house beautiful

First item of news is that I got a new wallet.




Joe had it waiting on my desk when I came home post-call! A Paul Frank knockoff, but cute nonetheless. Now if only I had some money to put inside.

Though so far vacation has consisted mainly of sleeping, eating, and playing Scrabble, I've been enjoying myself immensely. It'll start to get boring soon, I'm sure, but I have enough errands to keep me occupied for the time being: haircut, DMV, dog, Scutmonkey, cleaning, shopping, party preparation.

Speaking of cleaning, can I tell you how much I hate to do it? Well, I do. There, I said it. I hate cleaning. There, I said it again. I especially hate cleaning this year. There's very little else I would like to do with my hard-earned spare time than scrub the toilet. That's just the way it is, friends. But then of course if I don't do it, Joe ends up doing it during his time off (cleanest man alive, remember), and then I feel bad both that he's spending his hard-earned spare time cleaning the toilet, and that I'm not domestic.

The solution, I decided, is if we spring for a house-cleaner. Not someone who comes by all that often, as we do practice a modicum of good habits in our day-to-day lives (cleaning up spills, picking up after ourselves), but just someone to do the big jobs: floors, bathrooms, kitchen. Maybe once every two or three weeks. No big thing, right? And lots of other residents do it. I even got a very good recommendation from a co-resident in my class, who loves her house-cleaner and would follow her to the ends of the earth. There, easy, right?

The only problem is this. I have this guilt about hiring someone to clean my house. I would have this sneaking feeling that I'm some classist bourgeoise overlord--like, damn bitch, why can't you just clean your own house? Plus, how many people are we going to pay to do stuff for us? We already take our laundry to a service (they have this amazing way of folding all your clothes the exact same size, stacking them into this perfect cube of clean laundry) and hire some lady to walk our dog for us when we're at work. What, we need a whole team to help us with our lives now? What's next, a butler?

On a new subject, getting so much sleep the past few days must have tapped into my dormant REM reserves, because I've been having some very vivid dreams of late. Like last night, I dreamed that the dog was out on the balcony, pushing the flower pots over the edge, and somehow managed to wedge herself between the two railings. (To the person who was so thoughtful as to worry about Cooper's safety on the balcony, this would never happen in real life--she's way too huge, and we strung wire through the gap as a safety measure when she was a puppy. And in terms of the height of the railing, it comes up to mid-chest on me, and we never let her out unsupervised. But obviously, we worry about her too, hence the dream.) Anyway, in the dream, I was inside, and saw her slithering between the gap in the railings, kind of in slow motion, and then fall over the edge. I was yelling to Joe, "Stop her! Get the dog!" but he couldn't hear me because the door was closed. We didn't see the splattered dog bits or anything, but come on, we live on the 19th floor, so of course she died, and it was very sad.

But you know the worst part? The end of the dream was us getting in the car to go to the pound to get a new dog. Like, right that same day. I am a cruel and heartless person.

Currently reading: "Ghost World" by Daniel Clowes. Great dialogue. I enjoyed this book a lot more than "David Boring" or "A Velvet Glove Cast in Iron" because I could actually follow the plot.

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how to be a good little scutmonkey

The hospital is freezing today. I look at the babies in their isolettes and I get jealous. Why can't I have a temperature and humidity controlled pod in which to tool around? You put your hands through the little ports on the side and it's like a rainforest in there. Mmmm, tropical. Lucky babies.

After today, I only have two working weeks left of my intern year (I'm on vacation for two weeks before that), so in the spirit of my ten great truths about being a third-year med student, I decided to share some tips on how to be a good intern. Or if not a "good" intern, at least one who survives until the following July.


TEN TIPS ON HOW TO BE A SUCCESSFUL INTERN WITHOUT REALLY TRYING
(except for the "without really trying" part)
1.) Be nice to the nurses. This tip is number one because it is the single most important pearl to know going into your intern year. As much as we like to think that we're the little workforce that makes the hospital run, it's nursing that keeps this damn place from falling apart. Learn from your nurses. Be nice to your nurses. Understand why they might be annyoyed with you sometimes. (Imagine being a nurse for 25 years in the same unit, and every July, a troupe of wet-behind the ears interns comes flopping in, without a clue, but somehow they're the ones giving you orders? Lord.) I mean, there are definitely some mean nurses, just like there are some mean doctors, but there's nothing that goes farther than kissing up to nursing. Sometimes, they even give you snacks from the patient pantry! Also, remember than an angry nurse is a one-way ticket to a miserable call night.

2.) Find a special pen. You have no idea how much happiness having the right pen will bring you. If you think that sounds really pretty sad, welcome to your new life. It's the little things that brighten your day. Remember, choose a pen that you like, but that you won't cry if you lose. (Or if someone STEALS it from you. Hello, 8 South ward clerk!) Also, remember that with a extra-fine point pen, you can fit even more microscopic scribbles onto a single sheet of paper!

3.) Develop a system. This is something that you can't really plan ahead of time, it will just have to develop over the first few weeks or months of your intern year. How will you organize your day? What kind a rhythm will you get into? How will you prioritize the top one hundred of your one hundred gajillion tasks? Everyone knows the check-boxes. But everyone has their own little subsytem within the checkboxes. Mine is especially neurotic, involving two different colors of highlighter, two different colors of pen, and an elaborate binder full of old scut sheets for archival purposes, to look up the telephone number of that one social work agency in the Bronx that I called last January, or the medical record number for the patient I treated three weeks ago with rotavirus. You will all have your own systems. Just don't steal mine, or you're DEAD. (Just kidding. I would be flattered if anyone stole my organization system, but then I realize no one ever would, because they're SANE.)

4.) Admit that you're dumb. And I mean that in the nicest possible way. The reason that you keep feeling like the stupidest fuck-up in the entire hospital is because you probably are. Hey, I was there. I ordered a unit of blood for a 3 kilo baby my first week of internship, for chrissake. But the more you admit how much you don't know, the more you'll be able to learn, and the more people will be willing to teach you.

5.) Have no pride. This is somewhat related to item 3, but slightly different. Self-depracation is the key, the KEY, to getting anything done in the hospital. It's strange, but true. Let go of all your ego. Practice saying the following:

"I'm wrong." (Even if you know you're right.)
"I'm sorry." (Even if you're really not sorry.)
"My mistake." (Even if it totally wasn't.)
"You're right." (Even if they're so, so NOT.)

You have to be able to say these words without choking. Put some feeling into it! It's hard, but it will get you what you want in the end. So many disagreements in medicine are ego battles, turf wars, pissing contests. Just roll over, belly up, and surrender. When there's no more fight to be had, then you end up getting what you want.


MICHELLE
I need you to come up to put this bronchiolitic kid on CPAP. He's breathing at 78 and retracting to his spine, and his sats have dropped into the 80s!

