Tuesday, November 30, 2004

doctor evil

Sometimes I think I'm a bad person. Or at least that I use up all my good will at work, and when I actually step out of the hospital, all that's left is a cynical, self-centered husk. I was sitting on the subway post-call this morning struggling to stay awake, and seated next to a middle-aged disheveled man who was clearly trying to do the same. Obviously I was having more success than he, as the guy kept listing over to one side and doing the bob-and-weave so commonly seen during boring lectures in med school when the lights go down. The man was out of it, though from plain fatigue or chemical-induced delerium, I cannot say. Finally, he flopped over so far that he actually fell over onto the ground, where he lay there for what seemed like an eternity before lifting up his head, shrugging, and resuming his righted position back on the subway bench. I am a bad person because this is what I thought when he fell over:

Oh shit. Does this mean I have to do something?

He's an adult. Maybe I can get away with feigning ignorance because I do Peds.

But I'm wearing scrubs. I'm obligated to help. Shit. I'm tired. I was helping patients all night long. I don't want to help some guy on the subway too.

What if he's dead?

Should I get down on the floor all BLS style? Should I ask him if he's OK? Is it all right if I just nudge him with my feet instead of using my hands? That's probably rude.

Please get up. Please. Don't make me come over there.

Oh, thank god. He's getting up. Now to resume my life of apathy.

So you can see, I'm a very bad person. But that's the thing about working in the hospital. You spend all day giving and giving and giving to people and it's never supposed to be about you. Which is ultimately good I guess, that's why medicine is a satisfying profession and all that. But the unfortunate backlash, unless you're some kind of otherworldly saint, is that at the end of the day you're just sick and tired of being the go-to guy (or gal) for everyone's needs except your own. And this causes you to be selfish sometimes with your time and resources. I don't want to take care of you, random drunken stranger man. I have to take care about too many other people already.

I guess I'm not a very nice person.

Currently reading: The cartoon issue of The New Yorker. Franzen is right, "Peanuts" was much better before they introduced Marcie and Woodstock.

Sunday, November 28, 2004

couch therapy

I think I've gotten over the worst of my virus, and just in time to be on call tomorrow, where I can pick up a nice fresh illness. Sweet!

Last night, because we (read: I) didn't feel like doing anything that involved a lot of moving around or being outdoors, we rented "Boogie Nights" from Blockbusters. It was kind of a path-of-least-resistance rental, since all the new releases we wanted to watch were already loaned out, and it was the first movie we saw on the rack that neither of us had had seen or had some strongly negative reaction to. (Anyone interested in renting "The Golden Girls, Season 1"? I mean, really. There's nothing as funny as menopause, I'll tell you what.) Anyway, "Boogie Nights" was interesting enough, though I kept thinking how bad Rollergirl's feet must have smelled if she really never took off her skates.

Other movies that I caught (at least in part) this weekend while lying on the dog-smelling couch, clutching weakly at my fleece throw, sucking on a Cepecol lozenge:

  • "Father of the Bride 2." Oh how the mighty have fallen. The first "Father of the Bride" was great, of course. Love it, quote from it by heart, get the little tear in the corner of my eye at the end. But the second one, pardon my clinical incorrectness, is retarded. Oh ha, the daughter and the mother are pregnant at the same time! And Steve Martin is whipped! And then the daughter moves away! But it's OK, because they have a new replacement baby daughter! And Martin Short is somehow inexplicably incorporated into their family, even though he was their wedding planner, like, two years ago! And there's a Culkin kid in it! This movie makes no sense. And also, I resent them because they're so totally rich that they can totally build some "baby suite" addition to their house with all new furniture and toys, instead of just turning some closet into the nursery like normal people.

  • "Mulan." This was just on The Disney Channel this evening. What's the link between "Father of the Bride 2" and "Mulan"? That's right, they both feature B.D. Wong, the Famous Broadway Asian. (Well, he and Lea Salonga, who was also in movie, as the singing voice for Mulan. I guess the go-to list for Asian actors who can sing is kind of short.) In "Father of the Bride," he plays Howard Weinstein, Franck's ambiguously gay assistant. And in Mulan, he voices Li-Shang, Mulan's ambiguously gay captain. (How else do you explain the fact that he's in such good shape, I ask you?) What I don't understand is how come they had to get Donny Osmond (DONNY! OSMOND!) to play the singing voice of Shang. Hasn't B.D. Wong proven that he can sing? He played Linus in the Broadway version of "You're a Good Man, Charlie Brown," for crap's sake! He could certainly sing that "Be a Man" song. Maybe he just couldn't get through the lyrics without cracking up.

  • "Jingle All The Way." This was an accident. At first I clicked onto the channel and saw Sinbad dressed as some sort of mailman. And I couldn't figure out what movie it was, but thought it might be that one where he pretends to be a dentist so that he could crash at Phil Hartman's house. Then, in the next scene, I saw Arnold Scharzenegger wearing his "madcap" acting face (to contrast with his "steely death mask" acting face) and I realized that I was indeed watching "Jingle All the Way." To quote Arnold himself, "Nooooooooo!" And I changed that channel quickly, quickly, taking care not to look directly at the screen, to prevent myself from going BLIND.

Currently reading: "Salt," and the Cartoon Issue of The New Yorker with the cover by R. Crumb.


Saturday, November 27, 2004

on the job hazard

Just when I thought I had built up immunity to every snotty vomitty little kid virus known to man, I pick up this sore throat and cough from work. Damn you, walking germ bags.

Thanksgiving on call wasn't so bad. I was explaining to my interns (possibly to make us all feel better) that being on call Thanksgiving is the second-best scenario, given that in the wild world of Q4 call, we would have had to be on call sometime over the four-day weekend anyway. But what being on call Thanksgiving buys you is:
  • Pity. The world's most useful bargaining tool.

  • A two and a half day weekend afterwards. There's something vitally important about having an uninterrupted stretch of time off. One little snippet here and one little snippet there is not nearly as restful.

  • Enough free food to choke a rhinocerous. Between the anonymously donated turkey and fixin's in the housestaff lounge, the ten-course buffet donated by the nursing managers in the PICU, the impressive spread donated by a family on the Oncology unit, and the own snacks that we brought from home to cheer ourselves up, we were eating all day and most of the way through the night. There's nothing like gnawing on a cold drumstick while sitting in the housestaff lounge in scrubs, commiserating with your friends about sundry woes and pretending not to hear our pagers going off.

