Thursday, July 31, 2014
Tuesday, July 29, 2014
Of course you can't say that because that would be unprofessional.
When my senior asked me today what the medicine person thought about my consult I did say, "He laughed at me." I suppose that was unprofessional too. Oh well.
I actually got scolded to day by some woman for not reporting someone for cancelling an order and not telling us as a patient safety concern. "People will think you just want to complain and don't really care about making things better." She said. Guess what honey: That's right, I don't care. Because shit rolls down hill and somehow some way any complaint I make will become my fault. Thank you for illustrating my point.
At least I caught a snippet of Dyl before she went to bed. I kind of feel sorry for my co-residents who are single and childless. It must be lonely to go home to an empty apartment. Even though my hours suck and I'm winning no awards for mother of the year over here, at least I have my husband, my daughter, and my dog. They don't make it all worth it by any means, but they do give me a reason to keep on living.
The transition back to days is going ok. It only took me an hour to fall asleep last night, after which point I basically slept through until 5. SO much better than it could be.
It's amazing how one sick patient can blow up your day, even if you're only carrying three people.
Monday, July 28, 2014
At least the weekend was good, but it's going to be a long 6 days. At least I didn't have any coffee last week, so it will be more likely to be effective this week.
Rounding before 6 is just WRONG. On so many levels.
5 weeks down, 47 to go.
1 week of nights down, 7 to go.
Next week at least I have clinic.
Maybe I'll be tired enough to actually sleep at night tonight. (yeah right)
Sunday, July 27, 2014
What scares me most is the sleep deprivation when you come back 6 weeks post-partum. I have no love for maternity leave, but coming back to 13 hour days 6 days per week when you're still having to get up 2-3 times a night for an hour apiece sounds fucking awful. I suppose this is another case where you would foist off the responsibility onto someone else. Like your husband, mother, or a $300 per night night nurse (or whatever they cost around here).
I think I may leave this decision up to my husband in a year or so. Since he's the one who is going to be getting up and taking on the extra responsibility, he is going to have to decide to do this. There is no way with our current schedules it would be possible without a baby that was already sleeping through the night. Something would have to give.
Unless we can train the dog to breast feed.
Saturday, July 26, 2014
We're getting pizza now. Also, beer. I haven't had a beer since May.
For those of you thinking my week of nights wasn't that bad, this is true. But it could be so, SO much worse. For instance on CCU medicine, nightfloat runs from 9PM-11AM, and they don't provide a place to sleep. So if it's quiet you have to just sit there in unit. Leave it to internal medicine to make something that could be bearable into torture.
In other news: re-resubmission done!
What oh what am I going to do with all this time I have between today and tomorrow? Probably not enough, but here's hoping it will least be somewhat enjoyable.
Guilt inducing Dyl phrases of the week:
- "Mommy, are you going to work again now?"
- "Mommy has to go to work again."
- "Mommy do you have to go to work today again?"
- "I want to play with Mommy, now," "I'm sorry sweetie, Mommy has to go to work."
- "Mommy I missed you this morning."
- "Mommy I missed you last night."
- (reported from daddy) "I miss Mommy."
Oh, and for all you time log people, yes, the last two weeks were 80 hours each. This coming one will be too. XO
Friday, July 25, 2014
NO you cannot just take "a minute" of my time. I do not have that. Today I will get a total of 90 minutes with my daughter. 400 minutes of sleep. Even one minute of that will mean only 89 minutes with her. Or I will sleep less.
And when I am naked and typing on the computer with wet hair dripping down my back, Luca NO. This is not the time to bring Dylan to me up the stairs eager to see me. Now I have yelled at you, Dylan is asking what happened and I feel bad. I unfortunately DO need some time for personal hygiene and I can't get that done with a 2.5 year old hanging on my leg.
I say this to:
1) The person who wants an updated version of my CV NOW so that her department can apply for a training grant (and use my accomplishments to get it)
2) The disability insurance lady who couldn't get off her ass to get my documents together before residency started and has now strung me along for 6 weeks and the deadline is in like 3 days.
3) Our au pair, who threw out a bunch of cold cuts we bought this week because they were "rotton" (who knows) and didn't tell us, necessitating a last minute run to the grocery store because we didn't have anything to eat.