RESPIRATORY THERAPIST
No! I won't! You guys always call me at 3am and I'm fed up! I'll bet this kid isn't even sick! Also, you're a stupid intern and you suck!

MICHELLE
You're right. You've been around the hospital much longer than I have and seen many more bronchilitics. I'm probably just overreacting. But could you come over and check him out with me? Maybe I could learn something from watching you.

RESPIRATORY THERAPIST
(Mollified)
I'll be there in two minutes.

MICHELLE
And bring the CPAP machine with you, OK?


6.) Don't get too task-oriented. This is a tough one. So much of internship is receiving and carrying out orders that it's hard not to just zoom through your day check-check-checking all your boxes like an obedient little robot. But if you can, stop and think about what you're doing. Does the plan make sense? Does this kid really need this lab test? Is this really the best medication choice? Just because the attending told me to do it, does that mean it's really the right thing to do? Remember, you're not just an automaton. You're a doctor, for chrissake! (Insert impressive music and swelling of pride in the chest here.)

7.) Dress up once in a while. This sounds a little silly, but for real, it makes a difference. Even if it's a month where you could get by wearing scrubs all day every day. Even if you have to spend ten extra minutes getting ready that you could have been sleeping. Wear some makeup, if you're into that kind of thing. I mean, don't get all Tammy Faye Baker on our asses, but it feels good to look good sometimes, and not just like some dried-up work drone.

8.) Don't forget to read. I'm kind of a hypocrite for including this as one of the tips, because this has been a tricky one for me. If there's one thing that I don't want to do when I leave the hospital after a long day, it's flip open The New England Journal of Medicine. Work is work and free time is free time. But reading is important, and so I've been forcing myself to do it more. Mostly out of fear, though, that I'm going to be horrible and stupid as a senior and not have any wisdom to impart.

9.) Use the "I'm just an intern" excuse. Don't be afraid, it's not a cop-out. You are just an intern! And using the excuse will smooth over all sins. Well, not all, but many. Harness the pity! Anyway, you'll never be able use it again, so you might as well milk it for all its worth. Ride that line into the ground, friends.

10.) Don't forget to have a life. Have a non-medical hobby. Camp out at Borders and read comic books for an evening. Go out with your friends and have a beer, even if you're really tired and you're on call Q2 for the next few days. You'll be glad. Well, most of the time. I wasn't glad when I went over to Tammy's house for her fancy-pants dinner party and lost my wallet on the train and then had one glass of wine too many (read: I drank a glass and a half) and when I woke up at 4:45am for work the next day knowing that I would be in the hospital for the next 27 hours, I wished I was DEAD. But wallet-loss aside, it was a fun evening, so there you go.


Closing in on the end of my internship. Almost one year later, I'm a little bit smarter, a lot more tired, and ready for round two. Bring it, bitches.

Currently reading: Workbook in Practical Neonatology. Written by our department chair. He said after rounds this morning that I should drop by his office and speak with him about a career in Neonatology. I just may take him up on that.

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one day more

Just one more day until I'm on vacation. True, that day is a 24-hour call in the NICU, but still...one more day! It will be pure pain, though I keep telling myself that it can't be worse than Oncology call, and then I feel a little better. At least with NICU, the fellow is with you on the floor at all times. Also, I hear that on the weekends, the on-call resident doesn't have to carry the DR phone (DR = delivery room), so at least my work will be streamlined somewhat, not having to pop up and down constantly between deliveries and the unit. I'll be able to limit my suffering all to one place, which is nice.

Here are some things that I'm going to do on my vacation:

1.) Sleep. A lot.

2.) Take Cooper to the park and stop being a deadbeat dog owner.

3.) Work on Scutmonkey. For real this time.

4.) Have a party next Friday to celebrate the end of intern year, and also my birthday. I'll be 26. Not a very exciting age to turn, but I'm almost out of those good milestone birthdays. Well, until I turn 50 or something.

5.) Go to my sister's college graduation. This would be a lot more fun if we didn't have to drive out there to the middle of NOWHERE at the ass-crack of dawn (my parents couldn't get hotel reservations), and help her move all four years of accumulated STUFF out of her dorm room that same day. I'm not into heavy lifting.

6.) Maybe plan a trip to the DR with my sister. (That DR stands for the Dominican Republic, not the delivery room, as above.)

7.) Sleep some more.

I don't think this vacation is going to be long enough.

Currently reading: Alternating between The New Yorker and US Weekly. A little bit of highbrow, a little bit of lowbrow, just the way I like it.

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up all night

There's always a point in the night on call, no matter how tired you are, that you can start to see the light at the end of the tunnel. Usually it hits you around 2 or 3am. The rest of the team will be back in the morning, and the morning is only a few hours away! The reinforcements will arrive, and carry away all their trouble-making patients with them! I relish that moment that the first resident walks into work that morning that I'm post-call. There's that feeling that finally, there's someone else here to take some responsibility.

It's not even midnight. Morning is a long ways off.

I never know what to do when I'm covering other people's patients--patients on other teams entirely, that I've never before in my life laid eyes on--and I get a call from the nurse that the parents want to speak with "the doctor" to get an update on the kid's condition. Am I "the doctor?" Well...technically...yes. Do I know doodly-squat about their kid? Uh, sorry, which one of the identical incubator chicks is yours again?

Most people cop to the totally reasonable, "I'm only covering for the night, wait until morning and ask the kid's real doctor" response. But I know that a lot of parents work during the day, and can only make it here at night, after all of the day teams have gone home. I feel bad not giving them any information, so I try to scour the chart (memo to attendings: it would be nice to write progress notes on your patients once in a while for that purpose) and scrounge up whatever kind of an update I can manage from the computer orders, the medication list, the nursing notes. But it gets hairy when the parents start to ask you about which specific heart lesion their kid has and their long-term prognosis. Then I do have to cop to the "covering for the night" excuse and smile, backing away from the isolette and feeling for the doorknob.

Oh, one more thing. No matter how tasty, do not each a hummus sandwich for dinner when you're on call. You will stink like garlic for the rest of the night.

Currently reading: About radiologic findings for NEC

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when the working day is done

Who says that residents don't know how to have a good time? (Uh, me.) Went to Tammy and Grace's house this evening for dinner and wine. Maria brought Cuban cigars. I brought cheese. I played with their cat, and now Cooper is sniffing at me suspiciously, like I cheated on her. I wish I could have stayed longer, but I'm on call in the NICU tomorrow, and I had to get home so that I could sleep and charge the old battery.

I can't wait. Four more days until vacation! 50 hours of which will be spent on call! They're really making me work for it, see.

