now for a whole new set of abbreviations

I just took my last cardiology call last night. Thank god. Two months straight of cardiology call is enough to make me realize that I probably don't want to be a cardiologist. I mean, I know it's different to be a cardiology attending as opposed to being a cardiology intern or fellow, but I just don't know if I could think about one body part for my entire life. (But don't tell Joe I said that.)

[As a quick aside, here are the top three questions that people ask Joe when they know he's going into Ophthalmology:

1.) Are you going to do Lasik?
2.) Ophthalmology? Like, prescribing glasses?
3.) So, really, could you do Lasik on me?

The Lasik question I don't think he minds that much, but I think probably most ophthalmologists get a little peeved when people confuse them with optometrists. In fact, I dare to venture that most of the general population does not know the difference between an ophthalmologist an an optometrist. So here, in brief, is the difference. One is an MD. One can do surgery. One can prescribe medications. The other can do none of these things. And now I'll leave it to you to sort out which one is which.]

Maybe it's not cool to admit this, but I almost had to strangle one of my patients last night. Granted, it was a 23 year-old woman, not some 3 month old baby (the you'd really be scared of me, right?), and the reason that she's on our service instead of on the adult side completely escapes me. You're a grown-ass woman! Get thee to Internal Medicine! Then again, the very first patient I took care of in my Pediatrics internship was 27 years old. Hell, he's probably 28 years old now, and still sitting on the children's ward. Aren't there age cutoffs for the hospital? You must be less than 21 to ride this ride? Or maybe we could divide up the floors by age, like at [Children's Hospital in the Bronx]. One of the parents on our service (his kid is 5 months old) complained that the teenaged roommate in the next bed was surfing for porn on the Internet. On the nursing computers, no less.

But anyway, my big girl last night. Maybe we started off on the wrong foot because she came to me at 3:00am as a last minute transfer out of the ICU. Maybe we didn't quite jive because literally the first words out of her mouth when I went in to examine her were, "Can I get some drugs?"


MICHELLE
Drugs? What kind of drugs?

PATIENT
Pain drugs.

MICHELLE
Where's your pain?

PATIENT
My tooth hurts.

MICHELLE
Oh. OK. Well, for right now, I can offer you Tylenol or Motrin, and if you're really having extreme pain beyond that, we'll have to address it with the team in the morning.

PATIENT
I need oxycodone.

MICHELLE
Well, let's try the Tylenol and Motrin first, OK?

PATIENT
Dumb bitch.


And maybe it's because she wouldn't cooperate with nursing overnight and refused to have her bloods drawn and refused her echocardiogram and pretended to be sleeping with her thumb in her mouth (her THUMB in her MOUTH--hello, you're OLD) and ignored everyone that came in the room to speak with her. This just proves to me that I couldn't have done adult medicine. I cut kids a lot of slack, because, whatever, they're 5 years old, but I have a very short fuse, at least internally, with people who should know better. Which, unfortunately, sometimes includes the parents. Oh, you don't want your child to get vanc for their line infection because you read that medications starting with the letter "V" can cause autism? Well, OK then!

I think the worst page I ever got overnight (and I mean worst as un "unecessary," not worst as in "some kid is trying very hard to die right now") was from a nurse who paged me out of sleep at 3am to ask me if I could help her print something from the computer. Apparently, she didn't have a log-in password. Um, hi, do not page M.D. for IT difficulties. Thanks ever so much. Of course there are always the standard non-emergent late night pages, ("Could you change that Tylenol dose from 79 to 80 milligrams?") or the "just-need-to-document-that-M.D.-aware-so-I-don't-get-sued" pages, but on the whole, I really don't mind getting paged on call, even if I'm sleeping. Maybe because I'm still at that stage where I'm not sure that I should be sleeping in on call at all, maybe I should be prowling the halls checking and re-checking my patients in an endless loop until morning comes. So if I get sleep at all, what reason do I have to be annoyed with anyone?

(That's a good discussion for the comments section, actually. What's the most annoying page you ever got on-call? Share.)

I start the NICU on Monday. Hello, freaky preemies. At least it'll be something different.

Currently reading: My outline for the next Scutmonkey strip, "Surgery." Coming soon!

incredible!

Two questions. One: did you know that you can order Domino's pizza online? Two: Can you guess what we had for dinner tonight?

Currently watching: "The Sixth Sense" on TV. He's dead the whole time!

364 days

It's nasty out, and cold all over again. It was raining on this day last year too, all grey and gloomy the evening of our rehearsal dinner. We thought it would portend poorly for the wedding the next day, but we were pleasantly surprised to be gifted with a dazzlingly sunny Spring day, really, the only good-weather weekend day we had that whole month. Last Spring was like monsoon season on the East Coast.

So tomorrow's our one-year wedding anniversary. Crazy. I tend to be a little unfussy about such things--we didn't save the top tier of our cake, for example, because that's kind of sick (it's a freezer, not suspended animation, and I don't particularly like the taste of freezer burn), and I didn't even save my wedding bouquet, even though my co-interns were a little incredulous about this. What am I supposed to do with it? Fondle the dried up crappy stems for all eternity? It was pretty. But now the wedding is over. There are pictures. And if I want flowers, I'll buy new flowers, you know?

Not that I'm a complete unsentimental schmuck. To celebrate, we're going to Solera, the Tapas place where Joe proposed, and then to the hotel bar we went to after dinner that night to indulge in the bubbly. The only thing is, we probably won't be going out on the actual night of the anniversary itself, because it's the middle of the week ("a school night"), we both have uncertain ETAs home after work, and we both work early the next day. In fact, I'm on call again Wednesday night. Man, Q2 call and then Q3. Ai, dios no me ama.

So we're just going to save the whole brouhaha (hahahaha) for the weekend, when we have time to enjoy it. We were going to go out on Friday, but I think we're going to opening night of Andy's brother's movie (to jack up the box office numbers so he can be a Big Hollywood Success) that night instead. So Saturday it is. It's better, anyway, to save it for the weekend. That way, we have the next morning to sleep off the excesses of being the rootin' tootin' fresh-and-fruitin'-est newlyweds in medicine.

Currently reading: "Fast Food Nation". I read it already, but hey, I have to read something until my new books come.

50 hours and counting

Still at the hospital. It occurs to me that by the time I go home today, I will have worked about 53 hours this weekend. The fact that this is more hours than normal people work in an entire week is not lost on me.

In other unrelated news, as part of my package upgrade, The Underwear Drawer now has it's own domain name. You can now access the page through www.theunderweardrawer.org. Can you believe that www.theunderweardrawer.com was taken? And not even by anyone real. It's, like, being held for someone by some faceless domain-name-buying sharks, but I don't see any content on the page yet. Unfair.

I need to get out of here. I have cabin fever. Hospital fever. And I'm about to spike again.

Currently reading: Nothing, because my damn books still didn't get delivered from Barnes and Noble. I guess they meant 24 hour delivery on weekdays only.

q2

I like the idea of a Friday/Sunday call weekend, in that it opens up two full weekends off, but when your Friday/Sunday call weekend actually arrives, man, let me tell you, it's demoralizing. Not even that I'm that busy, it just sucks to be in the hospital on a weekend as nice as this one looked to be (as observed through the windows of my patient's rooms).