So as noted, being on call Thanksgiving is the second-best scenario. But the first-best scenario is being on call the Sunday of Thanksgiving weekend. Because that way, not only do you get the two and a half day weekend, you get Thanksgiving itself off, and you get post-call day off on Monday. You can see I've thought long and hard about this. Because this is what residents do. We scour our schedules, comparing various scenarios and keeping a keen eye out for any perceived inequities or favoritism. We are sad people.

Speaking of sad people, I woke up this morning gingerly testing my sore throat with repeated exercised in swallowing ("Still hurts...let me try that again...still hurts") and mentally giving myself medical advice with regards to hydration and the like. I'm so floored with having two days off in a row that I don't even know what to do with myself. Christmas shopping? Go see a movie? Get a haircut? Call up my sisters for lunch? Likely I will be so paralyzed by choice that I will just end up procrastinating and doing nothing. I'm like "Waiting for Godot" over here.

Currently reading: Finished "Geisha, A Life" and have now moved on to "Salt." That's a book about...salt. No, seriously.

Thursday, November 25, 2004

happy thanksgiving

Happy Thanksgiving, everyone. I'm on call today, and heading into the hospital in a few minutes. May your Thanksgiving dinners be bountiful, may your time with family be cherished, and may all your children stay healthy. Or at least reasonably well enough to be discharged home straight from the Emergency Room, so I won't have to admit them to my service.

Currently reading: "Geisha, a Life." I would definitely have a hard time wearing an outfit like hers, in which it's so hard to go to the bathroom.

Tuesday, November 23, 2004

blah blah work blah blah

Three calls in six days. Guh. I'm not going to talk about work anymore.

OK, maybe a little. Tell me, is there anything more frustrating than trying to put an IV into a fat baby? I mean, not just fat in the way that all babies are kind of fat, I mean a FAT baby, like a tiny little Jabba the Hut, a baby with full on rolls and dimpling not just near his joints and who are phyically unable to fully extend his legs because his thighs are so freaking huge. I know there's some weird, primal satisfaction as a mom to see your baby eat (and eat and eat and EAT), but come on, people. A 7 week-old baby should not weigh seventeen pounds. This baby from last night could barely even move. It looked like a giant, overstuffed haggis.

I was having a conversation with one of my interns the other day, and the point that I was trying to make at the time is that not all babies are cute. She protested, saying that all babies are cute at least in some way. But I disagree. Some babies are definitely not cute. Some of them are smushed-looking. Not just when they're born and are generally mashed and slimy and placenta-y. But some of them just look smushed normally. Some of them look too much like their parents, which can be oddly disconcerting, to see a thirty year-old face on an infant. And some of them are just freaky-looking. I'm not talking about babies with syndromes and stuff, I'm talking about normal, regular babies who just look weird. There was this one baby I saw in the Well-Baby Nursery that I was all jazzed to do genetic testing on, because to me, she looked dysmorphic and odd. But then when I saw her parents, I realized that maybe the baby wasn't syndromic, maybe she was just ugly.

It's OK, I can say it. I'm in Pediatrics. It's scientific!

So aside from bashing the poor ugly babies (may you all turn into beautiful swans someday), I've been just generally trying to recuperate in between my ward calls and keep up with the rest of my life somehow. I got an e-mail from Joe's mom today asking me what Joe wanted for Christmas. I honestly couldn't say right now. A winning lottery ticket, maybe? I've been doing a little preliminary Christmas gift-planning myself, but all that ends up happening is that I just end up looking for stuff that I want. Like this, I want, but am embarassed about. In case you can't be bothered with links, I'm talking about the Britney's Spear's Greatest Hits CD. Mostly, I want to get it so that I can play it loudly when no one else is home and dance around like a spaz. But also, I have a strange fascination with Britney Spears now. It's like this one time I saw a woman eating a wig on the subway. (You heard me. She was eating. A wig.) You're fascinated and horrified and embarassed and pitying and yet a little bit entertained. And that's my relationship with Britney Spears at this point. Also, I find the cover of her new album disturbingly airbrushed and trashy. Ain't no way Britney's been that tiny in years.

At least I have the rest of the weekend off after my call on Thanksgiving Day. Not sure what I'm going to do with those two and a half days off. Maybe just lie in bed reading magazines and let my brain sloooowly atrophy. Sounds like fun.

Currently reading: "The Best American Nonrequired Reading 2004" and "Geisha, A Life" which is like the real-life version of "Memoirs of a Geisha." The best part about Japanese writing is when they talk about the food they eat. Unfortunately, she hasn't really gone into it in great detail in this geisha memoir--they're too busy prattling on about kimono and such. Read some Banana Yoshimoto if you want to get hungry.

Sunday, November 21, 2004

early to bed, early to rise

I was so tired Friday night that I went to bed at 8:30pm. I'm ninety years old. The plus side is that when I woke up at 5:30 Saturday morning for my day on call, it wasn't really that painful. Thereby also confirming that I'm ninety years old.

While asleep, I had a dream that I was on my way to the hospital to take call, and forgot to bring a sweatshirt to put on when it got cold overnight. This was very upsetting to me. I've had multiple call-related anxiety dreams over the past year and a half in which I'm not wearing appropriate clothing. Like street clothes instead of scrubs, or high heels instead of sneakers. Not that I ever wear heels anyway. But this somehow seems to be the central dream focus of call for me, wearing clothes that confer the right degree of comfort, rather than any concerns about the work or the patients or anything like that.

But anyway, we had a good call last night. Not too busy, and our one sickest patient went to the ICU early in the day, which is not such great news for him, but probably good news for us, given how much hovering he required around his bed. I'm on call again tomorrow, and then again on Thursday. Apparently some anonymous donor provides all the on-call residents Thanksgiving Dinner. I just hope it's not Tofurky.

Currently reading: "The Best American Nonrequired Reading 2004." I wish they included more non-fiction in this edition.

Thursday, November 18, 2004

urea cycle defect

All my electronics are misbehaving. First, my pager doesn't seem to be working very reliably. Unfortunate my night on call, though luckily I was carrying two other pagers and a hospital phone on me. Next, my $3 Duane Reade calculator seems to have finally given out. Never again will it perform an insanely simple calculation that I was too lazy to do in my head. (Yes, five multiplied by ten is fifty.) Finally, every single printer on wards seems to be broken or out of toner, and every computer I touch seems to freeze or require some manner of tech support. I would suggest keeping your children far away from me. Especially if your children are ROBOTS.