The bad news is that on my way to Tammy's house, I lost my wallet. In typical hoarder style, I had everything in my wallet. Not that much cash, but bank card, learner's permit (no driver's license, remember), health insurance card, Blockbuster's membership. I would have retraced my steps, but I think I probably dropped it on the subway hurtling off towards the Bronx. It's gone, I've already relinquished all hopes of recovery. I cancelled everything right away, but with any luck, I'll at least get back the stuff without value--without value to anyone but me, that is. Unless someone tries to rent movies on our account. That would truly be insidious. Hmmm. Maybe I should cancel that card too.

Currently reading: Finishing "Singular Intimacies". Sometimes I think I'm really missing out, not working with adult patients. But most of the time, I'm thanking God for that very same fact.

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hi, bitter med student!


Vin is pissed!

The majority of the e-mail I get is very nice. Thanks, nice e-mailers! But here was an e-mail I got today.


Someone at my medschool thought it cool to forward to everyone your website. Clearly you have too much time on your hands. After practicing as a nurse in critical care and just about everywhere else in acute care I decided to go to med school not only because I wanted to test myself but also because I knew many interns and residents who belittled those they cared for and who constantly showed their dim wittedness in their choices and comments. You are a shining example of this. The very fact that you took the time to post your thoughts on the internet show that you not only have too much time on your hands but that you have an overwhelming self importance typical of most medical students. I'm sure that your residency is as cushy and the never heard of by anyone else high school and college you went to. And hopefully the children you see will be saved by your superiors. Next time you feel like sharing your thoughts for the world... stop and think... do I really want to say anything about the fucking patients or any other fucking idtiots (except yourself).... and if the answer is anything but no... talk to yourself in the shower and don't insult students, attendings, residents and most of all patients... seriously....

students of eastern virginia medical school


The best part of this e-mail? The fact that that the sender's name in the e-mail was entered as "Vin Diesl" [sic]. (I loved you in "Triple X," by the way.) Look, don't get all bent out of shape, man (or lady). I'm sure you and your friends are very smart and dedicated. And angry! Heh, no really, let's just be friends. We're all in the same boat here. And I'm going to overlook that remark about the "cushy residency that no one's ever heard of"--I know better than to get into that kind of conversation.

Anyway, I'm back for my last week in the NICU. I've had some very sick patients in my time there, but I think that they're all turning the bend (or I hope so, at least), so I'll have some very sick but not critically sick kids to hand back off to the next team. They're not getting better terribly quickly, mind you, but that's how it goes in the NICU. Day by day by day, gaining gram by gram by gram if not sidelined by any number of catastrophies large and small. At least none of my kids are fungemic anymore.

One thing that I've realized during my month in the NICU is that while I love Pediatrics, I think my personal bent is more towards acute care and less towards the primary care. Not that I don't like going to clinic and seeing my patients week after week, but everyone has their interests and passions. And, I hate to admit it, but I really get sick of filling out those school forms, WIC papers, working papers, school physicals, Early Intervention referrals and what have you. I need to find some sort of a job in Pediatrics where I don't have to do that. Or, barring the existence of such a job, at least one where I don't have to fill out such forms every day.

OK, so enough with this vague talk about passions and interests--I'll tell you the real moment that I figured out that I probably wasn't going to do General Peds. In clinic last week, our usual lecture was supplanted by a case discussion, where my preceptor brought up an interesting patient that she had and solicited our suggestions for how to deal with this patient's particular problems. By the way, I love our preceptors and the lectures that she gives; I think they're so applicable to general practice and she gives such real-world, practical advice. (For example, one week, we went down the block to the local Farmacia to just look at the prices of all the over-the-counter medications, the formulations and dosing forms, and learned which meds were covered by Medicaid and which weren't. See, practical knowledge.) But this week, I just couldn't get into the case.

The case, to sum, was that of a child who refused to wear clothing.

The mom of this patient is distraught. How can she send this child to school? He won't wear clothes! When Mom puts clothes on him, he screams and tears them off. This has been going on for a week! What to do for the little guy? She's tried everything. Bribes, looser clothing, attempting to clothe him surreptitiously while he's asleep. No dice. The kid just doesn't want to wear clothes.

That's when I realized: I'm not smart enough to go into General Peds. I'll pick a Pediatric subspecialty, know a lot about one area, but there's no way I can get a handle around all of General Pediatrics and be good at it too. There's just too much to know, and kids are just too hard to understand.

Currently reading: "Singular Intimacies". This book is as good as people said it was, but it's a little uncomfortable to read. Hits a little too close to home, you know? I loved the scenes in the OR. How many times in med school did I contaminated myself and had to re-scrub and gown? Come to think of it, I just did this two months ago, after scrubbing for a C-section.

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more martha than martha

Due to some call-scheduling swapping with Mark, I ended up having three full weekends off this month. Take a good look at how sane I am as a result of this. You'll never see it again.

Given that I have some time free, and in my continuing quest to become an old lady, I thought that this would be the weekend to do some gardening on our balcony. In my rich fantasy world, our balcony will become a Pleasure Pavillion, filled with sweet-smelling blooms and rich foliage. But, closer to reality, and still pretty nice, is just having some potted flowers to enjoy. I think we did a pretty good job, but judge for yourself.



We got lost in Queens, trying to find Home Depot. Driving down Roosevelt Avenue, I saw a lot of cool restaurants that I wanted to try, but Joe had to meet up with Dave later on so we didn't have time to stop. Queens is literally (and I mean that it's documented to be) the most ethnically diverse area in the world. And only along Roosevelt Avenue could you see a Tibetian restaurant called "The Amazing Yak."



Finally, we got there. I thought it would be clever to go to Home Depot Friday night to get a jump on the weekend, but apparently everyone else had the same idea, because the place was packed.



Surveying the goods. The wooden planters were nice, but at $18 each, a little too nice for our budget. We ended up using the green plastic planters that we already had.



We ended up getting two carts of flowers and soil. I was surprised that the big bags of potting soil were only $2.00 each, but then I realized, as Joe pointed out, "Honey, it's just dirt."



The next morning, we started planting. I hope Joe's not mad that I show this photo. There is the verisimilitude of plumber's crack in this shot, but it's not really crack, it's just the indentation between his back muscles.



It was all messy and such. After planting, my hands looked like Hobbit hands, that is to say, all caked with dirt under the nails.



Here's one planter combination: lavendar petunias interspersed with Coleus. (Coleus are the green leaves with the pinky-purple centers.)



And here's another planter combo: pink and white petunias with Coleus. We alternated the planter colors along the edge.



It didn't really take that long for us to get the job done. Here's one side of the balcony, all flowered up.



And here's the other side. I told Joe to raise his fists in triumph, but I think he was a little lackluster about it because he was all hot.