Joe and I are both on call all day today through tomorrow morning, which means that the dog is at the Dog Spa, plotting dastardly escape tactics with her other hooligan dog friends. We had a nice day together yesterday, though, after I got home from work at around 9:30am, with breakfast together at the local diner and a walk across town to the paper store on 19th betweeh 5th and 6th. I don't know the name of the place, I just call it "The Paper Store," they sell all sorts of luscious things that I covet, like assorted vellums and heavy cardstock in delicious colors and textures. I don't know what it is about paper products I enjoy so much, but every time I walk into that store, I end up buying some overpriced something, even if most of the time I never end up using the blank books/paper sets/postcards because they're deemed too nice to write on. This time, I got some of this 80lb two-sided duplex cardstock that I'm planning to use as a cover for Scutmonkey #1. It's fuschia on one side and this persimmonny orange-yellow on the other, and so pretty it makes my eyes hurt. (Joe favored the aqua/lime green combo, but I told him "Get your own damn cardstock, bitch!" No, actually, I told him I'd do his colors next time, if there is a next time. But seriously...own cardstock, bitch.)

Then we walked uptown to Best Buy and got a new printer. We've been thinking about getting one for a while, but it's just so hard to coordinate our schedules to have time to look at them together that we've been putting it off for about a month. It's very groovy and multifunction, and I dig it. I just haven't really gotten a chance to use it yet. Maybe tomorrow.

I was waiting for a patient to come up to me from the ER, but just now, checking her labs, I noticed that her sodium was 169 with a K of 7.8, bicarb of 6. Whoop, and now I'm getting a transfer from the PICU. Sounds like maybe they're clearing a bed for that first kid.

Currently reading: My PICU patient's transfer note.

crazy!

I didn't really notice this until I checked today, but I've been getting a lot of traffic on the mother site from various and sundry links to "Scutmonkey." (So far, "The 12 Types of Med Students" strip has been the most popular.) So much so that when I actually tried to check my own site today, I couldn't get into it, because I had exceeded my monthly bandwith--something I've never even come close to doing. Probably it's the big pictures in conjunction with the fact that I have about ten times as many people visiting as usual. Wow. I'm overwhelmed.

So today I upgraded my account to "Gold" (not that that means anything to anyone who doesn't use Homestead) and now the page is working just peachy. Peachily? As an added feature, I can actually start to sell stuff from my site via Pay Pal now, once I get my ass in gear and figure out how exactly one does that. Once that's set up, though, it'll be sweet, because as soon as I have a little more time, I'm going to start selling the first print issue of "Scutmonkey" by mail...about which more later. It will be nothing fancy, probably just 'zine style, but if there's proven interest over a couple of issues, maybe I can work on submitting to an actual publisher. (You know, like one that's not just me at the self-serve machines at Kinko's.) Thanks so much for spreading the word, everyone! Thanks, studentdoctor.net! I really do appreciate the links. (Plus, it was the multiple hits from your page that clued me off to the fact that my page was totally broken.)

But ANYWAY. Enough of the my nerd talk, I'm killing myself here. (Bandwidth? Comic books? Sweet Christ, I'm a nerdling!) If you look at the time that this entry was written, you can easily deduce that I'm on call again. (Just as a guide, almost all not-on-call entries are written before 10pm, because a girl needs her sleep when she's working for the Man every night and day. Big wheels keep on turning!) Man, I like cardiolgy and everything, but after two months, I'm getting pretty sick of being on this service. Give me any other body part to think about, please. Well, not that one.

I'm excited to get home post-call tomorrow, though, because I got e-mail confirmation that my Barnes and Noble book order just shipped, and there's nothing quite so exciting as having fresh new books to dive into when you have (most of) a day off. Oh, there's the nerdling again. I just hope I can get some sleep tonight so that I have the energy to start reading one of them. Well, if only these freaking kids would stop being all sick and stuff, maybe I wouldn't keep getting paged so damn much. "Oh, but I'm in v-tach." Yeah, cry me a river, man, I'm TRYING to SLEEP.

(See, that was a joke. But remember my scandelously bad overnight cross-cover a couple of nights ago? It really happens.)

Currently reading: Harriet Lane to look up the correct dose of aldactone for my new admit.

she works hard for the money so you'd better treat her right

What's really confusing is having a dream that you're at work. I dreamed I was running around the wards, seeing patients, putting in orders, doing scut, and not even in a surreal dream-sequence way, either. In a completely linear, ordered narrative. It's like I went through the whole morning in my sleep already. Which makes waking up really confusing.

Sometimes I wonder what I would be doing if I wasn't in medicine. Let's say I never went to med school. What would I be doing right now, at 25? Would I be working? Would I be in grad school? Would I be married? Would I be a scary lady with tinfoil wrapped around her head to keep out alpha rays, eating baked beans out of a can on the downtown A train?

I don't think I've ever had a real job until this one, and even residency is highly suspect on the scale of "real jobs." How does one apply for a real job? Is it really like in the movies, looking at the want ads in the paper and circling them with a red wax pencil? Or do you find jobs through word of mouth? Through connections? How do you know what kind of job you want? And how do you apply?

OK, so let's think about this now. Let's say I'm a senior in college, and med school is not on the map. What should I do next year? Let's take something that's not too much of a stretch: Grad school. What would I study? Sometime unbearably obscure that would make my parents scream? How does this sound: "I have a Ph.D. in Medieval Studies"? Gah, that would not only make my parents scream, but make me scream. In FEAR of my Birkenstocks-with-socks, leg-of-mutton-chomping, mead-swigging SELF. How about grad school in something more hard science-like? A Ph.D. in Neuroscience? That was my major in college, it's not such a stretch. Except for the fact that I hate, hate, HATE research. The only thing that I learned from research in college is to despise it. Bench research especially, but really, any kind of research kind of gives me the willies. I basically need to rule out any kind of careers that involve using SPSS.

OK, so no grad school. I need to make money. What else can I, fresh out of college, do? Ooh, I like to write, maybe I could be a writer! Yeah, and then maybe the mice in my tenement apartment can pick my bones clean after I die from starvation due to my short destitute life spent living in SQUALOR. So not every writer is successful. Need a backup plan. How about I write for a magazine? Hey, it doesn't have to be "The New Yorker." Heck, it could be it's oft-confused lower-brow namesake, "New York Magazine." That could sound good. See it on a business card: Michelle Au, Girl Reporter. Except that I know from my friend Jamal (who was a reporter a "Sports Illustrated" for several years) that the position of "Reporter" isn't what people really think it is. People think it's all running around with a notepad and a fedora that says "PRESS" on the brim, getting the scoop, interviewing the rich and powerful, maybe solving a few crimes on the side. But what it really is, apparently, is sitting at a desk all day and checking the facts in other people's stories. It's a step above copy editor (unless you really love grammar and punctuation), but maybe not as much excitement as it seems.

[As an aside, I often feel like I'm shattering people's glamourous visions of medicine when I tell them stories about work. "Wow, you were working the in EMERGENCY ROOM overnight? Was it all like, all, 'A van transporting a bunch of senior citizens crashed into the backyard birthday celebration for a bunch of five-year olds, ETA ten minutes!' And everyone starts running around getting out chest tube trays and defibrillators? And the driver of the van was the alcoholic uncle of one of the five year-olds who DIES and is wracked with anguished guilt as you pronounce in solemn tones, time of death, thirteen fifty three and then snap off your gloves angrily and slam them into the GARBAGE?" And then I have to break it to them that I basically spent 12 hours getting coughed on and doling out Motrin like it's going out of style. But anyway.]