I was in an extreme state of fatigue all day yesterday, because the dog inexplicably decided to pee on our bed overnight, and I woke up at 1am to a very large wet patch at my feet, soaking through the comforter (that somehow is the grossest part, THROUGH THE COMFORTER) into the mattress. It's a testament to my powers of self-delusion that even though it was totally obvious what had transpired, I kept trying to convince myself that maybe Joe had spilled a glass of water at the foot of the bed prior to going to bed, and didn't tell me because he didn't want to wake me up. And that maybe Joe liked drinking water with urea in it.

I tried to continue sleeping, rearranging my legs so that they straddled the wet patch, but every time I moved, my feet touch it and I would get all annoyed and starting thinking about strategies for mattress cleansing and suchlike. Finally, at 3am, I gave up and moved to the guest room to sleep the remaining hour and a half on a mattress that, you know, wasn't soaking with dog urine. I also decreed the next morning that the dog no longer sleeps with us at night. Her spending the nights with us was never my idea to begin with, because she keeps us up occasionally what with her whining and toenails clacking on the floor and spontaneous growling at mysterious things out the window. I have rhabdomyolysis from her 80-pound bulk sleeping across my legs. And now with the peeing. She's in the dog house. Sometimes she picks up UTIs or chemical urethritis (I speculate) after spending time at the Dog Spa, since they hose down every surface of the place with bleach--but come on now. At least be incontinent on the floor.

So this was not the ideal night's rest to have prior to my call last night. I could barely concentrate on rounds, so I had to ask people to repeat things constantly, and I'm sure that my interns were going to kill me.


INTERN
The patient was afebrile overnight, taking good POs.

MICHELLE
(Deleriously)
Yes, but did he have a fever? And was he taking good POs?


Nonetheless, despite my bad head-state and pan-electronic malfunction, we had a reasonably good call night. One call down, six more to go.

Currently reading: "Bridget Jones's Diary." I love the British slang.

Tuesday, November 16, 2004

i have to do this for a whole month?

Day two on the wards and I'm still alive, but very tired. I don't know what's wrong with me. The list is reasonable, the kids aren't so so sick, and we're getting good support on all sides. So why am I all stressed out? My co-senior and I were both working today, so since she was on call tonight, she ran the team and I took the senior admitting resident pager (heretofore known as the KIDS pager, because that's what it spells when you dial the pager number on the phone: 5-4-3-7), to field any new patients coming to the floor.

I hate holding the KIDS pager.

What is this horror anyway? A pager that goes off ceaslessly? That never, ever, ever stops going off? Because people don't ever stop paging KIDS. And they call for everything. They call because they know that there will always be a senior resident on the other end of the line who call back promptly, because if we don't, next thing we know we have a hypotensive septic onc patient who just came off pressors five minutes before transfer sitting on the floor without signout from the PICU. Because the sound of the KIDS pager is the sound of fear. OK, so maybe that's a little dramatic. But it is at the very least the sound of work. Lots and lots of work.

And the worse part? Someone set this pager to one of the musical ringer tones. And the song? "Theme from Love Story." Come on, people. As if it wasn't annoying enough?

I can't wait until I'm on call tomorrow night. At least I got my new sneakers to make me feel special.

Currently reading: I have "The Best American Non-Required Reading 2004" on deck, but not quite enough energy to start it at the moment. Did you notice the cover illustrated by Adrian Tomine? Quality!

Monday, November 15, 2004

senior citizen

Today was my first day as Ward Senior. And it was kind of fun. I'm still trying to learn my new role, differentiating my job from that of the interns, and catch up with the five million bajillion sets of rounds that I'm expected to be at every moment of the day. But I find that the biggest difference is that now, when people ask me what I want to do about a patient, it's not just a Socratic exercise or a topic for academic discussion. They actually go ahead and listen to what I say.



ATTENDING
So, what are we going to do about this kid?

MICHELLE
Well, what I'd like to do is send this lab test, start this med, cut back on his fluids, and get him ready to go home tomorrow morning.

INTERN
OK!
(Starts doing all of those things in an incredibly efficient way)

MICHELLE'S INNER MONOLOGUE
Oh my god. I have the power of Greyskull.


I mean, obviously, it isn't just all about rounding and me telling people to do stuff while I sit at a desk counting my money. ("Three, four, five...six cents!") As seniors, we're ultimately responsible for all of the patients on the team, so I did have to spend a good deal of time walking around, examining all my kids, talking to the parents, and basically making sure that the story I understood from rounds was actually the real story. Nothing as embarassing as having someone come up to you asking how long we should continue Patient X's antibiotics, only to be caught completely unaware that Patient X was on antibiotics in the first place.

But being the senior is fun. There's more responsibility, there's learning, there's teaching, and sometimes even free food. And the quiet relief in knowing that you have some experience under your belt. Today, we had to tap a kid on the floor who had been tapped literally nine times in the ER, all unsucessfully. It was tricky, and the kid's back had all these little holes up his spine from past attempts, like he was perforated down the middle. And the mom wanted to stay in the room while I was doing the LP. So yes, there was some sweating, but when I finally got that needle in position and that pretty, pretty CSF started draining out, I had to refrain from doing the freaking-out-with-joy dance and just handed those hard-won tubes to the intern, who rushed them off to the lab. I got the tap, helped a patient, avoided being throttled by the mom, and I didn't even have to tube the samples down myself. It's a beautiful life.

Currently reading: About bronchiolitis in preparation for a talk I want to try and give tomorrow.

Sunday, November 14, 2004

petty

We weren't planning on some Big Night Out earlier in the day, but yesterday evening turned out to be some sort of gigantic med school reunion. Though, to be more precise, it was a third year rotation group reunion--preferable, since those are the only people I like from med school anyway. We met up with Dave for dinner down on Irving Place (I ordered a "thai pizza" which came all rolled up in tube-form like a burrito--why not call it a "thai burrito" then?) and then took the subway up to the Upper West to have drinks with Guillem and Heath'n'Sheryl, who were in town for the weekend. It was fun to catch up, and I got some anesthesia lowdown from Sheryl, which served the dual purpose of making me both excited about my switch, and very, very nervous.