The no-dog zone, where we're keeping all the gardning supplies. We had to impose these limits because she ate our last hose and we had to buy a new one.


It feels good to get all that done. I think we're going to have an end of year barbecue out there in a couple of weeks when I'm on break. Do you think there's ever a point in my life where I'll stop thinking of June as "the end of the year"?

Currently reading: "The Curious Incident of the Dog in the Night-Time". Almost finished! There are some books like this one that you enjoy so much that you just want to gulp them down.

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oh lord.


Bush pauses to comfort teen.

Some excerpts from the article (The Cincinnati Enquirer, May 6):

Lynn Faulkner, his daughter, Ashley, and their neighbor, Linda Prince, eagerly waited to shake the president's hand Tuesday at the Golden Lamb Inn. He worked the line at a steady campaign pace, smiling, nodding and signing autographs until Prince spoke:

"This girl lost her mom in the World Trade Center on 9-11."

Bush stopped and turned back.

"He changed from being the leader of the free world to being a father, a husband and a man," Faulkner said. "He looked right at her and said, 'How are you doing?' He reached out with his hand and pulled her into his chest."

..."The way he was holding me, with my head against his chest, it felt like he was trying to protect me," Ashley said. "I thought, 'Here is the most powerful guy in the world, and he wants to make sure I'm safe.'"

Several things about this:

1.) I wonder what Bush's armpit smells like?

2.) I am so sick of Bush harping on September 11th like it excuses anything that he's doing over in Iraq. The fact that the Republican National convention this year is going to be in New York City, one of the most left-leaning cities in these here United States, makes me ill. It's just exploitative, trying to reinvigorate his image with that from his soaring approval rating days in 2001. Maybe he'll deliver his nomination acceptance speech from the top of a pile of rubble, standing next to a fireman.

3.) He really cares about kid, not about the "I-feel-your-pain" photo op. Look how he's looking right at her, not at the camera. Oh wait.

4.) "He wants to make sure I'm safe." I don't know about you guys, but I feel much safer living in New York now that our nation is reviled the world over.

Ah, politics. You may agree with me, you may disagree with me, but at least it gives us something to debate when we've all had a few beers.

Currently reading: "The Curious Incident of the Dog in the Night-Time". This book is great! Thanks again for the recommendation, Birdy.

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don't quit your day job



(From Ugly Dolls.)


A lot of people have been asking me when I'm going to post the next Scutmonkey comic. The answer is: when I get a chance to draw it. I have it halfway fleshed out in my mind, and in hastily scribbled sketch outlines, but I just don't have the time to work on it right now. Or I'm too tired when I get home and I don't want to just hack at it and do a crappy job, because it does require some degree of focus.

The good news is that I'm on vacation in a week and a half. Two weeks off! And, since Joe and I didn't get vacation together again, there are no big travel plans in the works. So my plan for vacation is to do some urban gardening on our shiny new balcony, to finish my surgery comic, and to at least get most of the legwork done for Issue #1 of Scutmonkey. I've been very slowly getting it all together (though there's been a lag since I started NICU), and I think if I just had a couple of days off, I could probably pull it all together.

All this cartooning would really be a lot easier to do if I didn't have this crazy day job. But I guess if I didn't have this day job, I really wouldn't have that much to write about.

On a completely unrelated note (well, somewhat related, as it's about work) I have become completely obsessed with the transilluminator. In brief, it's a light that shines through the patient's subcutaneous tissue (on a kid's hand or foot, for instance--even a whole arm, if they're tiny) and basically shows you where their veins are. I don't know if it's like the story of Dumbo with the magic feather, but I got an IV in an eensy weensy little baby the other day (that's purely scientific, by the way, "eensy weensy") when I used the transilluminator. Sometimes I just like to play with it myself, shining it up through my own fingers to see where all the veins are inside. Fun!

Currently reading: That article in this week's New Yorker about searching for giant squid.

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sorry, avril

I was getting all ready to go down to see Avril Lavigne in the Winter Garden today (the hospital's fancy lingo for "big empty lobby,") working furiously to finish up my work early so that my afternoon would be free. I am not embarassed to tell you that I was all excited. I even had my little phone camera on me so that I could snap pictures and make people jealous. I would be in the first row, pushing over crippled kids to get a good spot if necessary. Avril would be singing straight to me, dammit, ME!

Come 2:00pm, I was just about ready to head on down to the performance, when I got paged to the Delivery Room for the delivery of 32-week triplets. By the times they babies were all out, the bloods were all drawn, the IVs in place and the orders written, Avril was long gone. And to add injury to insult, I got paged for another C-section before the third triplet was even dry. In all, I went to four deliveries today, yielding six babies. I guess that's efficient, but dagnabbit, I could have been bopping to "Sk8r Boi" and flinging my hair around instead.

One of the NICU nurses who did manage to make it down there said that the performance was actually not that well attended. "There were only, like, 20 kids there," she told me. "The rest of the people were doctors. Male doctors." Hey, I would have been more than happy to even up the census.

Currently reading: Nothing. I keep falling asleep.

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post-clinic call

Probably one of the more demoralizing things about being on-call (aside from, you know, actually being on call) is being on-call on your clinic day. Your clinic day should be a free day, a happy day, a play-doctor's-office day. You should see your patients, do good work, and go home. Having to return to the hospital after clinic is the ultimate defeat. Sometimes, when I head from clinic back to the wards, I limp a little bit, just because I'm so whipped.

Poor Mark had post-clinic call today, and didn't get back to the NICU until 7:15pm. By then, Ray, Jen and I had been waiting in the call room for two hours. Yeah, we all got out a little late, but I felt worse for him. At least we got to go home.

The thing that sucks about getting out of work so late is that you pretty much only have time to eat dinner and go straight to bed. But here are some pictures of this past Sunday to entertain you. As backdrop, Joe and I went to visit my grandmother in Queens, and then stopped by Home Depot for some furniture to furnish our newly finished balcony.



Joe and my grandmother this weekend in Flushing. (Flushing is where all the Chinese grandmothers live.)



Home Depot. (In case you can't read the gigantic orange sign.)



It was like some kind of "Mad Max" post-apocalyptic war zone in there.



Guess how much these chairs were each. Guess. Guess! OK, I'll tell you. They were ten dollars. Only ten dollars! At that price, we felt obligated to buy more than just four, but there was no room for them in the car.



Joe assembling our new patio furniture. (Look closely, he's under the table.) Yes, that's the Empire State Building. If you know the Murray Hill/Kips Bay area, you can pretty much figure out where we live from this photo.


Currently reading: Still working on the three weeks of backlogged New Yorker magazines.

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wooooo!

