Wednesday, October 21, 2020

he for she

Read this the other day, about how female voices are routinely ignored in the OR, but when how when women are sufficiently assertive, they receive negative feedback.  How historically the "solution" has been to teach women how to talk more like men, but why that doesn't really work, and at the same time, shame women who do assert themselves for not being sufficiently demure.

I have so SO many examples of this from training.  From my first year as an attending.  Part of being an attending anesthesiologist is to use your words to argue on behalf of your (often unconscious) patient.  To argue for more testing preop if it is merited, to tell the surgeon that something they want to do is unsafe, to correct a trainee when they do something dangerous, and to resuscitate a patient and lead a team if that is necessary also.   If you're not assertive enough, you get mown over and the patient suffers.  If you ARE assertive enough someone eventually complains that you were a bitch and you are told to tone it down or (lol) sent to executive training (if you're lucky) to learn how to be more "effective," or to anger management if you're not lucky.  

I sometimes wonder what it would feel like if when I entered the room, people assumed I was the one in charge, or if I knew that I would be listened to, just because I said something in a normal tone of voice.  

Anyway, read the article and let me know what you think!  

In other news, U of M has instituted a stay at home order for undergraduate students.  People are SO upset about this, but... in reality they can still go to class if it is necessary for the class, still go outside to exercise, still go and pick up food.  Mostly, this is an attempt to try to curb the partying, and to keep CV from spilling out from the undergrad population to the wider community where it is likely to do a lot more damage.  I also think that given we are supposed to have a football game this weekend, this was an attempt to curb the inevitable superspreader event that was to become because of Big 10 football related festivities.  Kids can actually choose to go home, but have to be COVID negative first so that they don't kill their parents.

I honestly have no problem with this rule.  While it is true that students were most likely brought back on campus for financial reasons (so the university would get rent and tuition money), the vast majority also wanted to come back. Now that they are here it has become obvious that the CV cannot be contained, AND that it's not spreading primarily due to in-person-class interactions.  I personally think that having football is stupid, but 1) I mostly feel bad for the athletes, and 2) since they are having it, this is probably the best risk mitigation strategy they can come up with, short of re-cancelling the season, which would (I am guessing) be financially devastating.  I also wholeheartedly approve of the COVID testing before they go home, though I suppose it's just a matter of time before some entitled rich student / family has a tantrum about that and demands to go home without doing this, and kills a couple of people.  

But, anyway....


Tuesday, October 20, 2020

stupid admin

In the area of stupid admin that wastes hours of your time, yesterday Luca got a call from the car insurance company asking him if our health insurance covers auto accidents.  I mean, why the hell wouldn't it, right?  How is this a question?  And how would you even figure something like this out? 

Apparently this is because of a unique-to-Michigan law.  One that I don't understand.  At all.

Well, anyway.

Of course the answer is different for me and Luca than it is for our au pair who has different insurance.  So to find the answer he had to search the insurance website and contact our au pair's cluster coordinator, who naturally had no idea what we were talking about.  

So.  It turned out our insurance does cover this, and hers does not.  Off the top of my head, this seems completely obvious.  Our insurance = good.  Her insurance = terrible.  However he didn't feel comfortable providing the non-researched off the top of the head response, and, quite frankly, neither would I.  So he wasted three hours of his day trying to figure this out.  This, understandably, left him quite pissed off.

So, dear internet, what bullshit administrative task have you wasted time on this week?



Monday, October 19, 2020

Things I am loving

Ok.  Let me just say this.  After a full night of catchup sleep, I feel so much better.  SO MUCH.  I can't even describe it.  

I had a research orientation meeting this morning which was very useful.  The power points they distributed are a literal treasure trove of resources.  There was so much information it was a bit overwhelming, actually.  In addition to that, I also managed to get a number of important emails sent, wrote 4 resident evaluations, scheduled a bunch of meetings, and set up online access to a local bank account that will enable us to do transactions requiring things like cashier's checks locally.  I don't know why it's so hard for me to get off my butt and move these things forward sometimes, but it is.

I wanted to share with you all (dear readers) things that I have been loving lately.