What else could I have done? Computer stuff? I don't have the skillz to pay the billz. Advertising? Well, it would be fun to say stuff like, "I landed the Weingrip Account!" (not unlike "Cathy") but then...I would be like "Cathy." Aaack! Teacher? Hmm, summers off. But the rest of the time, it would be like doing my job now except for much, much less money. Snotty kids that leave you, parents crawling up your ass, occasional flickers of, "I made a difference!" buried under a growing mound of jaded cynicism. And pretty soon I'd be old and drinking burnt coffee out of a Hallmark "Shoebox Greetings" mug, bitching about how kids these days just don't understand old-fashioned values. Maybe I would form insular tribal alliances with other teachers and get all territorial in the teacher's lounge.

My main problem is that I've wanted to do medicine for so long that my vision of other jobs and careers is seriously stunted. My scope is basically that of an elementary school student. Teacher, firefighter, policeman, astronaut. (Or, if you will, cosmonaut.) I don't even know what most people do for a living. And even when people tell me, I don't really understand what their jobs are. What is a consultant anyway? What does an advertising executive really do? Or like Coleen's job, which she's explained to me several thousand times already, but which I still don't understand. She... designs... computer... thingys? See, I don't know. I'm lost.

Which I guess narrows it down to medicine. I hope my patient's feel good, knowing that their doctor is doing what she's doing because she really isn't good at doing much else.

Currently reading: I'm still between books! But I think I'm going to order "The Spirit Catches You and You Fall Down" from barnesandnoble.com. Same day delivery in Manhattan! And just to make it worth my order, I think I'll get "Eats, Shoots and Leaves" and "The Curious Incident of the Dog in the Night." (Sounds interesting--thanks for the suggestion, Birdy!)

comments?

I had a bad day at work, starting off with some scandelously bad overnight cross-cover (mystery resident, you shall go unnamed, but I hope your ears a burning right now) and ending with a headache like this [two hands held about three feet apart, parenthetically flanking my cranium]. Tomorrow had better be an improvement, because I'm already going into this weekend at a sleep deficit, and I'm on call Friday and Sunday. I'll take a Friday/Sunday double-header weekend if it means I get two full weekends off, but man, it hurts when you get there.

Joe's on call tonight, so it's just me and the dog. I have a ton of things that I could do, but honestly, not a lot of things that I want to do. So I think I'm going to sneak into bed and watch "21 Grams" with the dog. I head Sean Penn plays a patient with heart failure. How fitting.

Also, please note that I just added a "Comments" feature to the site. (It's right under the entry, above the line.) I'm not really sure how it works or anything, but my guess is that you click the link and make, uh, comments. If there's nasty talk I'm taking the feature down, but I get so many pleasant e-mails that I never answer, I thought this might be a nice way to obligate me to respond.

Currently reading: The current issues of Time and Newsweek, but what I really need is a fresh book. I'm thinking "The Spirit Catches You and You Fall Down," but I think I have to order it online first. Any other good book suggestions? Why not try out the "Comments" section?

hawaii sucks

I stopped by Taco Bell on my way home from call yesterday. Bleah. I have Taco Bell remorse. Again, something that started off so tasty in my mind has become a leaden goo ball in my belly. One funny thing though--as I was standing on line waiting to pay, I saw an ad on the countertop for one of their new Seven Layer Chicken Bean Rice blah blah blah burritos. It was all like, "CATCH THE TASTE SENSATION! ALL WHITE CHICKEN MEAT!" And then in tiny letters down at the bottom, with an asterisk: *all white meat offer not available in Hawaii. What's up with Hawaii? Don't they have all kinds of wild chickens running around? It's true! And even if not, what's wrong with shipping them some frozen chicken breasts? Damn. That's discrimination right there. Sorry, Hawaii. You get that canned chicken spread stuff instead.

Currently reading: The New England Journal of Medicine article about Pediatric Palliative Care.

read the sweatshirt

I was walking the dog this morning in my Wellesley sweatshirt. She went to the edge of the curb to take a dump when some moron in a van almost runs over her while trying to parallel park into his spot. To be fair, the dog was pooping in the street. But damn, man, I can't move my dog when she's in the middle of pinching one off! She has to finish her business!

He got out of his van, this big hired-goon-looking Italian guy and his dad (straight out of central casting for "The Sopranos") and I thought he was going to lay into me, "what the hell are you doing with your dog behind my car, why not move out of the way, jackass," blah blah blah. But instead:


DUDE
You went to Wellesley?

MICHELLE
Yes.

DUDE
That's the women's school?

MICHELLE
Yes.

DUDE
One of the Seven Sisters?

MICHELLE
Yes.

DUDE
Oh. (Walks away.)

MICHELLE'S INNER MONOLOGUE
Wow, that conversation went a totally different direction from what I'd expected.

COOPER
(Licking another dog's poo)


How did he know that much about Wellesley? Maybe he had just watched "Mona Lisa Smile" on DVD. Maybe he cried at the sad parts.

Currently reading: My patient's tracing on telemetry.

cardi-call-ogy

(The above title is not quite as clever as my "on-call-ogy" joke, but hey, I try.)

Man, another patient of mine got a heart today. We're giving them out like candy at some kind of a...candy...convention. (Sorry, analogy lost a little steam there.) Good for you, kid!

On call again tonight. Between crosscovering and being on the actual service, I will have done 2 straight months of cardiology call by the time this block is over. And yet, I have learned next to nothing. One of my fellows today gave me a lecture about Tetralogy of Fallot and I was practically slobbering all over him with gratitude. So nice when people appreciate that as an intern, you're here to learn, not just do all their shit work. (Though obviously that's a huge part of our role too.) To think that I'm starting my sixth week on cards and no one had showed me how to use the telemetry program until today. I'd just been relying on nurses to call me when someone went into SVT, but I guess they don't always.

I'm sleepy.

Currently reading: My patient's EKG. Good thing Joe gave me those calipers for Christmas. (Yes, I got calipers as a Christmas gift. from my husband. What, you never got a romantic nerd gift before?)

the 12 types of med students

The new Scutmonkey strip is up, entitled, "The 12 Types of Med Students." Which one are you?

I for one have been many. Probably mostly split between the Painfully Enthusiastic and The Missing, the natural transition from third to fourth year. But I do have to admit that once, I was The Crier.

Currently reading: Still chewing on The New Yorker Spring Humor Issue.

the good and the bad

Just got back from dinner with Andy down in Greenwich Village. I took the crosstown to 8th Avenue and as I was walking through Chelsea to meet him at Art Bar, I looked at all the trendy restaurants and pretty people and could not figure out for the life of me how he could want to move to Chapel Hill. All my med school friends are moving to these crazy God-forsaken places. Brendan and Narges to Phoenix, Andy to el sud, Jamal to New Haven (even though that happened quite a while ago and he's technically a high school friend, I just wanted to lump him in there to show how everyone's leaving me), not to mention the legion of the insane that made the pilgrammage to Boston for whatever reason. Anyway, we had Indian food and Andy told me that I was wrong about the whole Passover thing, that he thinks that fries actually aren't allowed during Passover after all, because they're fried, and I guess frying isn't allowed during the holidays. So if I was wrong, I retract that whole thing about the Passover vs. low carbs diet. Just goes to show you: ask a Jew.