4) The journal who gave me 8 days (last Sunday) to upload my manuscript
5) The other journal who wants me to do umteedrillion additional sensitivity analyses each of which will take a minimum of 60 minutes to run AFTER I get the code set up before I do that re-re-submission, all because one reviewer is being asinine.
6) The med student who wants me to fill out a survey on how I decided to rank residency programs. Seriously dude, get a grip. You're surveying a bunch of interns in JULY. You are too stupid to be a doctor.
On the positive side:
1) 1 day left of night float
2) I get to see Dyl before AND after I go in
3) My paper got accepted to [very prestigious pulm crit care journal]!
The rest of you, you know where you can stick it.
Thursday, July 24, 2014
Tuesday, July 22, 2014
Last night was slow (about 1-2 pages per hour) from 10-5 with a few other tasks (1 admission, 1 post-op check, a few labs to review) sprinkled in. I definitely could have done other work had I needed to. I could have brought my home computer and just cranked this shit out in my down time.
But, I have a few worries:
1) That it will never happen again.
2) Bringing in my computer is a virtual guarantee of 4 horrible nights in a row.
3) It would be frowned upon (though I doubt anyone would know since I can work from the on-call room).
4) I will end up exhausted (though somehow I was able to sleep from 7:30-4 today... maybe it was the two benadryl I took. Hm.).
I know that's a fair amount of magical thinking for someone with an MD-PhD, but what can I say. So far every time I've even *thought* to myself that things weren't so bad from a busyness standpoint, a giant tidal wave of work has come my way.
Monday, July 21, 2014
The day was not perfect. I'd originally planned to take Dyl to school this am, but she ended up being miss pukey pants and was quite under the weather and had to stay home from school. The morning was divided between me a) writing an appeal letter for a manuscript, and b) convalescing with her on the couch watching Taylor Swift music videos. Poor kiddo. At nap time she just started becoming unhinged and inconsolable whenever the Boo came near her because she was afraid Boo would steal her food.
Anyway, I go in in 30 minutes. Here's hoping the nap is "enough" to make things suck less. Trying to keep in mind that it could be way worse: I could be doing a residency in internal medicine or surgery (or ob). On the other hand, if they followed work hour rules, it wouldn't be much worse.
Selfishly, I really enjoyed our time snuggling on the couch. Selfishly, I am worried that I too will contract the vomit disease. Selfishly, I wonder if that could get me out of a night or two (haha -- yeah right, I'm sure I'd have to make them up).
Crossing my fingers that it's completely horrible. It's one day longer than Ob and trauma night float, and 3 hours shorter each day, both of which were fine, so in reality I do think this will be survivable.
Sunday, July 20, 2014
Did a 13 today. I was grumpy and lethargic most of the day, but overall it was actually quite chill. No major problems. Two discharges. Should have been satisfying but really all I wanted to do was take a nap. Sometimes I wonder whether I'm actually learning any medicine, or if I am just going through administrative motions and actually learning nothing. Huh.
I saw my neighbor and I couldn't think of a single thing to say that didn't have to do with a) the hospital, b) the hours I'm working, c) annoying things people I work with do. And none of those things are interesting to another person, so I opted not to converse. It would be nice to talk to people, actually I think it would be really helpful, but I'm afraid I'm not worth much or very interesting these days.
Yesterday we did gymnastics, groceries, and then family lunch. Then after the nap we made happy half-birthday cake for Dyl's half birthday. I think we went to the pool too after that but that seems like so long ago, I can't really remember. It was nice, but I felt like I should have spent my one day off having more fun. On the other hand, how much fun can you really have if you have to go to bed by 9.
And... next week I switch to nights. Fun times. Just five, but still.
Got a paper rejected, but we're going to appeal since the reason is "stupid" (my PI's word, not mine).
Only 7 more "hard" months left. 4 "easy" ones. That's something, right.
Saturday, July 19, 2014
And the nurse looks at me like I should "do something" and the patient thinks I'm evil for not giving them more pain medicine, and God help me if there is a spouse present in the room because they are sure to yell at me as well since I'm obviously oblivious to their loved one's suffering and don't care at all. If only I CARED more, see, then I'd just go up on the dilaudid.
