice clinic shaking, terrified, without a clue what was going to happen to me. I walked out of the psych clinic much more confident that I still don't know diddley squat, but I know how to find out, and work, and learn. I completed six rotations in forty-eight weeks, with a maximum of forty-eight hours in between them. It has been a whirlwind. 

Friday night, many of the people I worked with at Chicago Hope Hospital gathered for a farewell dinner. Many of them were leaving this past weekend, and several others are to leave in the coming days. It's a bit sad. Many of the friends I've made will be staying in Chicago, so the transition into electives won't be completely foreign. Here's to a four week recharge, Step 2 CS, and a trip to New York. Beyond that I'm not thinking!!!

Wednesday, February 20, 2013

I...uh...don't know what to say

"My wants go further than a hairy vagina. I need some green!!"

Tuesday, February 19, 2013

Patient QOTD

Patient: "Oh god have you seen how big my ass is?? Do NOT give me Abilify!!!"

Can't say I noticed ma'am, but thanks for letting me know. How about Saphris??

Saturday, February 16, 2013

Today's Lesson...

When your friends come over and you have Garrett's Popcorn Chicago Mix, make sure that bits of the cheddar cheese popcorn do not fall onto the floor. Your cat may try to eat it, and leave you with a yellowish surprise on your rug (mere inches from the bare floor that would've been easier to clean...) the next morning.

Thursday, February 14, 2013

Am I high or stoned? I can't really tell.

In the last two weeks in Chicago the temperature has fluctuated approximately 40 degrees. It finally caught up with my sinuses, and last night I could feel the drip drip clog clog gunky feeling in the back of my throat that sure enough, I was going to feel lousy the next day. Sure enough, this morning I couldn't breathe through my nose at all and my throat felt like it was in a sling. I had some decongestant medication in the cabinet and I took one. Later in the day I was having all the trouble in the world concentrating. My head felt like it was on the ground floor, but my brain was definitely a level or two higher. It was definitely a medication side effect, and I just sat there thinking, as a schizophrenic lady was muttering to the elephants she couldn't help but see, People take this for enjoyment??

Thoughts as of late

I've been doing a fair bit of thinking over the last few months about beliefs and habits and goals. Serious smoke-inducing thoughts that require more than one little hamster running on a wheel up there. I would hardly classify them as profound or as an enlightenment. I would, however, describe having a sense of clarity about many things in my life.

Many of the rules and habits taught to me growing up I find well-founded, purposeful, and beneficial. Many others I never did get a straight answer for why. Nobody had an answer except "that's just the way things are done" and I reluctantly acquiesced. I found myself floating about, somewhat unhappy with the way a select few, though critical aspects of my life were going, why I was doing some of the things I was doing, or even why I was thinking the way I was thinking simply because "that's the way things are done." A lot of that began to change in my early twenties. I did a great deal of traveling (still a passion), had a good job, did the whole medical school thing, and discovered that a lot of people in a lot of different places had the same mindset: that we do things because that's just the way things are done, and are perfectly content with that. I, however, couldn't help but think to myself this is stupid! 

I had this realization that there was nothing keeping me from seeking out things I wanted or felt were better for me than what I was currently experiencing other than my own fear of breaking the mold. I understood that I wasn't happy with a few things in my life, and many of them lifestyles and habits that I had been taught--not values. 

Some of what I am experiencing stems simply from asserting oneself as an individual, and not still a child in their parents' house. That's not an easy step for anybody, and it's the most difficult on a parent.

I read a book recently called Among the Thugs by Bill Buford. While it's technically a piece about Football Hooliganism and its origins and implications, one quote really spoke to me.
"I have so many images for it--this state of being a citizen, of being civilized. I see it as a net that holds me in place, keeps me from falling. I see it as a fabric--a network of individual threads, intertwined, pulled tight--that keeps me warm, that I can wrap around both me and others. I see it as a property, a house, a structure, a made thing, walls to keep out the cold, a door to keep out the unwanted, a roof to protect me from the night and its terrible undifferentiated darkness. 
But I see it, too, as a weight. I see it as a barrier, an obstacle between me and something I don't know or understand. I see it as a mediator, a filter that allows only certain kinds of experience through."

