happy halloween from the chicken man

Currently reading: "Candy Freak," for the third time. How apropos.
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Monday, October 31, 2005
happy halloween from the chicken man ![]() Currently reading: "Candy Freak," for the third time. How apropos. Saturday, October 29, 2005
slow down, you move too fast / you've got to make the moment last ![]() First, the obligatory weekend baby picture. Joe's parents sent him a pair of new pajamas. Sent Cal pajamas, I mean, not Joe. (Though it would be funny and olden-timey if Joe actually wore real pajamas. And a sleeping cap. And walked around with a little candle in a candle-holder, looking for Santa Claus. But I digress.) They actually bought Cal a ton of other clothes, but they had to exchange them for the next size up. Because of Cal's MONSTROUS HUGENESS. They'll bring the rest of his wardrobe when they come to visit next weekend, but since this was the only thing that they couldn't exchange, they sent it early. It should fit him for...oh, I'd say another few weeks. This shot also gives you quite a nice view of the weird patchy baldness thing that Cal has going on the back of his head from lying on his back so much and craning his head around to look at things. I'm thinking of getting him some of that spray-on hair. You know, As Seen on TV. * * * So it's official. Earlier this week, The Underwear Drawer turned five years old. If this website were a kid, it would be starting Kindergarden and asking me where babies come from. Thank god it's not a kid. If this anniversary has shown me anything, it's that time really does pass quickly when you're a grown-up. Both on the large scale and on the small scale--for example, this week, while tortuously long due to my Monday-Wednesday call dyad, also seemed to fly by. I can't believe it's almost November already. In the past, I would have embraced this like-the-sands-through-the-hourglass phenomenon--after all, the faster the weeks and months go, the faster the year goes, which puts me one year closer to finishing med school or residency and starting my Real Life--but now, I'm not sure I like it as much. One more month passing means that Cal's another month older, and I'm not sure I want it all to go so fast. Already he's not a newborn anymore, and while he's way more fun now than he was, I can't help but feel like if I blink, he's going to be a teenager who just wants to hang out with his friends at the Moon Mall and play on the holodeck (for these will be the teen pursuits of the future, you see). Sure, I want to see what the next phase of my life will bring after residency, but I'm not in so much of a rush anymore. I'm no longer waiting for my Real Life to begin. I'm living it already. So here's to hoping that the next five years don't pass as quickly as the past five. Currently reading: "My Life," the Bill Clinton memoirs. I admit, I didn't finish this book the first time around. There's, like, a lot of words in it and stuff. Thursday, October 27, 2005
baby lucifer A few days ago, our nanny suggested that Cal might enjoy looking at some of those Baby Einstein videos. I want to hold off on letting the baby watch any TV--he's only three months old after all, and I want to get him interested in books first--but I was curious about the phenomenon of these videos, which has been described to me as audiovisual crack for babies. So post-call today, I went out and scored one of these tapes, figuring I could just see what the fuss was about and save it for when The Boy is older. There were about a million different choices ("Baby Beethoven," "Baby Van Gogh," "Baby Mozart") but I ended up choosing the Mozart one because everyone knows that exposing your baby to Mozart at an early age is the fast track for making sure that he's a Nobel laureate before the age of 35. Obviously. People, I have no doubt that babies love these videos, but my god, they are totally Satanic. The whole tape (well, maybe not the whole tape, I only watched about five minutes of it) is just footage of various pendulums and gears and perpetual motion machines moving around while Mozart is played in the background. So right off, that's bad. In this house, we will obey the laws of thermodynamics! No perpetual motion machines allowed! But then it started to get more disturbing. There was one scene in particular with silver rings spinning endlessly on a black background that was clearly some sort of hypnotic mind-control thing that subliminally programs babies to kill their parents in their sleep. And then every once in a while there was this interlude with a green lizard sock puppet who would prance around, making scrunched up faces (I think the sock-puppeteer was literally just making a fist inside the puppet's head) and then making this little "Bleaugh!" puking noise as it opened its mouth and spit out its little red felt tongue. Its little red forked tongue. SATAN! The video is now hidden in a bureau in our bedroom. Cal was only minimally interested in it while I was screening the thing anyway, so I think we can hold off on the whole Manchurian Candidate Baby thing for a few more months at least. I just hope it's not one of those tapes that makes you die seven days after watching it. That would be a bummer. Currently eating: Food. After I wrote that last entry about the Hot Pockets, my mom came by and did some cooking. We're saved! Wednesday, October 26, 2005