Fail fail fail fail fail.
You can give some people toradol, but not all. You can give some people tylenol, but not all. And most people, when they are "20/10", do not want tylenol. So what happens is I a) do nothing, and b) increase the PCA by a teeeeeeeeeny tiny bit. And then I go away and hope I don't get called again. Because in the end I know I've done nothing, CAN do nothing, but that it will probably get better. Maybe. And we'll probably get reamed out on rounds the next day too for being horrible unfeeling doctors. Well maybe not. We round so early that most family members aren't a) present or b) awake to do that. :-/
The next day is almost always better for them. I just hate being called for urgent problems I can't solve where I'm sure to get yelled at. And also where I feel bad for the patient. I wonder how long THAT is going to last -- the feeling bad part, I mean. At some point I wonder if I'll just be bitter and jaded and internally roll my eyes and do nothing with a light heart like everyone else seems to be able to do.
Part of the reason residency hasn't been that bad (yet) is that I have minimized the extent to which I do any of this, and because I like being a doctor (so far). My husband just does it, and doesn't whine about it. 1) He has more time. But 2) he actually likes domestic stuff.... well, at least doesn't hate it as much as I do. And also we have cleaners who come. I don't even remember if I hate cleaning toilets because it's been so long since I cleaned them myself. As I recall it's dusting and vacuuming that I really can't stand.
What's that? I'm lucky, you say? Well, yes. But not because my husband cleans. I am lucky because I am getting to do something I love with my life. Because my family is healthy and we have our needs met. That I am alive now, and not 200 years ago. Because I have found a balance that works for me. For us. Would my husband be "lucky" to have found a wife that cleans while he worked 80 hours a week? No. People would assume that it was her duty. Then I'm not lucky that the situation is reversed either.
I think some people who have to work really long hours really would prefer to stay at home. That sucks. However, I'm not one of those people. I am tired of people telling me that I'm a defective woman because I hate cooking. Because I'm not going to bake cupcakes for my daughter's class. And no, it's not because I'm "bad" at those activities. I *can* make excellent cupcakes, I just hate doing it.
(I also hate: sewing, crafts of any kind, and most other domestic activities that "good" mothers like. Also: yoga.)
And it's also not that I don't care about my daughter's happiness either. (Nice try though.) I love making her smile. It's just that I've realized that I can accomplish that in other ways. In ways that we BOTH enjoy. Win win! Right?
I think part of the secret to happiness is realizing what you like and don't like and to work towards maximizing the time you spend doing activities you like, while minimizing those you don't Yes of course, nobody ever has everything exactly their way, but it's not an act of selfishness to strive for this. And if what you like is different than what other people like, what other people expect you to like because of your gender or ethnicity or whatever, and they label you as defective because of it? That is THEIR problem, not yours, for expecting you to be exactly the same as they are. You are not defective. It's not your job to like some thing or some activity because someone else tells you you should. You like what you like, and that's ok. Stop apologizing for being who you are.
Anyway, enough. Off soapbox.
Friday, July 18, 2014
Sometimes it feels like you just can't win. I think many people don't realize that once you're breathing, eating, pooing, and peeing on your own, and your pain is under control, you need to leave. It's not that we don't care about you, it's because we can't do much else for you and we want you to actually get better. Which is not facilitated by you lying in bed all day.
That other getting better stuff? That's rehab and time. It's kind of on you. Sorry.
I also think some of the frustration is that they are just mad they are sick. Being in the hospital sucks, and the intern is the person who is the most convenient target to vent at because you are there. After the nurse, of course.
Annoyingly, I have a bunch of patients who are probably going to get discharged tomorrow. I like doing discharges. It is very satisfying.
I keep running into people who ask me how intern year is going. I say it's not nearly as bad as I thought it would be. They're all like, You just wait. I'm like, okaaaayyyyy.....
Next week I'm on nights. Blegh. However, I only have 5 of them, so not too terrible.
Tomorrow: gymnastics, grocery shopping, lunch, rest. Probably pool. Perhaps exercise.
Thursday, July 17, 2014
Wednesday, July 16, 2014
"No," I said, "I'm just old."
She laughed, "No, no! That's not what I meant at all."