Friday, February 8, 2013

Adventures in Driving....

While driving home yesterday (before the snow, which was rather slushy) began, I got behind this gem of a car/billboard. I can't say that I am particularly interested in finding out what exactly this company? website? group? organization? is all about. Another part of me is morbidly curious.
I just had to bring me car up...(actually I DID. Surgery and OB were just too ungodly early. And psych has me going all over the city. Perhaps after I take Step 2 CK (in friggin' IOWA) I will send the car back to the rents. We shall see. I much prefer the bus.

Thursday, February 7, 2013

My Personal Statement

So, as mentioned, here is my personal statement. I'm sure it will be revised and revisited multiple times over the next few months, but here is the first draft, and I think it sums up my story as concisely as possible. Italics mark my personal comments on some of these experiences for this page only.

What it means to me to be a doctor started with a seed planted when I was eight years old. I found myself unable to see the board in school, and my mother took me to the eye doctor because she and my teacher thought I might need glasses. My mother bypassed the optometrist as my family has a host of eye problems, and instead took me to our family’s ophthalmologist. I went into the appointment very unsure of what was going to happen (I had never seen most of his instruments), and upset with the prospect of having to wear glasses because I was afraid I was going to be made fun of by my peers (a concern long since abandoned). Dr. Eyeball assuaged my concerns. He told me that there was nothing wrong with me that I wasn’t any different than anybody else just because I might need glasses. In the end I did need glasses, but I was no longer concerned after Dr. Eyeball examined my eyes and put to rest any concerns I may have had, and answered what must have been dozens of questions, many of them unrelated to me and my eyes.  I realized then that being a doctor meant more than poking frightened, screaming kids with needles and drawing smiley faces on their arms with a PPD test to follow (my pediatrician's staff called it the Bunny Nose, how morbid). I couldn’t articulate my thoughts at the time, but I was fascinated and relieved to know that there was someone out there who could make me feel better, just by talking to me, answering my questions, and doing his job.

Fast-forward through the years, and the seed that had been planted kept growing. Encouraged by my family to explore my options and know what I was getting into, and know that I could actually do the job, I spoke with doctors, and I wasn’t intimidated by what they told me about the hard work. I delved into the sciences in school, and found that I enjoyed them, even though they required more work, more effort, and more time. I found work that rewarded me with a sense of fulfillment and completion. I shadowed and interred with the same doctor who inspired me many years earlier, Dr. Eyeball. In college, I spent several hours every weekend in the emergency room and outpatient surgery rooms. I was given many tasks that brought me close to the patients and many of them told me their stories. Many of them just wanted somebody to listen to them. I learned from many of these patients that I liked work with them; that I liked listening to them; that I wanted to make a difference.

I was placed on a wait-list the first year I applied to medical school. I found work as a chemist (my initial training). I was good at it, but I wasn’t challenged. I wasn’t engaged. My work didn’t seem to fulfill any purpose. The desire and drive to go to medical school did not go away, despite a lot of free time, a steady pay cheque, and a relatively stress-free lifestyle (I had a great deal of fun, but found that much of it was "fun" for the sake of doing something because I had little else to do. Living in a relatively remote area did not help my spirits most nights of the week, and I found myself quite unhappy). I found I wanted to be busy. I wanted to be pushed. I wanted more responsibility. I wanted to interact with people and patients, not an endless line of graduated cylinders and Erlenmeyer flasks. I still wanted to be a doctor, to make a difference in that person’s life who is unsure of themselves; who is unsure of what may be happening to them; who needs to know that somebody wants to help.

With this in mind and in heart, I applied again, and found myself on a journey I never could have imagined. I worked harder than I thought possible, and came through the experience with confidence and self-respect that had been sorely lacking before. I was taken to two countries, several states, and made countless new friends, acquaintances, and memories. I learned that my colleagues’, my patients’, and my friends’ experiences were different, but no less valid than my own (that really was a huge lesson for me to learn, and I did not learn it at home). Learning this lesson, I feel is the biggest step to becoming an effective physician: to listen, to accept that what may not be mine, but is still real, is still true, and that my patients are real people that I can learn from while at the same time helping them. I find that being with patients every day makes a world of difference for me. I enjoy getting up early and going to the hospital, simply to do my job. I found that I want to do it every day and have it be my job. I want to be that person. 