Joe's been on call next weekend, I'm on call next weekend, and we're splitting call Thanksgiving weekend (on different days), so we're basically like two ships passing in the night for the entire month of November. Which sucks, but who knows, maybe it's good for the marriage, since we never have a chance to get on each other's nerves. Or to see each other at all, in fact. We have a sham marriage, like Liza and David!

Speaking of schadenfreude (how's that for a segue), Joe and I were having this discussion in the cab on the way home last night. I don't know how to topic came up, but we were talking about thoughts that were normal, but not necessarily very nice to have. My example of such a feeling was taking some sort of dark glee in comparing yourself against the new girlfriend of an ex-, and noting that you are more attractive than she. Or more intelligent. Or have bigger boobs. (This last sentiment I have personally never experienced, unless I was comparing myself to a preteen boy or something.) This nasty little measuring-up has nothing to do with wanting to date your ex- again, or hating the new girl, or whatever. It barely has anything to do with you and your life, but it crosses your mind anyway. It's petty, but it happens. And my point was that it was pretty normal to have those thoughts. (Or course, the converse of this would be that if your ex- started dating some six-foot tall witty Brazilian supermodel-slash-astrophycisist, you might pout for a while.)

Joe, on the other hand, feels that this kind of petty rumination is ABnormal, and that he would never think such things, and my god, what was wrong with girls anyway? That in fact, the only thing that would come to his mind upon meeting the new boyfriend of an ex- and finding them to be dull or fat or pimply is that maybe it maybe it would mean that he (Joe) was ugly, because "people tend to set a pattern of dating people on the same attractiveness level." Which, aside from making no sense at all, is just a TOTAL LIE, because you cannot tell me that if Joe and I had broken up and I started dating, say, Michael Ian Black, that Joe would not be thinking:

1.) That guy is scrawny.
2.) And weird.
3.) And I have bigger pecs anyway.
4.) I win. In your face, Michael Ian Black! (Commence mental football touchdown dance.)

After some more discussion, Joe conceded somewhat to the above. But you could still tell he thought he'd be above all such pettiness. Which only proves two things. One: that men can be even worse women, because even if they're equally petty, they won't admit it. And two: Michael Ian Black is funny.

Currently reading: "Bridget Jones's Diary," as sort of mind junk food before I start work again tomorrow morning. I though Renee Zellwegger looked sorta cute in the first movie, but all the ads of her in the sequel look terrible, like they never let her wash her hair or something. What gives? Just because she had to gain weight for the role doesn't mean that she has to look like a total slob.

Saturday, November 13, 2004

twenty-twenty-twenty four hours to go

So I'm still working on the sedation piece for my Web-Based Curriculum elective from earlier this month. No, I didn't quite finish it before I went on vacation. Because I'm BAD. Keep your children away from me parents, I don't finish my homework. Also, sometimes I eat candy for dinner.

Did anyone get the title of this post, by the way? The Ramones? I'm doing a project about sedation? Oh, clever, clever me. I would have just called the post "I Wanna Be Sedated" but I had another post with that title already from two and a half years ago, while I was rotating through anesthesia as a third year med student. Funny how your views on a field can change from med school up through residency. Keep that in mind, wee med students. What sounds bad or good in theory might not be quite the same in practice.

I mean, I still think some of the things I noted back then are true: 1.) that OR cases might occasionally be boring between takeoff and landing, and 2.) that sometimes surgeons can be pricks. But I think it's going to take a long time before I feel comfortable enough to be bored during an OR case. Like, years. It just seems so nerve-wracking is all. This change in attitudes highlights the key difference between med students and residents, by the way. Med students have all the luxury of learning (yes, luxury) and ultimately none of the responsibility. Trust me, it's a nice life, so enjoy it. Residents, on the other hand, have the onus of needing to learn, and responsibility for everything. Well, not everything. Guess we can't really help it if the ceiling caves in over a patient's bed. (Unless yo' momma was so fat and she caused the ceiling to cave in by standing on the floor above. Oh snap!) So believe me, it's much more scary being a dumb resident than being a dumb med student. Not getting honors versus killing someone? I'll take the Low Pass any day.

I had a hard time falling asleep last night because I kept fretting to myself about being one of the seniors on the wards next month. I know, I know. "You're ready for it." "It'll be fun!" "You'll enjoy the role." I've heard all the arguments and encouragements already. But the fact is, I'm more than a little nervous about having to be in charge, especially overnight. What, all of a sudden, I supposed to know what to do? Because what if I don't? And then what, I ask you? Won't somebody please think of the children! (tm Maud Flanders) [correction: tm Helen Lovejoy. Thanks, Hazel!]

In typical obsessive-compulsive fashion, I'm sort of going over in my head what I'm going to say to the team our first day to briefly set the stage before rounds. Most of the interns have been on the wards before, which is nice, though I have one new Emergency Medicine intern who will be rotating through Peds for the first time. And to top things off, we have a shiny new crop of med students starting on Monday too. Oh, shiny med students, the glare is so bright! Hopefully they'll be somewhat enthusiastic and excited to learn, and not like those crops that rotate through near the end of the year that are all bitter and disinterested and hide out for hours in the student lounge. (In other words, med students like me.) I feel a little like an RA in college the day before freshman orientation. I want everyone to be happy and fun and be best friends forever and ever woo! Let's get all our patient work done early, so that we can make friendship bracelets and braid each other's hair!

There is also a secret fear in my heart that everyone's going to think I'm incompetent and hate me.

Currently reading: "The Corrections." Still. It's a long book, OK? Also related, the book club is updated through October.

Friday, November 12, 2004

open season

I had to head uptown earlier today for a pre-ward orientation meeting with the Chiefs. Afterwards, I found out that I've been slated for an extra month in the ER this April. Guh. ER time. One one sense, ER time is good as one can view it as basically call-free, what with being shift work and all. But in another sense, I find that a day in the ER can somehow feel three times as long as an analagous day in the ICU or the wards. There's just nothing to break up the time, you know? It's like working on an assembly line in a factory: pick up another chart, pick up another chart, pick up another chart. Done with that patient? Great! Here are three more for you to see. There's no breaks, no conference, no discreet teaching time, no designated lunch or dinner breaks. Just work work work. Cram half a sandwich into your pie-hole in between nebs. Then work work work again. Maybe they'll give me a pick-axe and I can break up some rocks while I'm at it.