One thing I didn't mention about work this week is that one of my patients who has been sitting on our service waiting for a heart transplant finally got her heart on Friday. Everyone was thrilled, as you would be too, especially if you saw her. Not that cute kids get the monopoly on our good will and affections, because, you know, ugly kids get sick too, but oh, if only you could see this child. She looks like a teeny tiny version of the girl in that Norman Rockwell painting, "The Problem We All Live With." She's so small her shoes look like little muffins.

I know I've discussed this before in a prior entry about heart transplantation, but at the same time we were celebrating and getting ready to bring our patient to the OR, there is another set of parents somewhere else in the country getting ready to bury their child, and probably another Pediatrics resident who took care of that child until he or she died. Maybe that resident even brought up the topic of organ transplantation to these parents. Who knows what the situation was? Who knows how that other patient died? We were lucky enough to be on the happy ending side of things (not that it's the end, because transplantation brings up a whole host of new medical issues to deal with), but somewhere out there, wherever this heart came from, there's another half to this story.

At any rate, I hope the surgery went OK. I guess I'll find out when I return to work on Monday.

Currently reading: The New Yorker, Spring Humor Issue.

high of 71 degrees? what gives?

Today I slept until 10:30am because I could, dammit. It's so gorgeous outside for the firt time since...well, November, I guess (and that's only because we had a mild Fall), that I really feel obligated to leave the apartment, take the dog to the park, do something outdoorsy. Except I'm so tired is all.

Still, New York in the Spring. What could be better? Sometimes I feel like that character in Woody Allen's "Everyone Says I Love You" who can't decide which season in New York she likes the best. Spring in New York is exploding trees (exploding with flowers, I mean, not actual explosives) and suddenly being able to dine al fresco. Summer in New York is all festivals and music and being able to wait outdoors for your friends at the start of a late night out. (Or else it used to be, before I started working this damn job.) Fall is crisp and sunny and hot cider at the farmer's market, with the promise of Halloween and Thanksgiving adding excitement to everything. And the Christmas season in New York I've already waxed rhapsodic about. I guess the only micro-season that I don't really like is January through March, and really, who does like that time of year? Things don't really pick up after Christmas until Daylight Savings anyway.

Working on a new strip in between finishing "Doctor Id," entitled "The 12 Types of Medical Students." It actually shouldn't take very long to finish, since it's only going to be two pages long. I've already pencilled half of it.

Currently reading: Coleen's entry about Christos. Good article in the New Yorker a couple of weeks ago about The Gates. At least that's one thing that'll make up for the grey cold crappiness next February.

doctor id

Hey everyone, the first installment of the new scutmonkey strip is online! I decided to post it a chunk at a time, thereby giving me impetus to work on the thing, as well as something of a time-frame. Call me Dickens. Except instead of books, comics. And instead of paper, Internet. And instead of people killing each other at the docks to get the latest installment, general apathy. But apart from that, I'm totally Dickens.

Currently reading: My old Ob-Gyn strip. Not because I'm conceited, I just want to see that it actually displays. I actually went back and poster lower resolution images so that they would load faster. If you had trouble seeing the page this the last time I linked to it, now might be a good time to try again. (Unless you're one of the residents depicted in the strip. Then, please, don't read it. Your butt is gorgeous!)

pearl paint

This might seem like the height of nerdiness, but I'm really, really in love with the new art supplies I bought at Pearl Paint yesterday. Yesterday was a perfect post-call day because:

a.) It was all rainy and cozy
b.) Joe was post-call too
c.) We had burgers, and
d.) We went to Pearl Paint

I love Pearl Paint. I love browsing in there and running my fingers over all the brushes and paper and foam core (whatever the hell that's for) and having this fantasy that I'm an art student living on the Lower East side of Manhattan out of my studio space, all grungy and poor and shit. For some reason I have this romantic notion about art students, like there's some intangible cool about being one of the legion dyed hair multiply pierced punks wandering around with their obscure band t-shirts and paint-stained hoodie sweatshirts. Maybe it's that sense of having a job where, at the end of the day, you feel that you created something, even if it is some tampon in a teacup (tm Daniel Clowes) bullshit piece of arte nouveau.

I know that must seem weird to say, because wow, how fulfilling to be a doctor, you help people, blah blah blah, but think about it. What did I do today, really? I wrote a bunch of prescriptions and sent seven patients home from the hospital. And then I answered a bunch of pages and ate lunch standing up in front of a computer. Wow, why don't they make a reality show about my life? Oh right. Because it would suck. Not to mention a headache to watch, because everyone's faces would have to be all pixellated to be HIPPA compliant, and it would be like "The Real World: Hawaii" where they had to blur out every single shot because people were walking around naked all the time.

So anyway, I yesterday I picked up a few new erasers, a right-angle straight-edge, and a draftman's mini-duster, whose sole purpose, it seems, is to sweep up those little plastic bits off your drawing after you've inked in your lines and erased the pencil marks. (I had been using a blush brush, but the static cling effect was terrible.) My real true love is the Factis soft eraser. Not only does it erase like some sort of an...erasing...machine (sorry, ran out of steam trying to think of a good simile) but the eraser bits actually cling to themselves, glomming together into one gigantic eraser bit rather than a thousand small particles. It's like the T-1000 of erasers! I came home and erased things and was very happy.

Currently reading: A blog that Andy mailed me the link to, with the e-mail subject, "They copied you!" Not that I own the intellectual property on the field of medical online journalling or anything. But if I see any comics on that site, they're dead. Also, I will out them because I think I've figured out what med school they go to. Don't ask me how. I have my ways.

trippy

Funny how things look a little weird and off-kilter when you're post-call. There's that strange combination of heightened sensory awareness and complete stumbling oblivion. This morning, as I was walking home from the subway, I was looking at things that I never notice, like the architecture of the buildings around me and the color combinations in store displays. (So it looks like citrus colors are the way to go this Spring. Good thing I changed my webpage layout just in time.) And as I was walking around town all wide-eyed and goggling at everything like a slack-jawed yokel, I almost got run over by a cab.

Maybe that's what being on overnight call does to you. It turns you into a tourist.

Currently reading: The insides of my eyelids.

los estudiantes

Nothing much new to say about work today. Kids. Hearts. Fluids. Intern getting blamed for damn near everything. Which just goes to show that there is nothing new under the sun. I bet even in biblical times the interns got blamed for everything. Except in those days, they got stoned to death. Thou shalt not prolong length of stay.

There's this third year medical student on Pediatrics who keeps calling me "Doctor Au." He's not working with me directly, but I spent a day with him in the Well-Baby Nursery last month as part of his outpatient Pediatrics rotation. "Doctor Au." I've already told him several times, once quite forcefully, after jumping at the sound of my title like someone being zapped with a cattle prod, to call me Michelle already, geez, I was only a med student last year for chrissake, we could have been neighbors for all I know. But still, "Good morning, Doctor Au." It's like those slapstick movies.


GOON
Thanks, Boss.

MAFIA KINGPIN TRYING TO GO STRAIGHT
Sure thing. And don't call me "Boss."

GOON
Sorry, Boss.