1. Fall foliage and weather.  Yesterday the air was crisp and dry, and I went for a long walk with a colleague around my neighborhood.  It is so beautiful here this time of year!  It was about 55 degrees yesterday, which was perfect for a long walk.  All of these pictures are less than a mile from my house and when I go for walks, pretty much the entire walk is like this.






One day I hope to have time to drive through the tunnel of trees in Western Michigan.  Also Mackinac island, the Eastern shore of lake Michigan, the upper peninsula, the beaches of Lake Huron, or the Christmas store in Frankenmuth.  But those are things to do next year maybe, when I have some vacation again and things aren't so freaking crazy with COVID.  

2. Our fridge is now at least partially overtaken by another prosciutto my husband bought. Below is a prosciutto, mushroom, and mozzarella sandwich my husband made yesterday on ciabatta bread he ALSO made yesterday morning.  Miss Boo thought it looked delicious as well. 

3. My Bogs slip ons.  So comfortable to wear, and easy to get on and off my feet.  Very convenient for our muddy dirt roads.  Now I don't have to let a little rain deter me from walking outside!

4. The Enola Holmes movie that's out on Netflix.  Dylan liked it too.  I kind of want to watch it again.

5. Indian food from Cardamom.  I especially liked the Lamb Korma which -- this is the description: Braised boneless lamb and spinach in a creamy cashew - almond sauce.  

6. Dry shampoo.  I never had much success with this in Philadelphia, my guess is because the air pollution clung to my hair and made it just plain dirty, and not just greasy.  Now I've been going 3 days in between shampooing, which is such a time saver since now that my hair is COVID-long, it takes forever to dry.  I have no idea what kind I have, but like many things I ordered it from Amazon.  

7. LIIFT4 -- While on one hand I don't feel like I've gone up in weights, the workouts still leave me sore and tired, so they must be doing something, right?  I'm on week six now, and starting to contemplate what program I will do after this.  Lifting regularly has seriously been such a help making my OR days less exhausting, the only problem is when my legs are so sore that I have trouble picking things up off the floor.  Lol.  

8. Modified Halloween plans.  Next weekend we are going to do a candy hunt/scavenger hunt and pumpkin carve with our neighbors.  I am terrible at planning things, so hopefully it will go ok!  Dylan's Halloween costume from last year still fits, so that is good.  So, yay?

Things are progressing slowly but surely on all fronts.  Trying to maintain the perspective that I am going somewhere even though it doesn't feel like it sometimes!

Sunday, October 18, 2020

Sublimate

I had a series of nightmares last night which, I think I am having a lot of anxiety about things going on.  In one, I dreamed that I never received my new MI license in the mail and I had to spend a day on the phone sorting this out getting passed around between people.  In another, I dreamed that the nurse complained that I was rude during our little PPE interaction and that I got in trouble over it.  I did not dream about a surgeon yelling at me thankfully.  I think I need to work on sublimating my feelings of anxiety about these things because clearly it got to me this weekend.  Any suggestions on how to do that?  Getting a massive amount of sleep last night seems to have helped significantly though. Wow.  I haven’t slept until 9 in YEARS.

We do have water in the house again, and can use all bathrooms, which is amazing!!

Also we watched the Enola Holmes movie last night and Dylan really liked it.  I was surprised!  I thought it would be too grown up for her, but I was wrong!  

Oh and my covid test came back negative since I caught Dylan’s cold too.  So that is good.  She is almost completely better too, so if the neighbor wants to play I plan on letting her.  

Today I’m meeting up with a friend and going for a walk.  I’d also like to get a bit of work done, and exercise.  For now, I am going to sit on the couch with my family and watch the SNL skits from last night.  

Happy Sunday!!



Saturday, October 17, 2020

A lot

The last 24 hours have been a lot.  I know I am not unique in these feelings, but I am longing for a time where it doesn't feel like there is constantly some crisis we have to deal with.  

I came home last night and there was a literal waterfall from a new place in the ceiling despite not having used water most of the day in any bathroom.   So we called our landlord and basically demanded that he call an emergency plumber in the face of heavy resistance because, "Why can't we just wait until next Thursday when the original plumber was scheduled to come."  The plumber arrived about an hour later.  He ripped out the ceiling that had just been put up where the old leak had been and... SURPRISE!  We found that the guy who had patched the ceiling from the last leak had accidentally put a nail through the supply line, and there was water basically everywhere running down the walls into the basement, under the floor, as well as through the ceiling. 