Don't mind me, I'm just embittered because my vacation is ending and the thought of returning to my Q4 workaday life is filling me with quiet dread. But actually, I'm downright filled with positivity! Or at least feigning positivity. Interview season has started again, and the halls of the hospital are awash with tastefully suited applicants and leather portfolios. Interview season is such a strange time. How to sell the program without seeming like a total liar? How to seem upbeat without seeming fake? How to convince total strangers that we're TOTALLY FUN and RAD and LOVE OUR JOBS and WOO WOO GO TEAM without having the applicants back away, wide-eyed, groping for the doorknob?

In one sense, it's fairly easy for me to sell our program, because despite everything that I whine and cheese about, I really do like my co-residents and I really do think we're rad, and some days I do get pretty excited about my job. But there are things that suck too. I mean, come on now, it's residency. It's not supposed to be a fucking cocktail party. So how to allow honesty but not scare people away? How to highlight the good without seeming like I'm blowing sunshine straight up to the splenic flexure? And how to eat as much free fancy interview food as possible without seeming like they don't pay me enough salary to afford food?

But anyway, those are thoughts for another day, when I'm officially back in the hospital and obligated to concern myself over such things. After a long and rainy commute, I'm back home, eating a late lunch of leftover chicken tikka masala, and the dog is giving me this look of sadness and longing like those kids in those "Save the Children" ads. (Before they get their sponsors, I mean.)

Currently reading: "The Corrections". Oh, such a madcap family romp. Also reading a little about travel in Asia in planning for our next trip in March. The good thing about going to Asia would be that if they decided to put me on night float in the ER after we got back, the jet lag would totally work in my favor.

Thursday, November 11, 2004

the other one

There's a young Asian couple on the 15th floor in our building that had a baby a few months ago. I don't really know them except by sight, and noted them mainly because they're two of only about five Asian tenents in the building.

Earlier this evening, I went down to the lobby to pick up our take-out dinner from Curry in a Hurry and bumped into another tenant, an older Park Avenue-type woman just coming in from walking her dog. We stood waiting for the elevator together and made some pleasant chit-chat. Then...



PARK AVENUE-TYPE LADY
And how's the baby?

MICHELLE
Baby? I don't have a baby.

MICHELLE'S INNER MONOLOGUE
At least, I don't think I do.

PARK AVENUE-TYPE LADY
Oh wait, you're the other one!

MICHELLE'S INNER MONOLOGUE
"Other one?"

MICHELLE
(Realizing, then covering)
Oh, you mean the other Asian woman, she and her husband have that really cute little baby on 15...

PARK-AVENUE LADY
Yes, yes, exactly! I'm sorry, I'm so sorry! You look so much alike!

MICHELLE'S INNER MONOLOGUE
Well...not really.

MICHELLE
(Laughing)
Don't worry about it, it happens all the time.

PARK-AVENUE LADY
Sorry! Sorry!
(Exits elevator)


At least she didn't ask me when my due date was or something like that. That would have been way more akward. One time my mom asked a woman when she was due, and the woman replied (in a surprisingly good-natured way), "I'm not pregnant. I'm just fat."

Heh. "The other one."

Currently reading: "The Corrections". Just took another trip to Barnes and Noble today and picked a few new treats out for all those frigid, early-morning commutes next month. Of my fiscal responsibility, Joe noted the other day (because he wants me to start thinking about getting a new computer), "You don't really spend that much money on yourself. Only food and clothes. And books. Lots of books." Speaking of which, the book club is updated through July 2004.
welcome to the book club

So it's not really up to speed yet, but the beginnings of the book list page are up here at the underwear drawer book club (there's also a new link on the sidebar). I'm only listing the books that I've read since I started the "Currently reading" section on my daily entries (I think that was about mid-April of this year), otherwise it's too hard to remember what I was reading, and I'm not going to slog through my old entries from 2001 to figure it out. Doesn't much matter, those older books will wash up on the list eventually, since I re-read almost all my books at some point. Right now I'm up through May of 2004. Check it out if you're interested--I'll work on updating it up until the present over the next few days, and then I'll probably update every month with last month's book list. Thank you also to Jenn and Chris for encouraging and re-encouraging me to get moving on the book club page. It's fun to look at my reading habits over the past half year, and on the selfish side, if it generates more good book recommendations from you guys, I'm all for it.

I'm having lunch with my dad today, and then I might head on over to the Museum of Natural History to take some pictures. (The reason I have to see my dad first is that he's a museum member, and if I pick up a card from him, I'll be able to get in for free. I love the museum and everything, but there's no way I'm spending $13 or however much it costs unless I'm spending most of the day there.) I've also starting to feel a kind of low-grade panic that it's so late in the week, and I'm back in the wards on Monday. My vacation's almost over already? But I was just starting to get used to it!

Currently reading: "Beg the Question". Another re-read. There's a lot of sex in this book. I get a little embarassed reading it on the subway, so I have to hold it almost vertical and very close to my face so no one can read over my shoulder.

Wednesday, November 10, 2004

cara is a goddess

Within hours of my posting my shoe lament, Cara of from doctorsquared posted a reply that she found Amber/Parchment Saucs in my size on Eastbay! Oh, lovely shoes. I snapped those puppies right up, boy. Thanks so much, Cara! I'm wearing those badboys the next time I'm on call. As Ward Senior, I'm sure all the extra traction will come in handy.

So that's one great thing about having an online journal. Nice readers help me find shoes. I should have mentioned that perk to Jen during my interview for the alumni magazine, though I didn't know about "Operation Shoe Find: Mission Accomplished" at the time we were talking.

The interview was fun, by the way. I found out that Jen and I overlapped our time at the Wellesley News (though she was much more involved at the administrative level than I), and I learned about some of the bloggers she was interviewing for the article. All my questions have been answered. I'm a simple girl. Anyway, I'll be interested to read the article, and will link to it when it comes out in February if there's an online version available.

Currently reading: Bouncing between "The Corrections" and The New Yorker.
the ones that got away



So I'd been eyeing this pair of "Amber/Parchment" nylon Sauconys for a while. They are a lovely burnt umber and on sale and besides, if you have a job where you're wearing the exact same outfit at least every fourth day, why not get all sassy with your comfort-shoe wearing self? Anyway, one of the PICU fellows has a pair of Saucs (he calls them by their nickname, they're so intimately acquainted) that he's been wearing since residency, and he says they're the most comfortable shoes he's ever owned. Sounds like an easy sell. But even though they were on discount, I hemmed and hawed. I looked at the shoes in my closet. I weighed my need for more shoes versus the desire for new shoes, and decided that it was simply desire that was driving my yen. But I still wanted the shoes. I even put them in my little Amazon.com shopping cart in the "Saved Items--To Buy Later" section, so that if I did change my mind or decide to throw fiscal responsibility out the window, there they'd be, waiting for me.