We just got this e-mail flier from the Chiefs that Avril Lavigne is going to be performing at our hospital this week. I guess it's some kind of obligatory philanthropic thing. Her appearance, which will take place in the hospital lobby, is sandwiched between the acts of of famed violin prodigy Midori and an autistic teenage pianist with total recall and perfect pitch. Not Avril's usual lineup company, to be sure, but who cares? Avril Lavigne! True, she is pseudo-badass, but in the context of the hospital, she will be so garishly out of place that she may actually assume the mantle of real badass!

The Chiefs said in their e-mail that they were especially excited about Perfect Pitch Autistic Girl, but of course they have to say that. Everyone knows that while it's cool to be able to sing a perfect F-sharp or be all famed for your fiddling skills, but to kids, having been on TRL trumps everything. Too bad my preemies can't enjoy it. Maybe I'll scoop up a couple of them, put them in my pockets, and head on down to the performance. "I'd like to give a shout out to all my babies in the NICU, and I'd like to request the song 'Complicated,' because that's what all your hospital courses have been like! I love you Avril! Woooo!"

Currently reading: Coleen's wishlist on Amazon.com. "Bullets Over Broadway"? I approve. (Don't speak.) Also, "Look At Me". Great book. I read it on my honeymoon and couldn't put it down, much to Joe's dismay.

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bubblicious

One of the parents of our patients has some kind of an inside business connection to a big-name candy manufacturer. Today, she brought in boxes and boxes of chewing gum, the kind that groceries buy wholesale, and began giving it out to everyone. "Take more! Take more!" she kept telling us. I took one fuity pack and one minty pack. I was chewing gum for the rest of the afternoon. Now my jaws are all tired.

Currently reading: Three weeks work of backlogged New Yorker magazines.

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food, folks and fun: a foto entry

Having the weekend off is the best. I get to sleep and stay out late on the same day! Amazing. Maybe I should just quit my job and hang out with friends all the time. Can I still be a "slacker," or is that not allowed anymore?

The only sad thing about all of this is that both the night out at Hallo Berlin and brunch with Brendan and Narges were goodbye events of sorts. Andy's moving to Chapel Hill in a few weeks, an Brendan and Narges are heading to Phoenix. What's the deal with the South? And I mean that in a serious, non-Seinfeld "what's the deal with.." rhetorical way. It's nice to have friends in different parts of the country to visit, but damn, it would be a lot easier to see them if they were here.



The awning of Hallo Berlin in Hell's Kitchen. I like how the restaurant is called "Hallo Berlin" (all cute and German) but they spelled it wrong on their own awning. Dumbasses.



Christina, Joe, and a plate of wursts. (We chose the bratwurst and the knockwurst.)



The Good Time Gang. Notice how Joe is very subtly starting to give me the finger.



I have a crush on Andy.



Kal and Andy. You probably can't tell from the picture, but Kal and I were dressed almost exactly identically that night.



Joe didn't quite get filled up with wursts, so he topped himself off at the end of the night with a slice.



This is the next morning, in case you can't tell from the sunlight. Joe and I met Brendan and Narges at Philip Marie, this brunch place in the Village. (The manager, Herb, is a neighbor, and his dog is friends with our dog. Yes, dogs can be friends.) I had a soft shell crab sandwich with pesto, which sounds strange, but was actually really good.



Outside the brunch place. As you can see, Brendan is freakishly tall. Or Narges and I are freakishly short. (I assure you that the former is truer than the latter, though I guess there are elements of truth to both.)



The streets of Greenwich Village. I would totally love to live there--in a house, I mean, not the streets themselves--except that I don't have $5 million dollars to burn. Maybe I should check under those couch cushions again.



This afternoon, I went to the Korean Nail place on my block for my one girly summer indulgence. There was massaging and everything! I was going for a summery color, but it looks like I ended up with bubblegum stuck on my toenails somehow. I don't think I have very attractive feet.


Currently reading: "Walk on Water". The history of pediatric cardiac surgery is really interesting. I'm learning and being entertained! All right!

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seniors

It's getting warm here, and starting to smell like summertime. People are getting pedicures and wearing skirts. We slept with the air-conditioning on last night. Fish are jumpin' and the cotton is high.

In addition, we just got our preliminary schedules for next year. In a month and a half, I'm going to be a second year resident. In November, I'll be one of the "ward seniors." The thought of going from first-year at one moment to a "senior" in the next is so strange, like some sort of artificial promotion come June 27th that is as anxiety producing for the incoming interns as it is for the outgoing ones.

Up until now, I've been able to rely on the good old, "I'm just an intern" excuse to get myself out of situations where I didn't know what was going on or what to do. Soon I won't be able to use that line anymore. And even worse, there will be new interns coming up to me, all wide-eyed and trusting, asking me for advice, asking me for help, asking me for answers with all the trust and assurance that I had for my seniors when the year started. But how the hell am I supposed to know? When they come to me after failing at putting in an IV or unable to draw blood, who says that I'll be able to get it? When they ask me the same questions that I had as an intern but never asked because I was too busy, or for which I never had the chance to look up the answers, what the hell am I supposed to say? Maybe I should just start studying frantically, constantly, and immediately. You know, kind of cram for my second year.

Such a strange thing, academia. June 26th you're "just an intern" and June 27th, you're a senior. But what really changed from one day to to the next? Are you really worthy of seniority, or just artifically promoted because one class left and another new class came to fill in their spot from the bottom up? Are you a complete fraud? Are you worthy of that level of added trust and responsiblity?

Funny, I think I made this same argument last year. Except last year, I went from "don't ask me, I'm just a medical student," to "holy shit, all of a sudden, I'm a doctor". I guess that was a scarier transition overall. At least this time around, I don't have to go through that two-day hospital orientation or take that HIPPA course online. Thank god for small favors.

Currently reading: "Walk on Water". One good thing about being a second year is at least I get to rotate through the PICU. Finally, I'll see what all the fuss is about.

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pictures!

So I found a program that allows me to upload pictures onto my Blogger account. Sweet. Here are some from two weekends ago, right after the building just finished re-waterproofing our balcony. Enjoy!



Cooper vs. The Easter Bunny.



On the outside, looking in.



Gorillas in the Mist.



Man-Dog love.



I'm a little scared.


Currently reading: The take-out menu for Blockheads Burritos.

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up all night with the babes

The best feeling in the world is walking out of the hospital post-call. That is, unless you did something really bad or some kid died, in which case you wouldn't be whistling and snapping your fingers or anything like that, but probably still feeling pretty relieved to go home. I had a rough call last night, but I think we handled everything reasonably and everyone made it through (relatively) unscathed. It just goes to show you, though, that no matter how big or small your service is, all it takes is that one really sick kid to keep you up all night.