Even though I miss the carefree lack of responsibility in which all medical students indulge (not that I knew it at the time), there are certain things that I appreciate are very hard about being a medical student. Mostly, it's difficult to figure out how to strike that balance. How to be around and available, but not get in the way. How to learn, but not be annoying. How to be friendly with your residents, but not a toadie. This is hard to do. And mainly, how well you get along depends on that unique mix of personalities between you and your resident.

This was never more evident to me than on Surgery, where my senior resident (who I will call "Anhedonia Man," because he acted so miserable all the time) pretty obviously loathed me, but loved my frat-boy goofy cow-tipping co-med student because he so clearly wanted to be a SURGEON. You could tell this was how he envisioned it in his head too, all caps. I, on the other hand...


ANHEDONIA MAN
(completely disinterested)
So, what are you going to do?

MICHELLE
What, you mean in life? Probably Peds or Medicine.

ANHEDONIA MAN
(world-weary sigh of disgust)


We did not get along. And as close as I am still to the experience and as sympathetic as I am to the cause, I've had the experience of not getting along with my med students. Or at least being very extremely annoyed with a few of them. But it's not their fault, right? They're just trying hard, wanting to succeed, doing what they think is right. They don't need to kiss ass. They don't need to pretend to be Mother fucking Teresa. They don't even need to pretend that they want to do Pediatrics, because hey, I'm enough of a realist to realize that not everyone wants to do what I do. They just need to be on time and show up and tell the truth and give a shit. Not even a big shit. A tiny shit will do.

(The one exception on the tell-the-truth rule goes to a third-year medical student that I worked with this fall, who bitchily complained how much she HATED Peds and HATED this stupid rotation and she wanted to do NEUROSURGERY anyway because that's what she wanted to do since BIRTH and she couldn't WAIT to get away from these BORING SNOTTY PATIENTS and just dive into the BRAIN SURGERY already. That's something you might not want to say quite so loudly. In the middle of the nursing station. In front of four people who are grading your performance. Just a hint, Brain Girl. Though it was quite entertaining to watch when she and another medical student started getting into a heated argument about who wanted to do Neurosurgery first. "I wanted to do it since I was a kid!" "Well, I wanted to do it since I was a fetus!" Kids, kids, plenty of 120 hour work weeks to go around.)

Oh yeah, and call me Michelle, goddamit.

Currently reading: Cannery Row. Hey, there's a Chinese guy in this story!

passover

Just got home from call. Nothing going on all day, and then an admission at 5am. What, kid, couldn't you have showed up a little earlier? Actually, I don't think they could have, because of the Sabbath and Passover.

Speaking of Passover, I ordered dinner last night for the on-call team, and Other Michelle (the oncology on-call resident) told me:


OTHER MICHELLE
Could you order me a cheeseburger, no bun?

MICHELLE
(Writing)
No...bun.

OTHER MICHELLE
Yeah. I'm observing Passover.

MICHELLE
Oh yeah, the no-leavened-bread or whatever.

OTHER MICHELLE
Though obviously, I'm not eating kosher.

MICHELLE
True.


Later, as I was getting orders from Tammy and Anjalee:


MICHELLE
So Other Michelle wants a hamburger with no bun, because of Passover. What do you guys want?

ANJALEE
I'll have the Greek Salad. Do you want to split a side of fries, Tammy?

TAMMY
Yeah, I could eat fries.

ANJALEE
OK, order a side of fries too. Or, oh wait, we could just eat Other Michelle's fries.

MICHELLE
Why wouldn't Other Michelle want to eat her fries?

ANJALEE
She can't eat them, remember? It's Passover. I thought you couldn't eat fries during Passover.

MICHELLE
Dude, she's observing Passover, not a low-carbs diet!

ANJALEE
Oh yeah, I got confused.


I watched "American Splendor" Friday night when Joe was on call. It was different from what I thought it was going to be, but good. It elucidates for me a little bit of the enigma of Harvey Pekar, though it only partially explains to me how you can be a cartoonist and not do your own art. Why not just write in prose then? I guess that's kind of like people who write kid's books and have other people illustrate them.

Currently reading: My employee benefits package.

weird

This is the weirdest call of my life. Because of the holiday weekend and the lack of elective procedures that were done leading up to it, there are only three patients on the cardiology service, two of which would probably have already been discharged were it not for sundry social issues. I've examined them all, written my notes, and am waiting for the attending and fellow to check in.

I'm bored.

This is all very bizarre.

Currently reading: A Newsweek article about Condoleezza Rice's testimony to the 9/11 commission.

bi-pod

First, an apology to the Pilot G2 X-Fine Point Gel Pen. I'm sorry, my pet. You are my new favorite. All other pens can go to hell.

So I'm a little pissed with Apple right now. Pissed because they're dumb. Well, either they are or I am, and I'd much rather blame the faceless corporation. To start from the beginning, I decided to get Joe an iPod for his birthday. Well, because he's turning 30 and he needs a fancy, high-tech gizmo to make him happy and forget about the fact that he's practically a geezer. Though, actually, the closer I come to my 30th birthday (a little over four years away now--I'm a president away from middle age!) the more I think that 30 is the new 20. But more on this theory later.

I bought the iPod off the Apple website because they offer free engraving, one small way to personalize the Gift of the Season (who isn't giving iPods as presents these days?) and because free is always good. To be fair, Apple warned me that I should not make the purchase with my debit card. They told me in the order form that banks had a way of declining payment for iPods ordered with debit cards because it would amount to a large, atypical purchase (for most people, anyway) and sent the fraud department scrambling. But I figured I'd try my luck and order it with my debit card anyway. Mainly because it's the only credit card I have. So maybe the moral of the story is that I shouldn't keep throwing out that junk mail that says I'm pre-approved for various and sundry cards, because they could occasionally come in handy.

Anyway, the bank rejected the purchase, Apple notified me, and I got a call from my bank's fraud department, all concerned. So I called them back.


MICHELLE
Yeah, so I know what all this is about, I bought this iPod, blah bling blah, so could you just approve the purchase? I'm not a thief. Ask me my mom's maiden name, the last 4 digits of my social security number, whatever information you need to know.

CITIBANK DRONE
Well, what would be easiest is if you just placed the order again, and I'll make sure that it goes through.

MICHELLE
Really? What if they send me two by accident?

CITIBANK DRONE
No, because I'm only going to approve the new purchase.

MICHELLE
Are you really sure? Because the thing's kind of expensive, and I would hate to order two.

CITIBANK DRONE
It won't happen. I will only allow the new order to go through. The old order will be blocked.

MICHELLE
(So foolishly trusting)
OK, cool, la la la!
(Scampers on merry way)


So what to I hear from Apple this afternoon? That my online orders are in the mail. Both of them. Gargh!

Though, I guess, in re-reading my telling of the anecdote, it really does seem that I was the stupid one in this equation. Damn you, exposure of own fallibility in the cruel light of reason! Again, I say, gargh!

I was getting all bent out of shape because I got the fucking things engraved after all, so how can they take them back, there's writing all over the metal casing? However, when I called the Apple Customer Service office, they assured me that I would be able to return one of them, unopened, and they would refund me the full amount of my purchase.


MICHELLE
Refund?

APPLE DRONE
Yes.

MICHELLE
Full refund?

APPLE DRONE
Yes.

MICHELLE
Even with the engraving?

APPLE DRONE
Yes.

MICHELLE
Really?