Ah, but it is true. On the other hand, I think I should feel complimented that she thought I was only 2-3 years ahead of him.
Today was 5:55-6:15. God, why does 5:55 seem SO MUCH WORSE than 6AM? Because it does. It really really does.
Tomorrow we round at 6 so therefore I will have to be there by 5:40 or 5:45.
Today was not busy, but it didn't really matter. Sitting around waiting for signout isn't much fun. Everyone tells me to read when this happens... but what? I guess I could do step 3 q-bank or something, but I'm not taking it until December, so that just seems premature to me.
Tuesday, July 15, 2014
I felt pretty tired, given aforementioned 3AM wakeup. Was in a fog most of the morning. Then thought 2/3 planned discharges weren't going to go after all. But! Then figured out a plan for them to go, and they went! Made the above decisions by self with prodding from my senior resident (who is awesome). Ate lunch at noon (and not 2). Sat down to eat lunch. Sat around in the PM contemplating jacket orders and schedules for next month with the other interns. Signed out at SIX. SIX.
Had dinner with husband and daughter. Daughter is in good mood tonight -- contrast with last night. Oh boy last night was bad.
Will shoot for an 8:30 bedtime. Ha. I'm tired enough, but it's hard for me to go to sleep at night because I feel really wound up when I get home. Hopefully that will pass too.
Then couldn't fall back to sleep. :-P
Oh well, 6 hours isn't horrible.
Just remembered... I have 8 weeks of nights, not 7. Sigh.
Monday, July 14, 2014
Sunday, July 13, 2014
I hate that when I get home I am too wound up to sleep right away. Thank goodness my husband was here to listen to me rant.
I hate that we can't input orders as we round.
I hate that everybody is pissy when they come to work on a Sunday.
I hate that I will get about 5 hours of sleep, then I will wake up, and then I will try to go to bed at 8 so that I have some semblance of a prayer of not being totally knocked on my ass tomorrow and for the rest of the week.
Oh well. At least I learned a lot last night.
Saturday, July 12, 2014
Now nap time.
I'll take the Boo for a walk and then hopefully lie down myself for a couple of hours. It helps SO MUCH.
Then I go in 6P-7A or so. When I do these overnights, I try to remind myself that when I was in college I used to go out until 5AM once a week, usually without napping, and that this is only a little longer than that.
Friday, July 11, 2014
I got to see a whole bunch of Dyl today which was really nice.
I did find out two glorious things today.
1) Since I have nightfloat first week next block, I actually start on a Monday night rather than a Sunday which means only 5 nights in a row instead of 6, which is the norm.
2) I have another week of clinic next block. Which is freaking amazeballs.
I don't have any golden weekends though for another 5 weeks. Oh well. Can't win them all.
This probably all means I'm going to get bitch-slapped on my overnight or my next block, but really, it's not so bad. Which is to say that:
1) Residency is SO MUCH BETTER than med school.
2) Also way easier so far than having a newborn. SO FAR.
I think I can do this.
Thursday, July 10, 2014
The gloriousness of clinic week is almost over. **wistful sigh**
And.... I got my revise and resubmit polished and resubmitted! Thank goodness I heard from the journal on Sunday of this week.
Saturday night I am on 6P-7A. That won't be much fun.
Next week is general / vascular surgery. I know a few, but not all of the patients. Hopefully it won't be bad. I still like my team, though, which is good, of course!
Wednesday, July 9, 2014
Came home, worked some more on revision (it's amazing how much better they get after you lay them aside for a day or so and then come back later).
Hopefully will resubmit tonight or tomorrow. PI has given permission to do it without his final approval. Woo!
Dyl has Hand Foot and Mouth disease. Poor thing has blisters all over her tongue and hard palate, not to mention her hands, feet, and butt. She did feel better once we gave her some Motrin. We'll see if she's well enough to attend school tomorrow, but I am thinking no, not because she's febrile, but mostly because of the extreme whiny-ness from being in pain from her mouth blisters. Poor pumpkin.
I want to order some Boden clothes. I am justifying this to myself because I will need to look nice on at least a few rotations that are coming up and most of my work clothes are like... 15 years old. Will see.
And stop. Shower time.