I think that things were pretty much under control (or at least in a holding pattern of stable badness) around 3:30AM, but just as I put my head down and fallen asleep, I got paged from the delivery room for thick mec. Another house doc and I ran up to the delivery and everything went OK, but man, the timing of that page, it's like they were watching me from a remote monitor, waiting for the exact moment that I dipped into Stage 2 sleep to call. Bastards.

I'm really tired. I'm going to take a shower and then crawl into bed. Sometime yesterday, my building decided that it was finally warm enough to turn on the central air-conditioning in the building. Ooh, clean bod, cool sheets! Nothing could be finer.

Currently reading: "Walk on Water." I'm finding all this talk of post-op cardiacs particularly relevant after my two months of cardiology call and this month in the NICU. Wish I had read the book before I started.

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healthy pink mucosa

For the past month or so, Joe has been complaining of stomach pains on and off. When reasonable, he realizes this is a simple gastritis, but at his most paranoid, I think he suspects he has stomach cancer. (I guess he knows someone our age with Barrett's esophagus, so it's not such a long shot in his mind.) I tried to convince him that he probably didn't have stomach cancer because 1.) he's young, and 2.) he's not Japanese (funny how some things from med school will just stick to your brain, like gum under a diner counter), but I think part of him continued to think that he had linitus plastica, especially when the trial of antacids I recommended didn't work.

I offered to write him for triple therapy (not that I necessarily think he had H. pylori, I just wanted to help him out), but he upped me by actually going to a gastroenterologist today and getting scoped. Just like that. Called up to the attending's office, didn't eat anything past 9am, and got scoped that afternoon. This may be one of the very few perks in being a doctor: access to care. They even gave him a whole shitload of free Nexium samples and the videotape recording of his scope to watch at home; a tape that he promptly popped into the VCR and showed me as soon as I walked in the door.

Never has healthy pink mucosa looked so good. I mean, not like I really thought he had stomach cancer either, but it's hard not to worry sometimes. The biopsy results will probably be back next week so we'll know about the H. pylori part of it (couldn't they just do a blood test for the antibody?), but in the meantime, the attending gave him a few suggestions. "Try a proton-pump inhibitor. And don't drink coffee."

DON'T DRINK COFFEE.

This was the advice given to a man who has had at least two cups of coffee a day for the past 12 years. Whose devotion to Peet's verges on idol worship. Who gets caffeine headaches at 10am if denied a cuppa joe (heh) in the morning. Who just got a $150 coffee maker for his birthday, for Chrissake. (It's a great coffee maker, I'm told. Among its many high-tech features, it can grind beans, keep coffee hot for hours on end with active heating plate, and travel through time.)

Given the choice between gastritis and no coffee, I'm still not sure what he'll choose. But my feeling is, someone's stomach is going to be bothering him at work tomorrow morning.

Currently reading: "Walk On Water". Help, I'm becoming one of those doctors who only read books about medicine! Somebody stop me! Though I have to say, "The Spirit Catches You and You Fall Down" was one of the finest books I've read in a very long time. I would recommend it to anyone.

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retreat: the aftermath

The intern retreat was so much fun. It was strangely like being in college again. The best part was being able to spend time with friends without having to constantly look at the clock because rounds are starting in 5 minutes, or because we have to run off to clinic and start seeing patients before they destroy the waiting room in an uproar over the long wait. Basically, it was nice to interact like normal people.

It must have been confusing for people around us, I think, to see so many women (with a handful of exceptions, we were women) wandering through the streets of East Hampton, toting cases of beer or looking for a good place to get brunch. I'm not sure what people made of us, though I'm almost certain that more than one person thought that we a sorority. This one older couple actually asked me when I went up to pet their dog, and when I told them that we were Pediatrics residents from [University Hospital] in New York, they promptly asked me for my business card so that they could refer their pregnant-with-twins friend to my clinic. I'm pretty sure that a new mother in The Hamptons is not going to be so psyched with the idea of bringing her babies to my clinic (diplomatically, I'll just say it's not the most posh of environs), but I gamely gave her my contact info and will let the new mom work it out for herself.

The minus of having such a fun weekend is that it eventually ends, and when it's time to go back to work on Monday, you're even more tired than when the weekend began. I have to wake up at 4:30 in the morning to get to the NICU? You have to be kidding me.

Don't be scared, by the way, if the look of this page changes somewhat over the next few days. I'm fiddling around with a couple of different templates because I'm not totally happy with how this current one is working out.

Currently reading: "Eats, Shoots and Leaves". I would be long done with it, but I have to admit I haven't done much reading since Thursday evening.

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inside the on-call room

The residents' on-call room is roughly 6' x 9', outfitted with a bunk bed (if there's only one resident taking call, the top bunk is useful for throwing your crap on) a file cabinet, and a desk, on which sits a computer and a phone. There is one door leading to the bathroom, which has a curtained-off shower area. Let us take a closer look at the details of this room, shall we?

The bed, although strewn with stuff, is meticulously made, with a roll of dense hospital blankets at the foot, and the coversheet tucked into pristine "hospital corners" (ho ho) at the edges. The reason it is so neat and unlined is because no one really gets to sleep in it. It's just there to taunt you.

On the desk is a bottle of water (to fight dehydration from the inside), a small botle of moisturizer (to fight dehydration from the outside--all the handwashing, though hygienic, is murder), a roll of pink-tape (the kind NICU nurses use to secure ET tubing, and that residents use to tape up signout sheets), several copies of a Neonatology textbook written by one of the departmental bigwigs (donated by the department or a pre-emptive strike against pimping, I do not know), a "scut-bucket" (filled with tape, IVs, syringes, gauze, t-connectors, lab tubes, what have you) and a half-eaten pack of gum. On the wall, next to where the computer's mouse sits, is a thousand old ink marks made by a thousand former residents who entered orders on the computer or clicked on labs while holding a pen in their right hand.

In the bathroom is a collection of tiny little tubes of toothpaste, that hospitals give out to patients in their little "welcome kit." You know, tiny cake of soap, toothpaste, flimsy toothbrush, mouthwash, socks with grippy treads on the soles, pitcher for water, basin for puke. There's a big bin of tiny toothpastes in the supply room, you just have to know where to look. Not that you'd want to steal it anyway, it's generic and gritty and barely even minty, a toothpaste you use in desperation at 4am when you feel like you're growing moss from your enamel. I would not recommend using the hospital mouthwash, though. It's yellow and it tastes like toilet-bowl cleaner. Hold out for brand-name.

On top of the file cabinet is the buffet. Half a cup of cold coffee. A wilted salad. A partially gnawed turkey sandwich, 9 hours old, purloined from noon conference. A muffin from yesterday morning. Get in my belly.

The callroom. Like a creepy monastic dormroom. Learn to love it.