APPLE DRONE
Yes.

MICHELLE
Sweet! La la la!
(Skipping away)


So I guess what this story really shows is that I've learned nothing.

Currently reading: The New Yorker and To Kill a Mockingbird. Still haven't gotten to the trial yet.

retreat

In a stunning coup which combined skillfully applied discharge strategy and limited intake volume due to the upcoming holiday weekend, the team and I somehow managed to whittle down the cardiology service to three patients for a few hours this afternoon. Then we got a PICU transfer, but still, four patients. This likes of this the hospital has never seen! (And never will see again after the weekend and the surgery and cath service start picking up again.)

So I've been working on planning our class retreat. The chiefs have arranged for all of the interns to have the first weekend of may off so that we can go off to the woods to bond and shit. We decided to rent a house in the Hamptons for our love-in. We will grill burgers and drink Costco boozes and lounge in the hot tub. It'll be like "The Real World: Pediatricians." Wow, that would be the most boring show ever.


PEDS RESIDENT #1
You're a racist! And a homophobe! I hate you! Also, I'm an alcoholic nudist and I have Daddy issues!

PEDS RESIDENT #2
Turn that frown upside down! Let's hug and then put sparkly stickers on our ID badges!

PEDS RESIDENT #1
Well...OK.


I don't know how I ended up in the position of coordinating our retreat, it just kind of happened. But it's really stressful. I hate being resposible for other people's money. Even more, I hate fronting money (as for the rent and down payment) out of my own pocket and then chasing after people to be paid back. It makes me feel like someone's landlord. Or a loan shark. And then what if this rental is a con? What if we show up and it was all a scam and I just lost $2400 of everyone's money? What if it sucks? What if we don't have fun? What if I didn't mail in the lease in time and we don't get the place after all?

I used to be in charge of a lot of things when I was in high school and college. I used to kind of like being in charge. I liked making the decision and driving projects. Now I'm just sort of content to ride along and not take on any more responsibility than my regular job entails. Isn't being an intern enough?

Argh, now I just called the Hamptons Guy to try and confirm that he got our lease, and his cell phone is off. He did mention that he was leaving for Florida on Thursday. Florida. Who leaves for Florida in a big rush? This makes me think:

a.) Total scam artist. Cashing my check and absconding to the South under an assumed name and a glue-on beard.
b.) Didn't get the lease before leaving for vacation. The house will be rented to someone else, our retreat will be ruined, and everyone's going to hate me.
c.) There may be an off chance that it's actually a legitimate operation and he'll call me back soon telling me how to get to the house and where I can pick up the keys.

So the good news is, he didn't cash my check yet. And the bad news is, he didn't cash my check yet. Shit. $2400. Remind me never to volunteer for anything every again.

Currently reading: My Citibank account balance.

people with jobs cooler than mine

Hee! I've been messing around with the colors on this page. This makes me inordinately happy because I'm a sad, sad human being.

So you know what I just found out? My friend Andy's brother is a screenwriter (that's not the new information, I knew that part already) and his new movie is coming out at the end of the month! I just saw an ad for it on the bus this morning. It's called "Godsend," and I watched the trailer when I came home to confirm what I suspected was the plot. (Andy had given me a quick synopsis last year, which went something like "blah blah blah couple blah blah blah kid dies blah blah cloned blah blah clone kid turns evil blah blah and Robert Deniro's in it!" How cool to have written a screenplay for a movie! So much cooler than, say, getting shot with a stream of steaming liquid poo. Not like I have any experience with that. Ahem.

Currently reading: To Kill a Mockingbird (for only the five millionth time), and Unlikely

don't worry, i'm a doctor

The weather's turning warm, the sun is out, I'm post-call, and I have an Egg McMuffin. It's the little things.

So I had a surprising thought at around 2am last night as I was watching over the dozen or so kids on my service, mostly children with congenital heart malformation in various stages of surgical and non-invasive repair. You're not going to like this, especially those of you who have kids or who have ever been in the hospital yourself. The thought I had was this:

I don't know what I'm doing.

In the most general, outward sense, yes, I kind of know what I'm doing. I know for the most part the important questions to ask, some of the things to look out for, what I problems I can pretty much handle overnight and what problems will send me running to the phone to page the senior or fellow "911." I even feel like I have pretty good clinical judgement a lot of the time. Maybe. Hopefully. But when you really dig beneath the surface, I feel like deep down, I really don't know what I'm doing at all.

Probably because so much of being an intern is pretending that you're in control and moderately abreast of the situation even if you're completely clueless and terrified. You walk into a patient's room and they think, with relief, "oh, the doctor is here." How many times have I come in while a parent is talking on the phone, only to have them cut their conversations short because of me? "Look, I can't talk right now, the doctor just walked in. I'll call you right back." They don't know that I have less than a year of training under my belt. They don't know that I have no good answers for many of the questions that they're asking. They don't know that when I say, "well, that's a discussion we'll have to have with the team," what I'm really saying is, "I have no idea, I have to ask the attending what to do." And honestly, I'd rather the parents not know that unless I tell them. Most people have some sense of the heirarchy, residents below the attendings and fellows, but rarely do they know just how inexperienced your typical intern is.

Often times when you're on a subspecialty service like cardiology or oncology, the intern on overnight is the only doctor on the floor. The first few times this happened, I was like, "Is this a joke? You know these kids have cancer, right? Shouldn't there be someone supervising me?" But you're the doctor. And no matter how little you know, I guess you always know a little something. Or you pretend until you find some backup. And even outside of inexperience-related cluelessness, there is a whole different categoy of cluelessness that interns face when taking care of so many new patients night after night.


NURSE
Oh, I was looking for you. Patient Donnelly? Just spiked to 105 and is having EKG changes on telemetry.

MICHELLE
Oh. Hmm. That sounds concerning. I'll be right there.

MICHELLE INNER MONOLOGUE
Who the hell is Patient Donnelly?


I'm feeling less and less like this every day. In three more months, I'll be a second year resident. A senior. I feel less panicked, and less often overwhelmed. I'm getting the hang of things, I guess. But there are still moments where I wonder how in the world I got this job. And I guess it's better to know that you don't know rather than to think you know it all.

purty

Ooh, new look! And it's only 99% plagirized from other code! OK, 99.99%. But I changed some of the colors and font sizes around, and that's what's important.

I would write more now, but feeling my way through all that computery stuff nearly killed me. Thank god I don't do this for a living, or I would be rapidly and summarily fired.

sunday night dread

You know that sickly feeling of apprehension you used to have Sunday night when you were in high school? That feeling of, oh, I have to go back to school tomorrow and I'm not sure if I finished all my homework and I have that presentation to do tomorrow in front of the whole class and it's field hockey in gym class I hate field hockey I don't want to go back to school please don't make me go? Well, that feeling never really goes away. All this weekend off has done is make me dread re-entry into the work week even more. All day tomorrow, and call on Tuesday. Not to mention call on Saturday, so I'll be in the hospital every single day for two weeks straight.

Guh.

it's not lowbrow, it's avant garde

Now a word about comic books.