I decided to go visit my shoes online today. But wouldn't you know, they're sold out in my size. Dammit! I knew I should have bought them before.

Wouldn't you know it, they're available half a size larger and half a size smaller than I wanted. But no 6-1/2. I actually do wear a size 6, but I like to leave a little extra room in my sneaker for gym socks or post-call foot expansion. So while I could convince myself to get a size 6, that's just a one-way ticket to regret. As for the size 7, they're just plain too big. Believe me, I've made these mistakes in the past. I know that my feet are not that adaptable.

Dammit. I should have bought those shoes.

They do have other colors still available, though. Unfortunately, those colors are ugly as sin.



What the fuck is that? Do I look like Smurfette? Or how about this one:



That one would be great, if I were on the math team and ate my own dandruff. Or how about this one:



Maybe if I were a tennis pro from the 50's. And there's nothing like a pair of white sneaker to scream "HELLO!!!! I'M NEW!!!!" These green ones I actually think are pretty cool, and so renegade in pointing the opposite way from the other shoes...



...but it doesn't matter how much I like the green ones, because I had my heart set on the "Amber/Parchment" ones. I wanted the Aaaaaaamber/Paaaaaarchment ones! Why did they sell out? Why?

Dammit.

Currently reading: The article in the New York Times "Dining and Wine" section about gourmet ramen restaurants in the city. Have you guys seen that movie "Tampopo"? Ramen fever coming to New York, it's like my dream come true. Now I'm all hungry.

Tuesday, November 09, 2004

post-travel, pre-travel

Cooper has been a little under the weather since we got back from Hawaii. I don't really don't what's wrong, only that her tail is down, she has a runny nose, and is sleeping somewhat more than usual. So she probably picked up some kind of a cold at the Dog Spa. It's like kids in daycare or something. She's fully immunized against everything including kennel cough (Bordatella, though not pertussis species--who knew?), so I'm not too freaked out. But I did do a crazy dog-lady thing yesterday: I fed her some soup. Really the soup was for me--I was having chicken soup with rice for lunch--but the formerly dormant Jewish grandmother in me decided that the curative properties of chicken soup were equally applicable to canines. Anyway, Coop seemed to enjoy it, especially the chicken part, so I guess she's can't be that bad off.

We only just got back from our latest vacation (albeit the first one together in a year and a half), and already, I'm trying to plan our next big trip. It's a bummer that Joe only gets one week off at a time (he gets 4 one-week vacations, I get 2 two-week vacations), because it really puts a crimp in our style as far as planning trips for far far away. If I'm flying 30 hours to get to Bali, I want to stay in Bali for more than three days, you know? Especially since the plane tickets cost five hundred million gajillion dollars. There's a strong possibility that we may go on a trip with my family, which would be very fun--the last time we all went somewhere together was in 2002, to Japan--but in case those plans fall through for whatever reason, I'm researching some contingency travel itineraries.

But anyway, the two possibilities I've been investigating are the Two European Capitals trip, and the Thailand Sex Tours trip, minus the sex tours part. The European Capitals trip would be easy enough, it would simply entail flying into London for a few days, taking the Chunnel into Paris for a few days, and flying back. New York to London is practically a commuter flight, only 6-7 hours of flight time each way, and we'll end up in big navigable cities with excellent subway systems, and lots of sights to see. I've been to both London and Paris several times in the past before, but haven't been since high school or thereabouts, so I would love to go back. Joe hasn't been to either, so I think he would like to see what all the fuss is about. And I'm just such a sucker for cities with a good subway system.

The second trip possibility was inspired by this New York Times article that I read this weekend about traveling on a budget in Bangkok. I think the biggest hit we would take in traveling to Thailand would obviously be the price of the airline tickets. Well that, and the torture of sitting on a plane for anywhere between 24 and 30 hours. I shudder to think. But anyway, once you get there, I think the living is relatively easy. The hotel recommended by the article sounds decent and goes for only $22 a night. Food is cheap, the region seems safe and pedestrian friendly. Oh yeah, and the article mentions that you can get a two hour Thai massage for $6. (Of the last bit, Joe accuses, "That's the only reason you want to go!") Well, kinda, yeah.

Anyway, coming back from vacation means coming back to reality, and there are a number of meetings and errands that I have to tend to this week. First, I had to print off another run of "Scutmonkey," since the first print run sold out. Already the second print run is taking off, so I might need to start looking at getting more supplies for a third printing. (Speaking of which, is there something going on in Texas that I don't know about? A lot of orders have been coming from Texas lately. Just wondering.)

Today I had a meeting with respect to some GME funding problems for my switch. The fact that there were funding problems at all was fairly traumatic news to me, delivered just before I went on vacation, and leading me to think that I might be jobless next year and forced to sell those Miracle Vegetable Peelers at Bed Bath and Beyond or some such in order to make money. I mean, I joke about quitting residency to go work at the Gap, but I don't actually want to sort the Relaxed Fit from the Boot Cuts. Anyway, the upshot of the meeting is that I do have a position with Anesthesia for next year, but the GME office has nixed all mid-year switches, and insists that I start July 1st or not at all. I've eventually come to terms with this, but mostly because I have no choice, and I was thinking about the situation while in Hawaii, which made all work-related issues seem cosmically insignificant. So as long as they don't go changing the rules on me again, I'll be fine with finishing out my year in Peds. This development, of course, makes me the biggest sucker on the planet, becasue instead of taking the position to start last July 1st as it was offered, I insisted on staying on for an extra few months to help out with Peds coverage, so now I shot myself in the foot by trying to be Little Miss Helpful. But I'm trying not to think too much about the fact that I'm doing an extra year of residency for no reason, and trying more to think more about the fact that I'm learning and getting all this extra experience and sharpening my clinical acumen. The mind games we play with ourselves.