Sometimes the anesthesia machine in some of the older ORs reminds me of Tuesday, October 25, 2005
whaddaya gonna pick? The saddest thing ever is that the only food we had in the house for me to pack for lunch were pepperoni pizza-flavored Hot Pockets. Actually, no, the real saddest thing ever would be no lunch at all, but that's what I would have been faced with had I not brought along my freezer-section puff pastry. Whereas Joe has some other options, owing to the fact that he is not chained for 90% of the day in a room where no food or drink is allowed, I have to bring lunch because I don't have enough time during my lunch breaks to run down to the hospital cafeteria. Well, technically, I would have time to purchase the food, but I just wouldn't have time to eat it. Plus there's the matter of attending to certain mammary payload during my lunch breaks. So I pack my lunch. Which is why today, I spent 20 minutes sitting next to the shower in the OR locker room, hooked up to a breast pump and eating a Hot Pocket. It was but one step up from being some high school misfit who eats lunch in the back room of the library, by the microfiche archives. A very small step up. Currently reading: About regional nerve blocks. Sunday, October 23, 2005
the kids are alright I did my first awake craniotomy this week. An awake craniotomy isn't quite as dramatic as it sounds--the patient isn't awake like, "Hi, how are you? And what are you doing with that giant bone drill?"--but they're not under general anesthesia. We have them deeply sedated so that they don't complain when their head is pinned and the surgery begins, but they're not intubated, and they don't have any respiratory support except for the little bit of oxygen that we throw at them through the nasal cannula. The trick is to keep them asleep enough that they don't move or react, but awake enough that they don't, you know, STOP BREATHING. It's a little scary to find that balance, especially since, in neurosurgery, the patient is positioned and draped in such a way that you have almost no access to their airway. I mean, yeah, if there was an emergency you could just tell them to stop the damn surgery and rip off the drapes, but...I don't like emergencies. It was cool, though, my first awake crani (and the patient's too), and though I had done some reading about it and had a lecture about the technique just that morning, I just couldn't get over the fact that they were basically sawing into the skull of a lady that was, however sedated, responding to questions just a few seconds ago. Gah! Anyway, I talked to the patient in the recovery room afterwards, and she said she felt great, no pain, and didn't remember anything from the surgery. Sweet! Another victory for the good guys! But anyway, that's not what I wanted to talk about. What I wanted to talk about today were med students. So far this year I haven't yet been matched up with any of my own med students--probably because I still have too much learning to do--but from my vantage point behind the blue curtain, I see a lot of medical students rotating through General Surgery, OB-Gyn, Neurosurg, what have you. And oh, it is so painful. And I don't say that in the way that med students are clueless or bad, but in the way it kind of hurts to watch video footage of yourself when you were in the eighth grade, all awkward and spazzy. Med students, I FEEL YOU, because I've been there. I know what that's like, to not know what to do, where to stand, what to touch in the ORs, and I certainly know what it's like to struggle to stay awake during a 7 hour case where, though you're scrubbed in, you still can't see a damn thing because the incision is the size of a walnut. On top of it all, I went to med school at [University Hospital] too, so I know that special brand of [University Hospital] med student pain, all old-skool and crusty. Med students, hold my hand. Breathe with me. It's going to be OK. [Quasi-tangential aside: I was in the OR the other day and met a first-year med student who was observing during a Neurosurg case. Hi Zach! Or whatever your name was--I'm not good at remembering that kind of thing. Anyway, near the end of the case, the Neurosurg resident was talking to me about something or other, and first-year dude was like, "Michelle? Are you Michelle Au? Of 'Scutmonkey'?" And I said yes, and it was cool, but also a little weird, to be "recognized" at work. Also, I have to say that Zach comported himself very well in the OR, because lord knows, if I had set foot in an OR when I was just a first year, I would have promptly contaminated something sterile upon five minutes of setting foot in the room, and, in the process of backing away in