On my way home today, I stopped by Barnes and Noble to pick up a gift for Joe. (It's his 30th birthday today. Yes, he's an Older Man.) The salesclerk was ringing up my stuff and then suddenly asked me, "Are you a doctor?" At first, I was kind of surprised, wondering how she guessed, and then I realized that I was wearing scrubs. Ah. The gig is up. I told her yes, kind of reluctantly, because you can never tell what people will say next ("Yeah, can I ask you a question? I have this rash on my buttocks that's spreading...") but she was just really curious, asking me what field I was in and at which hospital I worked. I paid for my books and she handed me my receipt. "Thank you," I told her. "No, thank you, for being a doctor," she replied, all earnestly.

Funny. I don't know if being a doctor is just one of those jobs that people like to talk about, and I'm too entrenched in the workaday ethic of intern year to really think about it being anything close to "noble" or "meaningful," but it's nice to be reminded sometimes, even if it's by people other than your patients, that your job is important.

Ooh, but speaking of workaday ethic, our intern class retreat is this weekend! We're going to the Hamptons. I've never been there before, but I like to say it. "I'll be in the Hamptons this weekend." Makes me feel like a socialite. It's funny, because the whole point of the weekend is for us to bond with each other outside of the hospital, but I'll bet that the hospital and the goings-on therein will be the only thing we talk about all weekend long. You can't blame us, really. It's the only thing that every single one of us has in common.

Currently reading: "Eats, Shoots and Leaves". You wouldn't think a book about punctuation would be so entertaining, but I was reading this book on the subway, and I was so engrossed that I missed my stop.

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beyond

I was trying to restart an IV on an ex 23-week preemie just now. (To give you an idea, a full-term baby is born at 38-40 weeks gestation.) Of course, I couldn't get it. The fellow came, looked, and told me (not unkindly), "This is beyond your skill." She said I could have taken one look and known that there was no way. I guess that's a pretty safe bet when the bore of the catheter you're working with looks thicker than the circumference of the vein you're attempting to cannulate. The nurse first attempted twice before calling me, who attempted three times, and even the fellow gave it the old college go once. No dice. Why does it make you feel better once someone senior to you fails at the same task that you failed? Somehow it makes your failure justified, I guess, like it wasn't just you being a wuss, the task was just really hard.

Have you ever seen a baby so small that his whole hand is the size of the pad of your pointer finger? Me neither, until now.

Currently reading: Lab results.

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flying babies

So I'm on call in the NICU, covering something like 25-35 babies overnight--the exact number is unclear, apparently some of the patients I'm taking care of were never signed out to me, so nurses are calling me for random med orders and lab tests and I'm all "who in the what now?" Not to mention that I keep getting paged to the delivery room for new babies that are being popped out, one after the other, and the whole Upstairs-Downstairs adventure is making me tired. A piece of advice: when you get called to the delivery room, run. Because next thing you know, you'll be strolling in and someone will be throwing a slick squidgy baby at you like, "here, catch!" and you didn't even get a chance to put on gloves yet to avoid the birth goo.

The question I've been getting asked a lot since I started in the NICU, not just by parents, but nurses, attendings, and fellows is, "Do you have kids?" Like after this delivery we just went to, which was vacuum-assist but otherwise uncomplicated and really quite adorable, mom and dad were crying tears of joy and all that sweet stuff. The NICU fellow asked me, "Do you have kids?" Usually I say something along the lines of, "I'm only 25!" or "How could I have time to have kids?" or "Yeah, I have kids, I have 25 sick kids to take care of on the 6th floor!" But I think what they're really getting at is that if I don't have kids, there are probably some things that I really just can't understand. And I think that they're probably right on that assessment.

Currently reading: The signout note for one of my patients, because parents want to speak with "the doctor" about when the baby is going for surgery, and not only do I not know what surgery she's talking about, I don't even know who the baby is.

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nicu nack-you everywhere a nicu

Thoughts that were running through my mind my first day of NICU, during rounds in particular:

"What the hell are you talking about?"
"What the hell are these abbreviations?"
"What the hell are those numbers you're reciting?"
"What the hell is that? Oh, it's a baby."
"No, seriously, what the hell are you talking about?"

Orientation to the NICU is disorientating at best and completely panic-inducing at worst. It's such a strange other planet that you might never know about unless you had a real reason to work there, even if you've been in the hospital for years (which I kind of have, counting med school). First of all, it's the quietest nursery you'll ever be in. Almost fifty babies all in one large, ovoid, track-like ward, all almost completely, eerily silent. There are the babies that look like normal babies; maybe they were full-term, or grew to be, maybe they needed surgery or feeding or whatnot, but are otherwise good to go home pretty soon. These are the exception. The majority are scary little bird babies, all pink and translucent with closed eyes and squirmy movements and little old man faces, who look like they might be screaming their heads off if 1.) they had the lungs to do it, and 2.) if they didn't have that damn tube down their throat. If you like cute little pink fat babies with adorable little reflexes and, oh, OPAQUE SKIN, then the NICU is not the place for you. Well, maybe I shouldn't presume that. It could be the place for you. The real question over the next four weeks is whether or not it's the place for me. But either way, even if it's not, I guess there's really nothing I can do about it.

The one good thing that I've learned from the NICU, even on the first day, is that everyone who works there is really calm in the face of a crisis. Or maybe they have different levels of crisis than we're normally used to. (Crisi-tunity!) During rounds today, the fellow's code pager went off, and she charged over to the bed of the baby who decided at that moment, for whatever reason, to stop breathing. The baby's nurse was, very calmly, bagging the kid, and everyone went about (deliberately and expiditiously, but not running, not spazzing out), collecting the intubation tray, getting more oxygen tubing, checking the equipment. Finally, after what seemed like an eternity (maybe three minutes) of waiting for the kid to come back himself, they intubated, and we waited for a few more moments (probably another full minute) for the sats to rise from the teens back into the 90s.

And that's not even the real story that I wanted to tell you. The REAL story is that the parents of the baby next door had brought a whole tin of marble cake for the nurses station, and while this whole little drama was going on, almost everyone who wasn't involved directly in the code was eyeing this cake, discussing the cake, planning when to eat the cake. I noticed that no one actually touched the cake while the code was going on just a few feet away (that would be a little too bread-and-circus, I suppose), but after the kid was stable on the vent and the respiratory therapist was taping the tube down, we each grabbed a slice, got our stuff, and resumed rounding.

The NICU. Stranger than fiction.

Currently reading: Finally! "The Spirit Catches You And You Fall Down" . It took more than a week, but it came! I guess the 24 hour delivery in Manhattan is not the same option as "Free Delivery." Well, shoot.