Tomorrow I have an interview with Wellesley Magazine, because they're doing some sort of an article about "Blogging and Wellesley" for the next issue and somehow found me through their research. I've never been interviewed about the site before (someone from Medscape actually e-mailed me about an interview for an article once, but I was kinda busy at the time so I never wrote her back--didn't seem to matter, since she included me in the article anyway despite the fact that we'd never spoken). I feel like I have more questions for her than she'll have for me, though. Like: how did they find the site? Who else are they interviewing? Is this going to be all embarassing like that time they interviewed me for the admissions viewbook and when I read over what they printed, I was like, "God, I sound like a total moron." You know, those kinds of questions.

Friday I have an orientation meeting with the Chiefs for the wards. Next block will be my first block as Ward Senior. It's all exciting and scary and a little bit surreal to think about being the Ward Senior. There was something comforting about being an intern, to feel that there was always someone above you to call, even at 3am. In deep shit? Call the Ward Senior! But who does the Ward Senior call when drowning in doody? The PICU, I guess. Just the thought of it makes me want to cram frantically and glue my PALS card to my left hand.

Currently reading: The special election issue of Newsweek. It's like a car crash, I just can't look away. I am really riveted by all this inside stuff on the campaign trail, though. Makes me want to go out and rent "The War Room." Speaking of Newsweek, I really have to say that I don't understand how this guy that writes "The Borowitz Report" is supposed to be funny. Because he's just not. He won the National Press Club's humor award? What? The judges must have been high. I guess he does have that Jay Leno brand of humor. The unfunny kind.

Monday, November 08, 2004

hawaii recap

I culled a small handful of the many, many, many photos we took during our trip to Hawaii to create some sort of a vacation narrative. The pictures have deliberately been loaded kind of small and crappy so that the collective weight of them wouldn't kill your computer. However, if you want to see any of the photos big-like, just click on them and they will magically enlarge by the magic of internet techmology (tm Ali G). Also, if you want to see any of the less snap-shotty, more scenic pictures, check out the photo project for pictures of Oahu and Kauai (parts 1, 2 and 3).



Saturday night, we flew into Honololu on the island of Oahu. Honestly, I don't know if we would have stopped in Oahu at all if it weren't for the fact that it's the only place that ATA flew. Honolulu is very huge and touristy, overrun with t-shirt shops and the like, but for one day, I can handle it. Here's Joe on Waikiki Beach, right in front of our hotel. We stayed at the Sheraton Moana Surfrider, which was at the top limit of our hotel budget, but so worth it after 18 hours of travelling. The best part was their breakfast buffet, which served miso and all manner of Japanese fare in deference to the huge number of Japanese tourists that flock to Hawaii for vacation. (It actually probably took less time for them to fly there than it took for us from New York.)



There's me in the water on Waikiki Beach Sunday morning. I have this thing about swimming in the ocean--namely, that I don't really like it. Big waves freak me out. I don't like unpredicable depths. I'm not really into the thought of fish brushing up against me or seaweed wrapping itself around my appendages. And that's why I look like such a spazmoid in the picture. Notice also the two tiny children playing happily in the ocean about ten times farther out than I am.



There was only one thing I could really think of to do with our day in Honolulu, and that was to go visit the U.S.S. Arizona Memorial at Pearl Harbor. See, there's a battleship--one of the non-sunken ones.



There's Joe looking over the edge at the top of the U.S.S. Arizona, which sank upright. There's only that little part of it poking up above water, I guess that's one of the smoke stacks or something.



In front of the museum, there were a bunch of mushrooms growing in the grass. Probably because there had been so much rain in recent days, but I don't know exactly. What do I look like, a mushroomologist? I told Joe to take a picture of me pretending I had been poisoned.



The next day, we hopped on one of the interisland planes to Kaua'i. The actual flight time itself was only 20 minutes, so I was surprised that they even tried to serve drinks while we were up there. You barely have time to slug it down before they're racing back to tear the cup out of your hands and slam your seat back into it's upright and locked position. And then I remembered that the round-trip tickets cost more than $200 per person. So I realized I was entitled to drinks. Drinks of molten gold with diamonds embedded in each ice cube.



We stayed at a bed and breakfast on Kaua'i right near Poipu Beach. I inexplicably had a hard time pronouncing the name of the beach (I kept saying "Poo-poo") but it's pronounced exactly like it looks: Poy-poo. Right after we checked in, we walked along the shore until sunset. There were sandy parts of the beach too, but there was some interesting wildlife in the rocky tidepools. People kept telling us to look out for sea turtles, but we never saw any.



Tuesday morning, we woke up really early (thanks to jet lag, which turns night people into morning people) and hiked up to the limestone cliffs a short drive from our B&B. We were very agenda-driven on this vacation, which may have been a good or a bad thing, but almost definitely a holdover from work. It was actually our intention to hike along the limestone cliffs the day before, but weren't able to find the trail before it got dark and started to rain. So I insisted that we head back there the next day. It rained a lot in Hawaii, by the way. Probably half the time we were there it was either raining or overcast.



After breakfast, we took a two-hour drive to the north side of the island to take a hike on the Kalalau trail along the famed Napali coast. I don't think it was actually all that far from where we were staying, but there's only one major highway in all of Kaua'i, and the speed limit is only between 20-30 mph along some of the smaller roads. There's Joe pointing to the sign at the trailhead. The sign says 11 miles, but I have to admit, we only hiked four. (I actually don't think you're allowed to do the full 11 mile hike unless you have overnight equipment and get some sort of special permit from the Parks Department.)



There's me at the start of the hike. You can tell it's the beginning because I'm not all muddy yet. Four miles sounds short, but it was actually a really hard hike. Not for the uphill portions, which were actually reasonable, but more for the downhill parts. It had rained the day before and everything was really slippery. If I could have changed one thing about the hike, it would have been that I would have brought a walking stick. Well, I guess Joe could have used one too. So two walking sticks.



The rewarding thing about the hike is that you can really tell that you're making progress. Here we reached the point where we could overlook the beach where the trail started. You can see my ugly-ass Tevas in the picture. I'm glad I bought them though, because any other pair of shoes I would have gotten more upset about raking through the mud.



Finally, we reached the downhill portion of the hike, towards Hanakapiai Beach. Son of a beach! Joe's trying to look all Man of the Mountain, but really, it's hot and tired and more than a little grumpy that he has to carry all the water and food on his back. (I was in charge of the camera.)



There was this little rocky stream that you had to cross before reaching the beach. Some park rangers had helpfully strung a rope across the stream to help with the crossing. At this point, we were really hot and sweaty and looking forward to jumping in the water.