horror, would probably have knocked over and destroyed some five million dollar piece of endowed equipment.] The most painful thing about watching med students from my safe little perch behind the drapes is how earnest they all are. They are trying, they want to learn, they want to do well. These kids are allllll-right! But oh, it's still painful to watch a med student getting pimped and fumbling, fumbling for answers. Still worse than that is when the attendings or residents are joking around with the med students--asking fake questions, making fun--and the med students are so earnest that THEY DON'T EVEN KNOW THAT IT'S A JOKE. And then they're trying to think of the correct answer to the question, "What ligament is connected to the ass bone?" and the residents and attendings are just looking at each other like, what the hell is wrong with this guy? It is during those moments that I want to swoop down on these tiny, freshly hatched little chickens and shield them under my wing. There there now, little med student. Lighten up. Everything is going to be fine. I was in the women's locker room a few weeks ago when I heard two medical students discussing the Blue Scrubs Rule. See, where we went to med school, the dean was very strict about scrubs. Med students could wear green scrubs anywhere, but blue scrubs, specifically designated for the ORs, could not be worn anywhere but in the OR area. The dean was so serious about this that she actually threatened to expel any student that she caught wearing blue scrubs outside of the hospital building. She made her point, but honestly, by the end of fourth year, we were all wearing our blue scrubs everywhere (I actually was wearing blue scrubs and walked right into the Dean's office for a meeting--what cheek!), and no one ever, ever got thrown out of school. But still, the threat stood, and the fear lives on. So anyway, these two med students were changing into their blue scrubs and talking worriedly about the Blue Scrubs Rule. After listening to them fret for a while, I had to intervene. "Actually you guys," I broke in, and basically told them what I just detailed above. "So don't worry. No one has ever gotten expelled for wearing blue scrubs outside of the ORs. I understand the worry, though." I paused, deeply, meaningfully. "I know. I WENT TO MED SCHOOL HERE TOO." I waited to let this latest revelation sink in, fully ready for them to break down weeping, clutching to my bosom with relief because the legends were true, there was life after med school, people did indeed survive. We would set up a beautiful mentor-mentee relationship where I would regale them with tales of my own hapless studenthood, and they would listen with shiny-eyed wonder, and like so many precious heirlooms, I would pass on to them the lessons that I had learned from my own med school days. It would be beautiful. Well, the reality of it was...I wouldn't say that they couldn't have cared less, but I think the things that they cared less about was short, and included such items as the internal state of affairs of an anthill in Sudan and the brand of fabric softener most favored by a particular housing complex in southeast Michigan. Basically, they just said "Oh," and started walking away, scared and not just a little bit disturbed at the sight of this somewhat disheveled Anesthesia resident, standing in the middle of the women's locker room with her arms spread open for a ready embrace. Currently eating: Nilla Wafers. I love Nilla Wafers. If given unlimited access, I could probably demolish an entire box of Nilla Wafers in a day. I am the Kobayashi of Nilla. A word to the wise: if given a choice between regular and reduced-fat Nilla, never get the reduced-fat kind, for it is a different cookie altogether, and not nearly as tasty. Friday, October 21, 2005
Anyone who tells you that anesthesiologists don't have OCD is a damn Thursday, October 20, 2005
the no-cry shot solution I got a lot of sleep on call last night, but come this morning I was still really tired. Maybe the spirits of the haunted hotel were keeping me awake all night. (Or something.) In ye olden days, this tiredness would not have been a huge problem--I could just use my post-call day off to cycle through various delicious phases if catnapping and vegetating--but now we have this child, you see. I spent a good portion of the morning trying to convince Cal that yes indeed, he did want to take a nice long nap with me, but after about 45 minutes he would have none of it and stared to emit his characteristic "entertain me now" caws. I have to tell you, he loves that Baby Einstein playmat thingy, though. He's starting to get a little bald spot on the back of his head from spending so much time on it, swiveling his head around to look at all the toys. If you know someone who's having a baby and you have money falling out of your ears, you should think about getting it for them. Well, either that or the pile of rags that I had suggested previously. So everything went well at Cal's doctor's appointment. For those playing along