In the past few years I've developed a passion for graphic novels and full-length comic books, but I guess if you look back, I've always been into comics. My childhood is littered with comic books, from "Peanuts" collections to Chinese comics (which my dad would read to me), and later, to EC comics from the 1950s like "The Vault of Horror," "Crime Suspenstories" and "Weird Science." Hope this doesn't make me too much of a Simpson's Comic Book Store Guy, but over the years, I even accrued hardbound sets of three EC series ("Crime," "Science" as mentioned above, and "Weird Fantasy," my least favorite of the three, probably because I got kinda sick of all the stories about space travel).

And of course, like any good childhood comic reader, I was a childhood comic drawer. My dad and I would take turns volleying back and forth comic strips, his more of the one frame New Yorker gag comic variety, I of the four-panel setup folding the paper into quarters for easy frames). When I was nine or so, I started what ended up being a four-volume series about a bumbling superhero called "Superguy," detailing his various well-intentioned misadventures in the city. One that I particularly remember was about Superguy filling in for his friend, "Superintendant," (I thought this was deliciously clever) who was going on vacation, leaving Superguy to fix the toilets and field complaints in his 21-story apartment building, curiously not unlike the one I lived in. Production costs and efforts were low in those days. A little pencil and magic marker, slap on a cover and force a few staples through (reinforcing with Scotch tape when the staples wouldn't hold), and bam! First edition!

So what I'm saying is, I've always like comic books.

Not so much of the Marvel/DC superhero comics that people think of when they think of comic book stores, and the snuffling, slavish teen boys that flock to those racks, peering through smudged lenses to survey this month's new crop of collectibles. I'm more into realism, novels in comic form, autobiographical stories. There are a few quasi-fantastic stories that I've appreciated, but on the whole, my favorite comics are grounded on Earth.

Do you like comics? Do you want to start reading graphic novels but don't really know where to start? Here, for you, is my incomplete recommended reading list:

"Jimmy Corrigan: The Smartest Kid of Earth", by Chris Ware. This, in many ways, is the pinnacle of the form. Astounding art, tightly complex story line, a full meal of a book. I've talked more about Jimmy Corrigan in the past (I would link the old page, but I can't find it), but I'll just say that it's a classic, and the kind of book where you see or appreciate at least one new thing on each re-reading. And now it's out in paperback for only $20, which is a real deal because this is a book you need not only to read, but to own.

"Maus", by Art Spiegelman. Enough has been said about Maus, between the Pulitzer and all the fuss that surrounded it when it first came out. So I'll just say it's well worth the hype.

Adrian Tomine. That's the name of the writer, not the book. If you read the New Yorker, you may also know him as one of the staff artists (as is Art Spiegelman), and I think the thing that really sets him apart from other artists is that he can capture any facial expression in the range of human emotion, no matter how subtle. "Summer Blonde" and "Sleepwalk" are his best, I think, but he also has a collection called "32 Stories" from his self-publishing mini-comic days that is interesting to read, especially to see his artistic development.

"Blankets", by Craig Thompson. Beautiful to look at, and beautiful to read. These coming-of-age stories always get to me.

Daniel Clowes. One of the godfathers of indie comics. Or at least one of the wacky uncles, if R. Crumb is the godfather. Of course everyone has heard about "Ghost World", since it was made into that movie (starring Thora Birch and a pre-"Lost in Translation" Scarlett Johansson), but his "Twentieth Century Eight Ball" collection along with "Caricature" also had a lot to offer. Clowes strength, I think, is in showing the ugliness in everyday people, along with having a great ear for dialogue, especially for that of disaffected teenagers. I have to be unpopular here, though, and say that I really didn't cotton to "David Boring" and Like a "Like A Velvet Glove Cast in Iron". I guess for the same reason I don't like French Dadaist film. I'm all, "wha?" A little too avant garde for me, I suppose.

"Box Office Poison". I love these graphic novels that are, like, 600 pages long. Makes me feel like I'm getting my money's worth. Unlike Blankets, though (which is also long, at 500+ pages) it's a slower read, because it's more dialogue and text driven. The art isn't the thing here as much as the characters, but still it's important that it's a graphic novel and not just a regular book with pictures in it. Set in the mid-90s showing the intersecting lives of a group of friends living in Brooklyn, it's a lot of fun to read. As one review put it, reading this book is like spying on your friends when they didn't know you were there. So much so that when I was at Barnes and noble and saw "BOP!", the newly published bits and scraps of Box Office Poison that didn't make the book proper, I snatched it right up and bought it on the spot, because I wanted to see what was happenning with the characters.

Lynda Barry. Well, obviously. Where Daniel Clowes is a master of disaffected teenage dialogue, Lynda Barry is a master of the language of children. Read "One Hundred Demons" or "The Greatest Of Marlys" and see for yourself. I would also like to put in a plug for two of her illustrated prose books. First, "The Good Times are Killing Me", which is as good a story about everyday race relations as I've ever read, and secondly, "Cruddy", which is dark and terrible and beautiful all at once.

Joe Matt is kind of a different story. Whereas I admire the comic writers I mentioned above, the thing with Joe Matt is you kind of hate him. Author of the autobiographical comic series "Peepshow," he gives you a full frontal assault on his life as a whiny, miserly, misogynistic, misanthropic racist loser. When I read Joe Matt's books (and I think there are only three: "Peepshow", "The Poor Bastard", and "Fair Weather"), you kind of want to kill him. But also, you can't stop reading. Which I guess is good.

Derek Kirk Kim is someone who really inspired me to put up my comics online. His website Lowbright (it used to be called "Small Stories Online") has an archive of all his work, and I found it after following a link to his serialized short story "Same Difference." (Please do yourself a favor and click on that last link to read the story in its entirety.) Like "Box Office Poison," you get that feeling of evesdropping on your friends, but in a smaller group. Small Stories was actually an excellent name for Kim's work, in that it deals with small, ordinary lives and small, ordinary disappointments therein. I'm going to buy his book, "Same Difference and Other Stories" once it's reissued from Top Shelf Comics in May.

OK, that's it. Better stop now before you all start mocking me for being Comic Book Store Guy. "Er, excuse me. No banging your head on the display case please, it contains a very rare Mary Worth in which she has advised a friend to commit suicide. Thank you." By the way, I've noticed that the women that work in the comic book store closest to me (not the owners, but the cashiers) are all exceptionally attractive. Not in that Monster Truck Pull hot chick kind of way, with big blonde hair and fake boobs, rather in that petite gamine little pixie way. They're like anime characters. This is surely a customer relations ploy. Seems to be working. I'm the only female customer I've ever seen in the place.

i'm golden!

It's my golden weekend. What this means, in typically pathetic resident lingo, is simply that I have the whole weekend off. (Pathetic in that we have a special term for the occurance, unlike normal people, who dont' need such specialized notation, because normal people don't have to designate special weekends in which they don't have to go to work--that's just what weekends are.) The saddest thing is that it's not really a golden golden weekend in the classic sense, which would be post-call Friday, with Saturday and Sunday off. Nonetheless, for me, two days off in a row is damn near vacation schedule. Imagine, I get to sleep late and go to bed late on the same day! Too bad it's Daylight Savings this Sunday, this carving a precious free hour out of my priceless off-time. I say it every year and I'll say it again: lousy farmers.

