Do you know what was playing on the stereo over in cath lab this morning? It was a chorus of monks singing, gregorian chant-style, a vaguely familiar tune. Listening more closely, I determined that it was Elton John's "No Sacrifice." After that, the monks launched into a somber rendition of "Can You Feel the Love Tonight." Monks with a adult contemporary soft rock sensibility. Who knew?
Yes, so after four weeks, too little sleep and too many placentas, I am finally done with my OB rotation. I start a four week cardiothoracic rotation today. This OB and cardiac back-to-back schedule was partially by design (I hadn't been on OB for a year, and I wanted to buff up my cardiac skills before starting to take TC call), but I realize now that in that design, I have totally wrecked my entire summer. Unfortunate.
Despite the call schedule, I did like OB, though. Overall, it's a happy place, what with the babies and whatnot. In addition, it's one of the few places where the patients actually understand what the anesthesiologist does, where they actually are happy to see us and thank us for our work. I've resigned myself to the fact that as an anesthesiologist, the patients are rarely going to remember my name, let alone put me on their Christmas card list--but it is nice to be thanked once in a while.
Hey. Sorry for the lack of updates in the past week, but dude, that new Harry Potter book is, like 700 pages long. There was a time where I probably could have just read it straight through in a day, but now I have a job and a kid and I have to pretend to be sane. Anyway, with about 100 pages to go on Friday, I just stopped by a Starbucks on my way home from work and finally finished the damn thing. (I knew that the second I stepped into my apartment, there would be no further reading, see: two year-olds, and the care of). Ultimately, it was very satisfying, though I had some concerns beforehand that it might be a let-down after all the hype. Not so. Well worth it.
My problem now is that I have finished reading Harry Potter, but other people have not. So every time I get to work, I ask people (attendings, co-residents, patients, what have you), "HAVE YOU FINISHED READING HARRY POTTER?" and they're all like, "No, I'm still working on it. Don't tell me what happens!" And I'm all like, "Blast!"
Or (OR!) sometimes I'm with someone who did finish reading it, but they we're in the room with someone else who hasn't finished reading it yet, and they're all, "Don't talk about it in front of me!" and then we, the finishers, can't say another word, because we don't know how much the other person has read. Maddening. READ FASTER, DAMN YOU!
Anyway, further updates to come, I just wanted to let you know that I was still alive. Also, I've been on call three times in the past six days, so I don't even know what my home looks like anymore. Where do we keep the cups? Where's the bathroom?
I recognized his father before I recognized him, but that was not surprising. Since the last time I saw either of them, the boy had lost a good deal of weight and all of his hair, these large, soft brown curls, which had hung almost to his shoulders and had made me mistake him for a girl the first time we met. That had been back in the Spring, when I was rotating on the Peds Pain service. He was on the oncology service, three years old and miserable, with a rapidly growing mediastinal mass. The last I had heard about him, he had been transferred to the ICU emergently and intubated. After that, I was off service for Peds Pain, but I had assumed, given the severity of his illness and the poor prognosis of his cancer, that he had died shortly thereafter.
However, there he was in the elevator with me, sitting up in his dad's arms, not only not dead but actually smiling and chattering, two things that I had never seen him do during the brief amount of time I had spent with him a few months ago. He was facing his father and with one finger reached up to touch his father's cheek, which bore a small nick from shaving.
BOY Why you have ow?
FATHER I have a cut.
BOY We go down?
FATHER You wanted to go get a snack, didn't you? So we're going to the lobby.
BOY Here?
FATHER No, this is the third floor, we need to go down two more floors.
BOY Two more.
FATHER That's right, baby.
The elevator doors opened and the two of them exited. I watched him go with the eyes of a doctor, noting his alopecia and weight loss, but also noting that he was out of his room without a mask or an IV pump, which boded movement in the right direction. But I also watched him with the eyes of a parent--it was almost impossible to listen to the two of them talking and not think about Cal--and those emotions were much more difficult to decipher. Did I feel glad to see that he was, at least for now, doing better? Sad to see a child so close in age to my own so seriously ill? Scared because here, in front of me, was proof that love can't protect your child from everything? Guilty because so far we've been lucky, whereas some other families have not been? It's difficult to say. Here, three days later, I'm still trying to figure it out.
A couple of days ago, I placed an order for a Thomas the Tank Engine ice cream cake at Baskin Robbins. The "Thomas" theme was for obvious reasons, and the ice cream cake was because Cal is allergic to eggs, which we discovered subsequent to his previous encounter with homemade birthday cake, after which he promptly broke out in hives. Nice one. Mom of the year.