I am delighted the problem has been identified.  However we had to shut off water to the house, which is annoying.  Also, the damage is so extensive that the wall and possibly also the floor are going to have to be ripped out as well in that room.  Also, and maybe this is silly, we finally have vindication that NO the problem wasn't that we kept using the bathroom despite the leak.  And YES it was the supply line, as we suggested before, but were told was ridiculous.  F8ck them all.  At least I’m not the one paying for all of this.  We do have to deal with our landlord being in the house all day.  The plumber I can deal with, but the landlord's presence is truly annoying.  

Other news... Dylan has a cold, which isn’t such a problem except that I now have it too.  So this morning we took Dylan to get COVID tested, and I am going this afternoon.  Our AP has a funny feeling" in her chest and is terrified she is going to die.  I tried to reassure her, but also I am kind relieved she is taking this seriously.  Good prognostic sign for not doing anything dumb this winter!

Where did Dylan get the cold?  My best guess is from the pediatricians office where she had her well visit and flu shot on Tuesday.  Could it be from me?  Maybe I guess.  I had two patients with surprise colds yesterday (maybe a wee sniffle in preop, but when you extubate the patient at the end of the case, the endotracheal tube is slathered in thick yellow mucus).  So that was awesome.  It was especially awesome when the surgeon discovered a massive ball of snot in her airway and screamed at me to “dry it up” when actually that will only make it harder to suction out her secretions.  But anyway, I digress.

What else....

I was urged to set up my launch committee meeting again.  I already communicated that I would set it up after I met with some of the people I want on the committee.  That won't happen for another week and a half.  I don't know why I am suddenly getting all these urgent emails about this, but it is stressing me out.  I barely know anyone in my department, and only recently became aware of certain individuals because there was a zoom happy hour that happened when I was on call.  I am still up to my eyeballs in work for my last grant, so I definitely still have plenty to do.  I just feel like.... when I first started, people told me, RELAX!  Get settled!  Give yourself some time to make sure your family is ok and that you've oriented clinically!  The research will happen!  And now all of a sudden, two months have NOT yet passed, and everyone seems totally up my ass about how unproductive I'm being.  Except I'm not, but I can't convince them because nobody is listening.  I always knew the advice to "relax" was disingenuous... I hate being presented with evidence that my distrust was merited.

Oh!  I also had a challenging day in the OR yesterday.  For multiple reasons.  The one specific thing I will share is this: I went to take over a room from a colleague with basically no sign out.  I knew the patient because I'd taken care of her before, so we proceeded.  In the middle of proceeding, this nurse I'd never met before comes up to me to scold me for having the wrong kind of mask (earloop masks are not allowed in the OR because... there is no valid reason, actually, it's just one of those rules).  So I said, "Thank you so much for reminding me, I will change it now.  While I'm out getting a new mask, I see that many of you do not have eye protection.  So why don't I bring some back with me so we can all be safe, and that is the rule as well."  So that is what I did.  I come back in the room and distribute the eye protection, and this nurse literally takes it out of my hand and slams it into the trash can.  And I say, "Did you just throw that away?"  And she goes on a rant during which she says how much she hates PPE and how much the visors suck.  

Anyway, we induce.  Everything goes fine.  The surgeon appears out from behind a computer.  I say, "Hello!  I am OMDG, one of the new anesthesia faculty!  I'm so sorry for not introducing myself before, things are a bit caddywompus with the emergency going on in OR Blah.  So nice to meet you!"  The nurse says not one word to me for the rest of the case, nor does she make eye contact.  I suspect that she thought I was a resident or some other variety of trainee and was putting me in my place.  But GODDAMN.  Stupid female bullying.  

So.  I know there is a lot of positive going on -- the plumbing is fixed!  I'm doubtful my daughter has COVID!  My department is trying to be supportive of me!  I won the battle of the PPE!  I work with lovely individuals!  I love anesthesia a lot!  It has just been a lot lately.  A lot.  I wonder if it's even reasonable to expect it to ever calm down around here.  Maybe in a couple of years?  