with the home version of the game, he's 16 lbs. 9oz. and 25 inches tall, which officially makes him Very Large. He got his little polio vaccine, and you're not going to believe this, but...HE DIDN'T EVEN CRY. I was prepared for the worst, all poised and hovering and ready to scoop him up the second it was over and make it all better with the HEALING POWERS OF MY MATERNAL EMBRACE--but honestly, he didn't even flinch when that needle went in. It was a sub-cu shot instead of IM, so it probably hurt less that the shots he got last time, but still, there was a needle on the end of that syringe, wasn't there? You know, the pointy kind. This kid is tough. I have other stories to tell, but I think I'm going to have to save them for this weekend. I'm holding The Boy in one arm and typing one-handed is just too damn slow. Currently reading: "Stiff." I guess this book is supposed to show us how important cadavers are to scientific research, but honestly, aside from organ donation, it's really making me not want to donate my body to science, especially if they're just going to crash cars into me or hurl blunt projectiles at my putrefying form. It also brings back bad memories from Gross Anatomy lab in med school, after the weather started getting warmer and the flies started gathering. Guh. Wednesday, October 19, 2005
Sometimes this hospital at night reminds me of "The Shining." I swear,
Greetings from overnight call. Am hoping that I'll be able to get some Tuesday, October 18, 2005
please sir, may i have some more? On my way home yesterday, I stopped by the wards upstairs to go pre-op some patients I was going to be working with today. Since I was on my way home, I already had all my street clothes on over my scrubs, as well as all my bags and gear. There was my giant orange L. L. Bean backpack, packed with that monster of a breast pump and all the necessary acoutrement, along with my little blue lunchbox/cooler, which I clutched in one hand. Also, I didn't really notice this until later, but my sweater (which I must say was a very nice sweater--was) had somehow acquired a giant raggedy moth hole since last winter, right over the stomach. Which is why it's no wonder that the nursing staff on the wards kept asking me who I was and scanning me for ID. I looked like a homeless seventh grader. Currently wishing: That I was still asleep. Sunday, October 16, 2005
come in, houston For those of you who follow this page closely, these last few weeks may have been like that final climactic scene in "Apollo 13," wherein the astronauts, whizzing through the Earth's atmosphere in their final descent, are thrown into radio silence, and everyone is just breathlessly awaiting their emergence to see if they survived the flaming re-entry or if they succumbed to the conflagration. Only much less dramatic. And not televised. And also, no one really cares all that much. Work, what can I say about work? It consumes me. During the day, of course, but (and I don't mean to scare you by telling you this) I even dream about work every night. Usually just procedural stuff that I'm trying to get more comfortable with during the day--pushing meds, inducing patients, what have you. Last night I dreamed that I landed a difficult IV access, only to have a medical student knock it out accidentally before I could tape that sucker down. Damn you, dream medical student! No dream Honors for you! So there's work, and then there's my home life. Cal is just so darn rootin' tootin' cute and changing so much every day that if there's a single moment that I'm not at work, I want to be spending it with him. Otherwise I start to get this feeling like I'm the dad in "Mary Poppins," who ignores his kids in favor of his big important job at the bank, until Mary Poppins and her bevy of dancing chimmneysweeps schools him on his grievously misdirected priorities. (And then he goes bonkers and gets sacked from the bank and his boss Dick Van Dyke DIES of LAUGHTER, and everyone seems curiously jolly about this fact, like "Ha ha! The old guy croaked!" and goes out and flies kites in a CELEBRATION OF LIFE.) Ah, yes, well. So that's why I've been away for so long. Living my life, you know. Just not writing about it as much. * * * A few weeks ago, Georgia (our nanny, you know), gently advised us that if we didn't want Cal's feet to turn gangrenous and fall off at the ankles, then we'd be well advised to get him some new socks. His old socks were creating a blanched ring of ischemia around his calves. Because they were too small. And also because of his FATNESS. Do you know how hard it is to go into the baby clothes section of Old Navy or some such store and only buy exactly what it is that you went in intending to get? VERY VERY HARD. Because sometimes they sell little fleece hats in the shape of pumpkin halves. And your kid? When wearing the hat? Looks like a pumpkin! HA! I mean, I'm frugal, but I'm not made of STONE. So now we have a million pairs of socks and a hat shaped like a pumpkin. We're ready for the winter! * * * Speaking of hats, have I ever discussed