Tuesday, February 5, 2013

Cuz shut up that's why!

Eight months (EIGHT MONTHS) before residency applications are due to the begin my school has us filling out a questionnaire full of what I find to be rather silly questions. But they didn't ask me about the questions or whether or not I would actually like to fill the bloody thing out, so here I am. Yet again, answering this question: Why do you want to be a doctor?

I will post my actual answer after I actually write it (again). One would think that after answering this several times (but the answer changes the further along into the quagmire you go) it would be easier and would not require at least a page. In short, it does not. Sometimes I just want to say "Why? Because shut up that's why!!!"

Monday, February 4, 2013

Good morning!!

Who doesn't love to see a snow plow barreling toward them on a one-and-half-lane street with nowhere to go. Good morning snowy Chicago.

Sunday, February 3, 2013

Miss Thang

We had a patient come to the outpatient substance abuse clinic. From the moment this girl walked into she had "Hot.Mess.Express" written all over her. She barely wasted a minute. She had relapsed on her alcohol abuse, didn't want to go to meetings because she didn't want every one (at an AA meeting...) to judge her for relapsing, she was constantly having problems that weren't hers at work, and on and on and on. At one point she was so adamant about not going to her meetings because she would be judged the doctor interrupted her and said "That's bullshit. You're making excuses."  All the while she is basically lounging in a chair meant for sitting (say hello to your inevitable back problems in fifteen years) and wore enormous sunglasses, and would not take them off. It was somewhat difficult for me to concentrate on what she was saying because these sunglasses were each the size of Montana. All I could think of was Miss Thang, you aren't Anna Wintour, please take off those giant shades.

After she walked out, I looked over to the doctor and mouthed "Borderline." 

"Yup. Any time a patient pisses me off, there's a good chance they're borderline. Don't get sucked into that."


As psychiatry has allowed me significantly more time to take care of not only personal matters, but academic ones as well (ie I actually have time to read about all this stuff being crammed into my helpless little medical student brain) I have been able to attack, with relish, the stack of books that I inevitably collect. My current book is County: Life and Death and Politics at Chicago's Public Hospital by David Ansell. It details many of the conditions, changes, and continued changes faced by John Stroger Hospital of Cook County (still colloquially known as "County").

Many doctors and medical staff recommend that students read The House of God. I've read that and do agree that it is an important read. I feel, however, that it is a little outdated, though no less relevant to learn and understand. The book was a seminal work in influencing some of the recent reforms made in the last few years toward the work environment residents and interns are placed in. As such I'm always on the lookout for new material, and County is now on my list!

Saturday, February 2, 2013

Awesome day of outpatient

Psychiatry is proving to be a real riot.

We had an autistic patient in his twenties. We heard him coming well before we saw him. Apparently one of his few means of communication is to scream. The doctor had to have him wait in the car with his handler in order not to agitate the rest of his patients. Totally understandable web one considers that half the patients are schizophrenic and bipolar. When it came time to see him, he again began to holler before settling down. His handler mentioned that he frequently liked to drop his pants, at which the patient began to laughingly mutter "Pull down da pants pull down da pants pull down da pants." To which the doctor replied, "No, you will keep your pants on." Then he started to do this crazy dance involving gyrating his hips, which he thought was the funniest thing in the world.

Afterward, another patient came in with what is termed IED, Intermittent Explosive Disorder. This patient was also clearly autistic, but had very little language impairment. He did, however, have significant cognizant and behavioral problems. His nurse told us that he had had his shoulder and wrist dislocated by the patient, and that the patient also bit his father's hand in a tantrum. He talked with us for a while, and he could clearly quote just about every Disney movie ever made. It was impressive. And a good day at the outpatient clinic. We were even provided lunch by a drug rep (always a plus to save a few bucks!).