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beanie babies

At the beginning of the year, my Neonatal Intensive Care Unit (NICU) rotation was the one I was approaching with the most trepidation. Everything else seemed scary but within the realm of normalcy--normal-sized kids, somewhat normal problems--but just the thought of all those tiny squirming gummibears in their clear heated pods was frightening and foreign to me. They reminded me of those Beanie Babies they used to sell in protective plastic cases. Don't touch, or they depreciate.

I start the NICU tomorrow.

Aside from the usual first-day cluelessness, like where I'm supposed to go tomorrow and what time I need to get there to pick up my patients, I feel extra-clueless because I'm completely lost when it comes to the language of the NICU. The diseases, the procedures, the parenteral feed fomulations, it's all new. I feel like I just spent a year doing internship but that somehow, I still know nothing. And my second night on NICU, I'm on call. Are they sure they want to let me do this?

I'm nervous. We'll have to see how it all goes.

Today there was a street fair up Third Avenue, which was short (in geographic span) but had all the essentials of streetfair vendory. We got a new dishtowel/oven mitt/potholder set, and I ate a chicken gyro. The dog sniffed at the butts of other dogs. We ate some kettle corn. Then I came home and watched some nonsense on CNN about the series finale of "Friends." Yes, CNN the news station. With the war and the election in full swing, this is news? I'm so sick of hearing about "Friends" and the end thereof. And, yet, I watched this CNN special. What does this say about me?

Do you know what else I watched? That movie, "Love Actually." Ask me if I liked it. (No, actually.) I'd heard it was pretty good from several reputable sources, but I ended up thinking it was kind of stupid. The only subplot that I thought rang vaguely of truth was the one with Emma Thompson and her husband, and how they left it kind of vague at the end with no pat resolution, as to how one deals with the issue of infidelity in a marriage where there are children and a history in the balance. But the other subplots were dumb. Especially that Liam Neeson one with the dead wife and the step-kid. What the hell was that? Encouraging your kid to run through the security gates in a post-9/11 airport? Poor judgement. (Yes, I know it was just a movie, but still.) People should not thinking that being BFF with your kid equates being a good parent.

And, like the old guys on that Bartle and James ad from the 80's, I say to the people who have made purchases at the Scutmonkey Shop, "Thank you for your support." I mean it. You all are awesome! I added some new products this morning too (tank tops for the warm weather, anyone?), so take a look if you haven't done so already.

Currently watching: "Thirteen". Well, I haven't watched it yet, but I rented it.

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rolling out the merch

I've been kind of miserable these past few days because, with the onset of this nice warm spring weather, my annual seasonal allergies have also dropped into town to say hi, like a rude, unwelcome guest who eats all your food and leaves your bathroom a mess. I made Joe write me a script for Zyrtec, so we'll see if that helps.

The movie last night was fun. The moral of the story was: don't clone your kid and intersplice the Evil gene. Because as we learned from Greg Kinnear, this could have some seriously bad consequences. Also, don't walk into a haunted-looking tool shed filled with axes and meathooks if you suspect that the aforementioned evil clone child is lurking inside. That's just logic, Rebecca Romijn-Stamos (soon to be just Romijn). But these things aside, go see the movie, everyone! Support Andy's brother! And if you should have the urge to yell "Bullshit!" during the credits, as one fine gentleman in the audience did last night, just keep it to yourself. (Maybe he was just mad that it was over?)

In other news, I am learning valuable lessons about bandwidth. See, what I learned is this: bandwidth is the amount of information that I can transmit from my page to your computer. Every time someone looks at something on my page, this chips away at my monthly allotted bandwidth. And with the advent of the recent successes of "Scutmonkey" (thanks, everyone!) I recently had to pay for some more bandwidth--mainly to accomodate the ten to fifteen-fold increase in traffic over what I've been used to for the past three and a half years of keeping The Underwear Drawer. Which is fine, it was just a small upgrade, and I'm glad to pay for it. Except that a week after I upgraded (just a week, mind you), I exceeded my maximum bandwidth again. I exceeded my monthly maximum in a week. Hmm. This is bad news.

I mean, don't get me wrong, it's good news, I'm glad people are enjoying the page and the comics and all that. But after that initial upgrade, it becomes very expensive to support this little hobby of mine. When I started the Underwear Drawer, the webpage service (offered through Homestead) was free. Then, after about a year, the price increased to something like $25 annually. No sweat, even for the med student I was at the time. Then, insidiously, the annual fee was increased to $82. Well, by this point, I had been keeping the page for years, I wasn't just about to scrap it all, so OK. Then, recently, with the debut of "Scutmonkey" and upgrading my package due to increased traffic demands, $135 a year. Still OK. But now, with the bandwidth demands, in order to keep my main page up and running (as opposed to showing an error message "Page Not Found" every time someone tries to access The Underwear Drawer), I'm looking on the order of maybe $400 a year. I may have a job, but I'm just an intern, and I don't get paid terribly well for the hours, so $400 is still a lot of money to me.

So here's the pitch. I already upgraded my package to support additional bandwidth, but I'm looking for some outside sources to help subsidize The Underwear Drawer and it's much more popular younger cousin, "Scutmonkey." I have opened up a store with fun merch through cafepress.com, where you can buy all manner of Scutmonkey gear, including t-shirts, sweatshirts, lunchboxes, messenger bags, what have you. They're fun and relatively non-advertisey, so it's not like you have to walk around with a URL plastered around your chest or anything.

In addition, as a bit of fun for the med student crowd (or their friends), I have created a seperate line of merch just based on the "12 Types of Med Students" comic. You can either get a t-shirt with the whole comic printed on front, or decide which one of the 12 Med Student types you are and get a custom t-shirt just highlighting that type. Decide which one you are and wear it loud and proud! It's fun! And if anyone wants to e-mail me pictures of them wearing their "Scutmonkey" t-shirts, I will happily post it online to utilize the bandwidth towards which you contributed. So please, look around, see what you like, and if there's a design you would like to see on a type of merchandise you don't already see featured in the shop, (frisbee, trucker hat, sticker, travel mug), please let me know, because I am more than open to suggestion. Thanks, everyone, for your help!

And now, just so I don't close on my solicitation for fundage, a little anniversary update. Tonight is our Anniversary Observed (much like how we always celebrate MLK on a Monday, even if his birthday is on a Wednesday or something), so I have to get all gussied up for our Spanish dinner of mystery and romance. Except that I'm really tired and I won't be able to put in my contact lenses because of my allergies, and all my makeup will rub off in the first five minutes of us leaving the house because of me blowing my nose so much. Also, no perfume, and I'll probably fall asleep during the main course because antihistamines and wine do not do a body good. So I guess I won't really be that gussied. But at least I showered.

Currently reading: "Drinking, a Love Story". We got it free from the Addiction Counseling office in med school, and wouldn't you know, it's pretty good.

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