with you the phenomenon of surgical scrub caps? Some people wear the free disposable shower cap things that they have outside the ORs, but many people who work there every day decide to take the plunge into the world of high fashion and get hats of their own. And not always, but oftentimes, these hats wind up being little conversation pieces or advertisements of that person's interests or hobbies. The nurse who wears the scrub cap with Yankees emblems all over it? Duh, loves baseball. The attending with the aquatic panorama on his cap? Enjoys deep sea fishing (and, being an attending, presumably has time to actually go do it). The plastic surgeon who does charity work in Africa? Wears a cap made of Kinte cloth. The resident who wears the Epoietin cap? Enjoys free lunches and golf trips. ![]() There's an etiquette to scrub hat wear, too. It's like going to the Oscars--you don't want to wear the same thing as someone else. For example, I was going to buy the hat pictured above for Joe, because he does the operations on the eyeballs and such, but he told me that one of his attendings already owned the same hat, therefore making it off limits. Not explicitly of course, no one would come out and tell you, "Hey, that's my hat, quit copping my style, punk"--but it's just understood. I mean, you'd hate to have a scene like in that one episode of Melrose place where Amanda and Sydney showed up to a party wearing the same dress and Amanda threw punch on Sydney's dress and then the started pulling each other's hair and fell into the pool. (Wait, I think the hair-pulling and pool-falling was a different episode. But it seemed like it happened every week. Did anyone ever use that pool for actual swimming?) I have several scrub caps that I wear on a rotating basis. I have a sock monkey cap, a Mister Potato Head cap, a Super Mario Brothers cap, and a Curious George cap. I also have a Pinky and The Brain cap that I was wearing last week when I was doing a lot of neurosurg cases--a move I thought to be tremendously witty and clever, but that no one else understood, even when I pointed it out. (Everyone was like, "Pinky and the who in the what now?" Come on, people! Pop culture! Catch the fever!) Most of these caps I just picked up over time because I thought they were funny, not with any particular theme in mind, but now that I've amassed enough data points, I realized they practically scream "FORMER PEDIATRICIAN." I wondered if I should get hats with more adult themes, with pictures of, I don't know, coffee mugs and, uh, tax forms on them or something. But then I decided to get this hat instead: ![]() You can take the resident out of the Peds program, but you can't take the Peds out of the resident. * * * So, sorry to that person who complained that all I ever talk about anymore is work and the baby, but as I work one buzillion hours a week and have a three month-old kid at home, that pretty much consumes 99% of my brain power. (The last 1%, of course, is thinking about WORLD PEACE.) I mean, I say sorry, but I'm not really apologizing or anything. I'm just acknowledging that I don't have a lot else going on these days. That's just the way it goes. Oh wait, but I am reading something new: Currently reading: "Stiff: The Curious Life of Human Cadavers." Kind of an impulse buy at the bookstore, but I'm enjoying it. This book is actually pretty funny, if you can believe it. (And I mean funny on purpose, not unintentionally hilariously bad.) Monday, October 03, 2005
special delivery...from outer space Wow, Nicholas Cage and his wife just had a baby boy, and they named him Cal too! Except they spell it "Kal." And also, the full name is "Kal-el," which as any nerdling will know is Superman's birth name, from before he left the planet Krypton. So I guess their kid isn't really named Cal at all. (Crickets.) Currently reading: Blah blah anesthesia blah. Sunday, October 02, 2005
got to admit, it's getting better, getting better all the time This has been the first week at work where I actually (maybe) feel like I (kinda) know what I'm doing. However, I think that the word is out on the street that I'm something of a wayward resident, what with being BEHIND THE PACK and all, so while everyone has been very nice about giving me a little extra supervision and tolerating my endless stupid questions, it makes me feel a little bit like the village idiot. Maybe I should get a little beanie and a too-small vest, and walk around talking about how me and George are gonna get a farm someday and I'll get to take care of the rabbits. Now that I'm only partially overwhelmed (instead of totally overwhelmed as I was a week ago), I have to say that this transition, even without taking the baby into account, has been one of the hardest things I've ever done. I've heard that other attendings who switched from Peds into Anesthesia had similar experiences, and this has actually made me feel a lot better. These are smart people, after all. If they had a difficult time switching over, it's OK that I'm having a hard time too. Throw the