Thursday, October 15, 2020

it's coming

Well.  

Hospital COVID cases have doubled in the past week.  

We've started seeing emails about when and how anesthesia staff will staff the Respiratory ICU in my building.

The hospital in Howell has started to overflow.

This is to say nothing about the field hospitals they are building in WI.

Oh!  Our local positive rate is 4.4% among symptomatic patients. 

We have had a few positive staff members this past week as well, but I don't know who.  

The second wave is coming, and it's not going to be fun.  My husband bought me a PAPR for when we run out of PPE again.  I doubt I'd be allowed to wear it though... unless there really were no N-95s left, or I grew a beard.

People seem to assume that it couldn't possibly get as bad as it did in March, but actually it could get worse.  Husband reports that Italy is closing again.

Oh, also the leak situation is out of control.  We now have a failing pipe in the basement as well.  NO IDEA where the water is coming from.  The plumber and homeowner accused us of continuing to use the the master bathroom, but we haven't been.  This is just so frustrating!

We also got an email recently about our launch committee meetings and applying for grants.  Still working on getting old stuff done.  It's coming, but slowly.

Had a good clinical day today, though!  At least that's something.  




Wednesday, October 14, 2020

microcovid

I reran microcovid this week for my county, and now the risk for a 1 hour play date outside wearing masks 3 feet apart is up from 6/1,000,000 to 15/1,000,000.  The increase in risk is almost entirely attributable to increases in population prevalence and my job as a front line worker.  Joy.  

I've been peripherally keeping track of the Supreme Court hearings and... ugh.  I don't even know why they do this.  It's not like anyone is going to change their minds.  It's all political theater, and we've learned nothing new.  Do I still think Barrett is well spoken?  Yes.  Will her nomination turn back the clock on human rights in the US?  Yes.  Can we please stop this distraction and focus on the fact that the country is literally exploding with COVID?  

My husband sent my daughter's teacher an email last week basically saying, "Hi, we are new to the district.  Thank you so much for all your hard work, and please let us know whether we can provide any information about our daughter that would be helpful to you.  By the way, she has a doctor's appointment on X day, and will not be at afternoon meeting.  Please let me know if I need to contact X, the school admin, to let her know."  And....

Crickets.

However, I did notice that Dyl got called on more yesterday, so perhaps the email made the teacher realize that my daughter exists! That would be positive!  (I realize this comes off as mildly sarcastic, and I guess it is a little, but it is also true that I am happy it seems to have been effective.)

To that end, I sat in the breakfast room to work yesterday and feel like I was able to get more done, so yay!  Thank you for the suggestion.

We are looking at two local schools, and will attend one virtual open house this afternoon (as if I didn't have enough to do already).  They are in person.  I honestly don't know how I feel about that heading into this winter, but I DO know that I do not approve of our local teacher's union stance of refusing to provide criteria for which they would feel comfortable returning to in person school.  Someone floated out the number 2/100,000 cases, which is basically a recipe to never return to school, ever.  I also find the rhetoric surrounding the issue (You are trying to kill us all/we aren't essential workers/we are unwilling to subject ourselves to even the smallest incremental increase in risk) to be sensationalistic and political.

I found this website that covers geography to be a delightful rabbit hole to fall into.  Also, I now know all the countries in Europe.  There have been many changes since I last learned them way back when in 7th grade!

Hm.  I feel like I have been low key bitching most of my last few posts.  Well, in reality things are going well, and I am happy.  

1) Call on Monday was outstanding and I didn't get called back after going home at 9PM, which WILL NEVER HAPPEN AGAIN, but is further evidence that the onerousness of call evens out over time. 

2) School appears to be a bit better, AND we are looking into private, likely for next year but maybe sooner.

3) We have agreed on inspection $$ with the buyers for our house in Philadelphia and they have secured financing.  Now we just have to wait for the house to appraise which happens next week I think.  

Onward!

ETA: Today I 1) opened an account at the local credit union so that I can... get cashiers checks for when we sell our house, 2) attended a zoom open house for a local private school, 3) did my preops, 4) did a bunch of work (but never enough) on my current project.