Except that ocean access was strictly forbidden. Apparently the surf is notoriously rough on Hanakapiai, especially in the winter, and there were signs nailed all over the place that we were not even allowed to go near the water. See on that sign, there's that little tally of people who drowned in the past. Apparently, one of the drownees was an Olympic swimmer, but I don't know if that's real or a story that people just tell to keep us away from the surf.



The most perfect think about this beach was that while we couldn't go into the ocean, there was this fairly huge freshwater pool right there on the sand, filled with this beautiful clear mountain runoff. (I assumed it was freshwater because I saw all these tadpoles swimming in it, but I didn't taste it or anything to confirm because I was paranoid about Giardia. You know, those Hawaiian beavers are rampant in the mountains.) So we got to cool off in the end after all, and wash off our feet and shoes. The water only came up to my waist, but I loved it. No waves or seaweed whatsoever.



There's Joe looking at the ocean, keeping a respectful distance. That's a small wave in the picture, but trust me, you'd have to be a lunatic to plunge into that surf, even without all the signs telling you that YOU COULD DIE. It was the most violently churning shore I'd ever seen, and there were huge pointy rocks everywhere.



The next day, we took a kayak trip up the Wailua river. The full original plan was to kayak up the Wailua and take a hike up to the base of the falls, where we could swim and have lunch. Only it didn't quite work out, because (as you may be able to tell from the picture), it was raining fairly hard that day, and the trail was flooded out.



So we kayaked up to the trail head, and then had to turn around and kayak right back. One way was tiring enough. Having to go all the way back without a break was kind of rough. I don't care what people say, that kayaking on a river is easy. It was hard, and I was tired. Luckily, we had tucked some Red Vines in the camera bag for some quick energy. Also luckily, the candy matched my paddle.



Since we couldn't hike to the falls, after we packed up the kayaks we drove to the top of the falls and looked at them from above. But I was peeved that the rain had ruined our plans. Then, after I got over being peeved, we went back to the B&B and napped for 2 hours.



Thursday morning, we did some downhill bike riding along Waimea Canyon . There's me behind the lookout sign, looking out.



There's Joe looking cosmically insignificant next to the mouth of the canyon. Waimea Canyon is billed as the Grand Canyon of Hawaii. And it is kind of like the Grand Canyon. Only smaller. And greener. And with fewer shops selling dreamcatchers and "authentic" silver and turquoise bolo ties.



There's me on the path lower down alongside the canyon. All the dirt on kauai is really red due to the high concentration of ferrous sulfate. One guide tried to tell us that the color was actually due to the high levels of "magnesium" in the soil, but I'm not sure why that would make it look red. Also, he some 18 year-old surfer/stoner-type, so I didn't really trust most of what he was saying anyway.



We finished our Waimea Canyon excursion before noon, so we had time to do some snorkeling along the south shore of the island. This might seem like something I wouldn't be that into doing, what with my general skittishness around the ocean and fish, but I was trying to be adventurous, god dammit. I almost packed it in after I cut my foot on some big pointy piece of coral, but snorkeling was actually surprisingly relaxing.



Fish! We bought one of those disposable waterproof cameras at Snorkel Bob's, where we also rented our snorkel equipment. Unfortunately, most of the shot were wasted on blurry small fish or on pictures of each other's butts. Because we are five years old.



We tried to get in one more snorkle the morning of our departure, but of course, it was raining again. We were about to get in the water anyway, figuring that the cloudy conditions and fewer beachgoers might bring the fish closer to the surface. And then we saw lightening. After running back to the B&B and gloomily watching CNN's post-election coverage for a hour, we checked out and gradually made our way to the airport for our four-part flight back to New York. Here's a picture out the window about 10 minutes prior to landing in Laguardia. And that's the great thing about New York. No matter where you go, and how much fun you have, it's always nice to come back home.

(Of course, I still have a week of vacation left. Joe, who has to return to work today, and is on call tonight, might have different feelings on the matter.)

Sunday, November 07, 2004

aloha redux

OK, so I have to take back all of the smack-talking I was doing about ATA for the past year. Every flight left on time, some even arriving early, and there were no problems with any of our layovers or connections. Which is no mean feat, considering we had two layovers on the way to Hawaii and three on the way back. Three cheers for ATA! Hip hip...oh, you get the picture.

So, needless to say, we're back from Hawaii. A state so exotic and foreign I forgot I was even in the United States half the time. That is until the last day, when killing time before our flight, we stopped by a strip mall and 1.) ate at Taco Bell 2.) Got Jamba Juice 3.) Went to K-Mart to get some photos developed, and 4.) hid out in Borders reading free magazines until our time was up. So I guess were are in the States after all.

And speaking of the States, not only did we miss Halloween while we were away, we also missed Election Day. Don't give me that look, we're from New York, it's not exactly a swing state. So, Bush again, huh? Thanks a lot, Ohio. First, you cause that blackout last year, and now this. I'm trying to temper my feelings a little bit though, and not see things in such black at white (the old Bush-is-the-right-hand-of-the-devil rhetoric), because it really doesn't help much at this point. And the thing that gives me some satisfaction is that the country is so vituperously divided right now that I don't envy the president in his job at all. There's some sense of justice in the responsibility they now have to clean up their own mess. Though I guess it's hard to fix things when you can't acknowledge any mistakes have been made.

Breathe in, hold, breath out.

Well, anyway. Next time.

So, funny vacation pictures with full narrative to follow shortly. But until then, why not check out the first batch of artsy fartsy shots that I slapped on up at the photo project? There are not so many pictures of me and Joe, but lots of pictures of lovely, lovely Hawaii. Go look and imagine yourself there. It's like travel porn.

New on the photo project: Oahu, and Kauai parts 1, 2 and 3.

Currently reading: "The Corrections." I am really enjoying this book so far, even though I'm only about a fifth of the way into it. I think I was overambitious in the number of books I brought on vacation. I did, however, finish "Magical Thinking" and "Memoirs of a Geisha," which were each entertaining in their own way. "Memoirs of a Geisha" was very much like a History Channel of PBS documentary about Japan, which was fascinating and unlike what I thought I'd be reading--which was basically a book about a whorehouse. I think I misunderstood about the whole "geisha" thing. "Magical Thinking" was entertaining, of course, but only solidifies my feeling that Augusten Burroughs is turning into David Sedaris. Maybe deliberately. What, Burroughs is on NPR too? Get your own gig, man.