Tuesday, July 8, 2014
Everybody is very nice. I have always liked surgery clinic. The surgeons I have worked with have always been great with their patients, and these ones are no exception.
The only sucky things are a) I don't know what the surgical workup is for a lot of these problems, and b) I have never used Epic before to write notes and it.... is SUCH A PAIN. It's painful when you're holding people up because you can't figure out how to work the frigging EMR and they think you're an idiot because of it. I want to be helpful, but I feel like I can't be yet.
Oh well. I gotta say, I don't mind that much.
Almost done with this revise and resubmit!
Monday, July 7, 2014
(The attending had a dentist appt this PM, that's what.)
So now I'm home eating lunch. I'm going to work on my revise and resubmit and hopefully get this Epic thing fixed via an annoying call to tech support. So.... I am actually working, it's just not residency stuff.
Tomorrow I start at 8:30!! Glorious!! Don't be too embittered though. Sat I do 6P-7A, and then get raped for 5 consecutive weeks. Oh joy.
Of course, it could be worse. I could have done internal medicine. Those poor souls. I see them walking around the hospital and they all already look utterly miserable. Whenever I talk to them I feel like I dodged SUCH a big bullet by avoiding IM.
Sunday, July 6, 2014
Crossing my fingers.
Still waiting on the [other article] R&R. Let's hope comments come right at the beginning of blood bank week.
Oh yeah! Hanna Andersson is having a sale. Some things are 80% off. I just got a bunch of leggings and dresses a size up for next summer.
Saturday, July 5, 2014
Friday, July 4, 2014
I peed once.
Well. That was a horrible, horrible day.
I feel completely incompetent. I had 14 patients by myself, and several were not doing well.
There are other issues too, which I cannot disclose. :-P
And I get to do it again tomorrow.
I can see that nobody gives a shit....
You know what's annoying? The fact that nursing signout is at 7PM, and our signout is at 6PM. So, when the nurses are going around gathering their stuff and finishing up their work so that they can sign out for shift change, THAT'S they end up calling you with problems while you're trying to sign out, and you inevitably end up dumping on the night person. Who the heck came up with this system?
Was thinking about small things that would greatly enhance my quality of life.
1. Having a non-public bathroom to use. Or at least one that didn't routinely have urine on the seat, smell like someone's giant dump, and that had a functioning toilet paper dispenser.
2. A place there to creep my crap. Like tampons. Or a clif bar. Or my skanky hospital shoes.
3. When I'm communicating with my senior via text about something important, it would be nice if the nurses didn't yell at me to LISTEN TO THEM RIGHT NOW OR ELSE as though I am wantonly ignoring them because I don't respect them, about.... the fact that a patient prefers vanilla to chocolate flavored ensure and can I please put that order in right away. I gotta wait my turn. You gotta wait yours.
4. If things like access to clean utility rooms wasn't something that a) didn't take a week to get approval for, and b) wasn't something that we had to arrange ourselves.
Thursday, July 3, 2014
(The dog hates it too -- you can just tell by the way she looks at you forlornly and slinks out the door when Luca walks her. Like she's saying, "Daddy REALLY??? This is inhumane."
Yes sweetie, it is inhumane. Sorry 'bout that.
Wednesday, July 2, 2014
Good day. I have 7 patients now, tomorrow we're getting another. Hopefully there will be at least one discharge. Busy busy!
Dyl has been really fun this week. We've been watching music videos on youtube before bed. Our current repertiore:
We are never getting back together
Tonight she requested Groove is in the Heart. Then we danced to Cruel Summer and then went upstairs to shower (I've been washing my hair every night since I feel so gross after a day at the hospital).
Any other suggestions for good videos? She likes pop, and I prefer not too raunchy (ok fine, Timber is the exception, but *I* like it so...).
Now she is refusing to go to bed.
Tuesday, July 1, 2014
It was a good day! I'm getting better at getting things done and being efficient. Of course I had relatively few patients today. By the end of the week I'll have 7 (at least).
I'm afraid to say that I am happy and that I like what I'm doing for fear of jinxing things. Oops guess I just did.
Crossing my fingers for another good day.
(Why is it that I have to work 13 hours per day to justify this particular division of labor?)
Something to think about.