So you know what I saw in the med school bookstore the other day? Multicultural family puppets. Mommy, Daddy, brother, sister, baby puppets of different ethnicities. I think they're supposed to be educational...puppets. Maybe you could learn valuable language and social tolerance skills by, uh, puppeteering. The Asian family puppets look kind of evil. I don't know, something about those slanty eyes makes me suspicious. But how about those White family puppets? The mom puppet is totally Christina Crawford in "Mommy Dearest." Also, hello, Thalidomide baby! I got my sister a set of the Hispanic family puppets for her birthday, so that she could practice her Spanish with them. "Hola! Donde estan sus piernas?"

graphomania

Today I was getting all freaked out because there is this very specific pen that I like to use when I'm on call, the Pilot P500, and a couple of days ago I noticed that I only had two left in my pen pantry. (Yes, Joe and I have an office supply larder.) OK, so first suspend your disbelief that I have an "on-call pen." Then try to ignore the fact that my freak-out was exacerbated by the fact that I lost my current P500 and got a stand-in pen at the bookstore specifically for my call night. Then, finally, ignore the fact that the stand-in pen I purchased (2 for $3.89, not a bargain) was the most frustrating pen I ever used in my life. Needle point my ass, Zebra Z4! That's one thick nib. Plus it kept bleeding through everything and leaving all these ink splotches on everything it touched, and believe me, I was longing for the precision point of the P500 in short order when the morning came.

(This is all only slightly exaggerated, by the way. I really do know all these pen brands and models. This is what happens to the part of your brain that's devoted to car trivia when you don't care about cars.)

This evening, I had it in my mind that we had to go to Office Depot. HAD. To. It was my mission. I even called the Office Depot in our neighborhood before we left just to make sure that they were still open. I needed my special pens, and nothing was going to stop me. Not even the fact that they didn't have them in stock.


MICHELLE
Whu? How? WHY? They had the Pilot P500 here last time! That's where I got them in the first place! Big box of ten! Right here!
(Gesturing futilely at shelf space)

JOE
(Pointing to a package)
Here you go. P500.

MICHELLE
Those? Are the P SEVEN hundred. They have a 0.7mm tip. Too big.

JOE
Big is good. Good for writing fast notes.

MICHELLE
Well, yeah, if I was working in the ER or something, but not for this, not for call nights on the wards. I need a micro tip to write on the flow sheets.

JOE
How about these pens? Ooh, they look cool and silvery.

MICHELLE
(Checking out packaging)
Even worse! 1.0mm tip. What am I doing, painting a house?

JOE
(Another box of pens)
These look like needle tip. And they're kinda like the Pilot whachamacallits that you want.

MICHELLE
Oh, the Pilot V5? Yeah, they're OK. I don't really like the grip feel, though. There's a ridge right here (points) that hurts my hand.

JOE
I see. Very specific.

MICHELLE
Hey, maybe there's some P500s hidden in the back of this row of P700s! (Digs) Oh, guess not.

JOE
So you want fine tip?

MICHELLE
No, fine tip is code for 0.7mm . I want Extra-Fine, 0.5mm.

JOE
You fine!

MICHELLE
You extra fine!

JOE
Heh.

MICHELLE
I'm going to cry, I think. I actually may have to shed the tears. Because they DON'T HAVE THE PEN THAT I LIKE. What the hell kind of store is this anyway? A store for ants? [Note completely non-contextual "Zoolander" reference.]

JOE
How about this?

MICHELLE
(Patiently)
Do we have to go through this whole fine and extra-fine point discussion again?

JOE
These are extra fine.

MICHELLE
Really? I didn't know they made G2s in extra fine! I had a brief dalliance with a G2 as a med student, but then one of the Psych nurses stole my pen and didn't give it back. Bitch.

JOE
(Fondling pack of blue pens)
I wish they'd let us chart in blue ink.

MICHELLE
Lemme see the G2s. Ooh, clicky! Don't have to worry about losing the cap.

JOE
It is a superior resident pen.

MICHELLE
But first let's try it out. Wait, let's simulate a work situation. Tell me something to do, and I'll write it with a little checkbox next to it.

JOE
Just get the damn pens.


We got the damn pens. Then we went to Borders and read for a bit, had some dinner (not at Borders) and headed home. But I'm still thinking about the pens. Did I make the right decision? Is the G2 the right way to go? Is this a new direction in my life? Or should I have just held out and placed a bulk order online for the P500s?

(If you think this is bad, you shouldn't even stand near me when I'm shopping for a new shampoo. We'd be there for hours.)

post

When I got home post-call, I was pretty tired, so I took a quick shower and jumped into bed. It was the perfect post-call snuggle nest: me, bed, down comforter, dog, rainy outside, all the lights on inside, and a comic book on my nightstand. (What? It's research.) My intention was to drift of to sleep after some reading, only I realized that I was more hungry than sleepy. So then I got up and made some instant noodles and dumplings. At 10:30am. Hey, I don't come to your house and tell you what to eat for breakfast, do I?

So I think I'm ready for bed now. I love post-call day off. It really makes up for being in the hospital for the past 27 hours straight. Well, almost.

call of the wild

I'm on call again tonight. The block is almost over. Tonight's my last cardiology call before I start...cardiology. Oh, the winds of change are here!

Actually, I'm really not looking forward to next month. Nothing against cardiology, which I find reasonably interesting (and at least conceptually easy to grasp, once you sit down and look at the pictures of all the different surgeries), but because I'm going on the service as the solo intern on the team, during a month when the House Doc (who serves as kind of the Ward Senior) is going on vacation. Wait, what do you mean you're going on vacation? You can't go! You have to stay! And help me do things! Hey, don't walk away from me when I'm talking to you! You must suffer as I suffer!

No, but seriously, next month is going to suck. In fact, let me give you an idea of the sucking that is to come. In October, I got pulled to cover sick call for cardiology on a day that the House Doc was out, due to some family emergency. There was already one intern on the floor (the other was post-call), along with a second-year rotator from another hospital, and two very competent fourth-year medical students. So I was pulled to be layer #5 of coverage. And still it was busy.

Now flash forward to next month. Only one intern. No med students, I assume, because the Match was just a few weeks ago, and not even the most gunnery of gunners is insane enough to do a "real" elective at this time of year. That said, it's still a little too early for the next crop of med students to start taking electives, so our student coffers will be empty.

I may indeed have an outside hospital rotator, but I've found from my time on the floors that the quality of these rotators can be very hit or miss. Either they're reasonable residents doing some helpful work for the team, or (as has been the case at times), you spend the whole day running after them with a shovel and a pooper scooper. So maybe at best, I will have one outside rotator. The Chiefs, God love 'em (that sounds sarcastic, but really, God love 'em, they're great) have already created an additional coverage schedule, but there are only extra residents filling in on days that I'm physically not in the hospital (post-call, clinic and the like). Because, you know, I love my job and everything, but sometimes, I do have to go home.

So, one intern. All the kids. It's going to be like being on call every single day for a whole month. Oh, the tears. So when are they going to start manufacturing those robot interns? Robo Intern. You know, robots that can call people and enter orders and write notes. Robots that can speak Spanish. "Initiate program COMPASSION. Running program. 'Hello little boy. Looks like someone needs a hug.' ERROR. Fatal error. Press any CTRL-ALT-DEL to restart." That would be awesome. And a little scary. But mostly AWESOME.

And now everyone in my life has fully sat through my little "boo hoo, I'm on cardiology all alone" pity party at least once (and some people up to 5 or 6 times), and are ready to slap me around if I bring it up again. OK, OK, I'm done.

(It's just going to suck, is all I'm saying.)