The morning of the party, I went to pick up the cake. What they brought out for us was this:
Which was...not Thomas. However, ultimately acceptable, as it did still involve vehicles, including one of Cal's favorites, a back hoe, which he calls, to somewhat amusing effect, a "crack ho." And it already had his name written on it and everything. So I didn't even say anything to them about the fact that the cake was totally different from the one that I had ordered, for which I had written documentation and for which I had paid many dollars. This is called "choosing your battles." Also possibly known as being spineless. Anyway, Cal seemed to like it all right.
So yes, my child is now two years old. I can't even believe it. Why, it seems like only yesterday that he was a symbiant leeching nutrients from my body. Now he's a MAN. A lecherous man.
Have you ever noticed that whenever people in movies or on TV take pills, they always take a sip of water and then FLING back their heads violently, presumably to facilitate swallowing? Why do they do this? It doesn't even make any sense! Do they do this when they're eating food too? Please explain.
A video blog entry from my visit to the vending machine on call last night. I would turn up the volume if you want to hear the audio; I didn't want people to think I was crazy so I was talking kind of quietly. Which is probably just as well, because I never realized before this moment how very much my voice sounds like that of Kermit the Frog. Hi ho.
I'm working overnight tonight, and I started to get kind of a bad headache around 5:30pm. So I started looking around the floor for some Tylenol, which I didn't think would be hard to find, being that I work IN A HOSPITAL, but for some reason there was none to be found. Finally I asked one of the nurses.
MICHELLE Is there any Tylenol or Motrin around here?
NURSE Yes, but it's locked up in the Pyxis.
MICHELLE Is there a way that I can get some Tylenol?
NURSE For which patient?
MICHELLE Uh, it's for me. Is that OK?
NURSE Yeah, just go get it with your Pyxis login.
MICHELLE OK, cool.
(Five minutes later...)
MICHELLE Yeah, so I logged into the Pyxis, but the only meds that I have access to are anesthesia meds. It's all, like, morphine and ketamine and stuff.
NURSE OK, I'll get out some for you. What is it for?
MICHELLE I have a headache.
NURSE OK, give me a second.
MICHELLE I mean, I could get the morphine, but I think that would probably be overkill.
NURSE No, I'll get you your Tylenol. We need you to be on your game tonight.
MICHELLE Or I could get the ketamine, and then we could turn off all the lights and dance with glow sticks.
I just recently upgraded my cell phone from this quasi-crappy Paris Hilton one (sans Swarovski crystals) to a newer one that has a better camera and the capacity to take video. Therefore, I predict more video on this blog in the future. Here's a short movie I made from the indoor play place this morning. This is what happens when you let dads loose in a kid zone--they turn into kids themselves.
Perhaps as compensation for being put on call every single day of my LIFE since this roatation has started, I was granted a "library day" yesterday, meaning that after morning lecture, I was free to go study for the boards without any further clinical responsibility. While one library day probably does not make up for 364 non-library days, I was still grateful to have the time. Cramming is like a crash diet. It works, but only for the short term. For the long term, you just gain the weight back, or (as the case may be in cramming), the stupidity. But oh, for those few hours, you know many things! Temporarily! Quick, ask me what the blood volume of a premature neonate is in mL per kg! I will only remember for a few more hours!
After the exam, I went back to labor and delivery, because of course I'm on call again tonight.
I just found out that this patient died in the ICU. He hung in there for a while, but apparently human beings need at least a few of their organs to work normally, and so he succumed. I'm sad, but not really surprised. He fought the good fight, and I'd like to think that we did too.
anyone know any shady rabbis willing to write me an attestation letter?
Last-minute cramming for my in-service exam tomorrow. And I do mean last-minute. I wonder if its too late to pretend I'm Jewish so I can put off taking the exam until next week. L'chaim!
I've been listening to streaming radio on the computer in the anesthesia work room over on labor and delivery. My favorite station is "The Big Hits of the '90s" over on Yahoo Radio. They should call this station, "Did You Graduate From High School In The Mid-90s? Then You Will LOVE This Station!" Because I did, and I do! Man, when was the last time I heard Weezer and Salt 'n' Pepa back to back? Sweet!
Hey, sorry for the lack of posts. But I've been on call five times in ten days, so not only do I not know what day of the week it is, sometimes I have difficulty differentiating morning from night. I just wanted to let you know that I was alive, and that Rachael Ray's people have't killed me. Yet.
I was on call last night and I am on call again tomorrow. In fact, of the past eight days, I have spent four of those nights in the hospital. It's like status workalepticus. But anyway, I got home this morning, and we decided to make the most of a nice family day by heading over to the Bronx Zoo.