fact that I have a 10-week-old baby into the mix, and my head-spinniness is suddenly very understandable, though I really don't want to play the baby card and use that a some kind of an excuse. Still, it's not easy for me to feel like I don't have job mastery--it changes the whole way I picture myself, you know? I never realized how much my professional identity played a role in my self-image until these past few weeks. OK, blah blah blah introspection-cakes BLAH. About a week and a half ago it started to get colder around these parts in earnest, and I realized that Joe and I were terrible parents because we never actually anticipated that summer would end (despite 58 collective years of life experience) and therefore had no warm clothes for Cal to wear. This was a problem. I hurriedly placed an order with Old Navy for some sweaters and whatnot, but ordered them all in the next size up from the size that The Boy is currently wearing, figuring we'd get the most use out of them that way. Which is all fine and good, only it didn't solve the problem of him having nothing warm to wear NOW. So being terribly bourgeois as we are, we took a little family trip to Baby Gap on Saturday morning and got Cal some warmer outerwear, at least to tide him over until the Invasion of the Grandparents from Ohio, who are sure to be bearing winter wardrobe gifts for the newest object of their abject devotion. Here's a picture of him wearing his new Elmer Fudd hat. ![]() We also got him a very cute little light grey button-down jacket that makes him look like Kim Jong Il. Baby's first communist dictatorship! Man, this kid has it good. When I was his age (oh no, it begins) I was wearing scary 70's hand-me-downs from my cousin. * * * OK, I just have to say this, because it's EATING ME ALIVE. Most of the time in the ORs, when I do something wrong, it's because I'm inexperienced and didn't know any better. But sometimes when I do something "wrong," it's not really "wrong" at all, rather it's the way one attending showed me to do it, and when I work with another attending the next day and do things the way the first attending likes it, the new attending is aghast and all, "Where the hell did you learn to do that?" when really, I learned it from watching you, dad! Take for example the practice of taping the eyes. (Expository aside for just about everyone: when patients are put under general anesthesia, we tape their eyelids shut to protect them from drying out or getting scratched.) Now, no one is arguing the practice of taping the eyes. We are all in agreement, yes? Taping the eyes is important. But the issue of how the eyes should be taped is the subject of more disagreement and personal variation than almost anything else I do during my day. FIRST ATTENDING Tape the eyes with paper tape, and squirt in some of that eye goo. MICHELLE Got it. (Next day) MICHELLE (Taping eyes with paper tape, squirting eye goo) SECOND ATTENDING What the--what the hell are you doing? Don't use paper tape, either use Tegaderms or pink tape over the lids so you can see the eyes! What are you an idiot? And never let me see you using that eye goo! The patients wake up and they can't even see anything! MICHELLE (Meekly) Sir, yes, sir. (Next day) MICHELLE (Taping eyes with Tegaderms, no eye goo) THIRD ATTENDING What in the dad-blamed--you forgot the eye goo! What are you, retarded? MICHELLE (Looking at the floor) Yes, ma'am. (Next day) MICHELLE (Taping eyes with Tegaderms, squirting in the eye goo to keep the eyes moist) FOURTH ATTENDING Oh my god--never, ever use Tegaderms on the eyes! It pulls out their eyelashes! And what the hell is all this eye goo you squirted in there? Never use that! MICHELLE (The picture of obedience) Yes, sir. (Next day) MICHELLE (In the car, on the way to work) ...so then he said to never use Tegaderms on the eyes because it'll pull out their eyelashes, and that I should be using the eye goo all the time. JOE Well, from an ophthalmology point of view, no study has actually bourne out that the eye goo serves any sort of protective purpose. And we always use Tegaderms to tape the eyes over at the Eye Institute. MICHELLE Oh lord, not you too. So what I've taken to doing, just so I can stop getting chastised, is remembering how each attending likes their patients set up. Which is good, because it saves me from getting "corrected" at all the time, but then I think about all the energy I'm expending memorizing HOW EACH ATTENDING LIKES THEIR EYES TAPED and not memorizing, I don't know, something vaguely medical. I'm going to get in trouble for saying this, aren't I? [Edited to add: My attendings aren't really this mean. These dialogues have been EXAGGERATED for COMIC EFFECT. In the name of COMEDY. Ha ha, comedy!] Currently reading: "The Anesthesiologist's Manual of Surgical Procedures." This seems like a pretty good book to own, but the hugeness and weight of it kind of prohibits me from toting it around to where I really need it, in the ORs. Maybe I'll just Xerox the pages that I need each day and stick them in my pocket. |