The above is not a picture of the zoo, rather it is a picture of what we had to prize out of Cal's hands in order for us to be able to leave the house. If I never see another episode of "Thomas and Friends," I will still hear those bitchy trains sniping at each other in my brain for all eternity. We finally managed to trap him with some very convincing talk about seeing a real train (well, a monorail, really, but he doesn't know the difference) and visiting the animals, but he still wouldn't leave the house until we had stashed a few trains in his diaper bag.
And there were a lot of animals. Look Cal, a tree kangaroo! With an actual joey in her pouch!
And look Cal, monkeys!
Cal, look! Look Cal! A panther!
Ooh, and look! It's a...something. (A tapir? I want to say tapir, but I don't really know what that is.)
However, in typical almost-two year-old infuriating fashion, this is what Cal was really interested in. Stairs. If we had let him, he would have been going up and down those stairs all day. Another high point: when we were on the monorail, having sanguinely observed the elephants and the red panda and five million species of Asian deer, Cal suddenly comes to life, excitedly pointing in front of us and shouting, "Dirt!" Dude, we have dirt at home.
On the "Skyfari" transport system. This made Cal very nervous, and he kept turning to us and asking, "Done? Done?"
At least he got some french fries out of the deal. Also, man are my hands vein-y. They're like zombie hands. Although I have to admit that I like having those big veins. One embarrassing secret that I will reveal to you is that sometimes in the OR, I sit there fondling my own veins and fantasize about the large bore IVs I could stick in them. This is an illness. I know that.
Anyway, hope everyone is having a nice weekend. Also, if you live in the New York area and are pregnant, don't go into labor tomorrow. I'm just tired is all. Though I have to say, I'm glad I wasn't on call today. I'm sure lots of people wanted a baby with a 7/7/07 birthday. As opposed to last year, when women going into labor on 6/6/06 were probably crossing their legs and hoping to wait it out. Because, you know, any kid born on 6/6/06 is going to be Damien.
MICHELLE Honey, that's what time we get up every morning. That's what time you were waking up less than a week ago, when we were both residents driving into work together.
JOE Really?
MICHELLE Yes, attending. Living the high life.
JOE Man.
MICHELLE Ah, how quickly we forget the little people.
The OB anesthesia call room looks like it has been inhabited for the past three years by a group of hygienically-deficient agoraphobic frat boys with mono. And then they all DIED, which, you know, accounts for the smell.
I'm on night float tonight, so I didn't leave the house until about 2:00pm. Even though I like having the morning to spend with Cal, sometimes I dread having to leave in the afternoon, as opposed to in the morning when he's still sleeping, because then there are tears and recriminations and I end up feeling like a jerkwad. I got off relatively easy this time--he was playing with his crayons and didn't even seem upset when I told him I was going to work and kissed him goodbye. (Though the temptation sometimes is to sneak out when he isn't looking, I don't really want to do that, or else he'll get the idea that his caretakers can just disappear without warning.)
I was halfway down the block when I realized that I had forgotten something at home. So I went back upstairs, and when I got out of the elevator on our floor, I could already hear him screaming inside. "Mama! MAMA!" Yikes. What to do? Go back in and risk escalating the situation to full meltdown, giving him a happy reunion for a few minutes, only to leave again? Or just forget it all and just get back in the elevator?
I opened the apartment door quietly and tried to figure out where the noise was coming from. It sounded like he and our nanny were in the other room, and she was trying to cajole him into the rocking chair to read a book. Like a damn hamburglar, I tiptoed into the computer room, extricated what I needed (I forgot that I had wanted to bring in some old ABA tests from which to study tonight, figuring I would be up anyway, and it is impossible to study at home, see above, "Mama!" etcetera) and very quietly tiptoed out of the apartment again. By that time, Cal was quiet, and I could hear the sounds of "Caps For Sale" being read in the other room.
Yesterday, I was a second-year anesthesia resident. Today, I am a third-year anesthesia resident. I am not smarter or more capable today than I was yesterday, though I feel like I should be. Now suddenly, I'm a senior, in my last year of training. I'm still a resident, but expected to start making a transition, to work more independently or to supervise others, moving away from following orders and moving more towards trusting my own judgement and making the calls as to what should be done. It's funny, because while taken one at a time, each day and week of residency seems to occupy an eternity, I look back to my intern year and I cannot believe how quickly four years have gone by.
I'm not graduating for a year yet, so this is not quite my valedictory, but if I could pass on one piece of advice to the med students or new interns, beyond what type of shoes to get or the best places to steal hospital Jell-o and government cheese, it would be this. Write those stories down. Even a few years later, you will not be able to believe what you've been through, or how much you've changed.
