ACL 2010

So I thought I'd mix it up this year, maybe hit up a different music festival, but as fate would have it, Austin sucked me back in with its yearly Austin City Limits Music Festival! Last year was pretty fantastic, catering to my love of 90's grunge with Pearl Jam headlining. And I (finally) saw Dave Matthews. So... was this year's music better than last? No idea. But it was fun!

For me, Friday's highlights were Spoon and Vampire Weekend. I was actually a little disappointed at the Strokes, but they did make me laugh with their filler between songs. Probably should have seen Phish, since their Ben & Jerry's ice cream flavor "Phish Food" is in my freezer just waiting to be eaten. Mmmm.

Saturday was really fun, mostly because of our adventure trying to catch a cab to Kerby Lane after the show. But that's a story for another day! MIA was amazing, I had tickets to see her in LA over the summer but the show got cancelled for some reason. It was worth the wait! She has such a great energy. I also liked the explosions on the screens with 'Paper Planes'. See picture here (thanks RJ!) :)

The XX were really cool, a friend of mine who'd seen them before said she was afraid they were on sedatives. In their defense, their music is really mellow. Beautiful and mellow. I'm not sure you could really rock out to it, but there were definitely people in the crowd having a great time doing that!

More Saturday coolness: Ozomatli (finally saw them!), Silversun Pickups, LCD Soundsystem and Grace Potter and the Nocturnals. At the end of the Grace Potter set, the entire band started playing the same drumset! We caught the very end of Muse, their song from the radio sounded pretty good from halfway across the park.

Sunday I only caught the Flaming Lips and Norah Jones, mostly because I wanted to spend a little time with my family and brother's dog, Keira, who's the prettiest Golden Retriever ever. She also likes to lick ears and hands which makes for some slightly confusing mornings. Sometimes I'd wake up with a ball by my ear and Keira sitting patiently by the bed waiting for me to throw it.

The Flaming Lips were part of the reason I went this year and wanted to catch them before they retire! Really fun show, but I don't think I'd want to be those kids in the audience watching them with their parents! Their opener was kinda awkward, probably a little to explicit for me to mention here. And parents... really? Babies at a Flaming Lips show? Norah Jones took me back to College and Schnucks grocery runs. Awww sunrise... sunrise! :)

Overall, fantastic time. Miss you Austin! :)

“XII If the radiology resident and the BMS [Best Medical School Student] both see a lesion on the chest X ray, there can be no lesion there”

I was reluctant to read the novel, House of God by Samuel Shem (Dr. Steve Bergman) mostly because one day during medical school I opened the cover and read the words “Except for her sunglasses, Berry was naked.” Uh… I’m all for art and free expression but I figured the book held the words of a male chauvinist-surgeon type and I was already annoyed with half of the male population in my medical school class. But as fate would have it, I ended up with a copy a few weeks ago and just finished it today.

It was written in the 70’s, before the ACGME insisted upon humane treatment of residents, when residents took q3 or q2 call without going home at noon post-call. Good Lord, I cannot imagine what that must have been like. It’s bad enough as it is. After having completed an emotionally draining adult neurology year, I can relate. I think everyone can. The calls alone put my pediatrics intern year to shame. And I can’t complain because I know my surgeon friends work even more.

I’m so grateful to all my sane medical and non-medical friends who kept me somewhat normal. Because after reading this book, I saw how easily I could've fallen off the deep end taking care of Neuro ICU patients. I’m already worried that I know residents who have. I mentioned once to a non-medical friend about a recent call I had, when the ER paged me on two patients who arrived with large brain bleeds. I had to tell their families about the imaging results, likely poor outcomes and consoled one of the families with a Spanish translator at 3am which felt wrong somehow. When I told my friend this, maybe I didn't realize how easily I laughed off the coincidence of having not one, but two horribly critical patients roll in the ER, my comment ‘man that really makes you feel helpless every time.' or how quickly I changed the subject afterwards. I don’t think I’ll forget the next question he asked, after a long pause: “Um, did you ever think of therapy?”

We probably all need therapy as residents, and The House of God highlights that. It’s an amazingly honest book about internship year that demanded change from the medical system. And it worked! In fact, there’s a rumor floating around that the 80 hour workweek limit will be shortened to 60 hours and interns will no longer do 24 hour shifts in the hospital. Hallelujah!

For me, my therapy was the ocean, friends and family who remind me that there IS life outside the hospital and it is wonderful. And my patients- those really sweet old ladies who'd tell me stories every morning when I’d check on them. And one ridiculously cute old gentleman with a fisherman’s cap who’d always ask me about Texas and talk about dancing. He wanted to learn how to incorporate his new cane into his dance moves. :)

It's nice to finally get all those House of God references people throw around. I’m also grateful to be a pediatrician again. It’s so much happier here. :)

Here in center frame, here there's only air... and just enough space to fit

Clarity, Jimmy Eat World’s release in 1999 (before they exploded into the pop music scene) is my favorite album of all time. I remember in high school hearing this great song on the radio that went something like “you’re not bigger than this, not better, why can you learn?” and I fell in love! But what was the name? Who was the band? The mystery song made it onto a mixtape I took to college, radio static and all.

Skip forward a few tracks to junior year of college. I remember being at KWUR and popping in an old Jimmy Eat World CD. I thought, “wow, I like their new stuff, I wonder how their old stuff sounds.” The last DJ who reviewed it gave Track 2 the most stars so I cued it up. Just as it started playing I had the most awesome flashback to when I first heard it. That was when I fell in love with Jimmy Eat World, and their album Clarity became timeless to me.

And I’m not alone! Last year Jimmy decided to play Clarity in its entirety at five shows across the country to celebrate the 10th anniversary of its release. Unfortunately, the last show was last March and I realized this last June. Blast. But... yesterday I found out that they recorded that show, and it’s on sale! Since April of last year. I may be the worst die-hard fan of my favorite band ever.

Go here to hear/see/buy it!

And for your listening/dancing pleasure:

One Truth

I just had a week so rough it's almost delicious, the kind of week that if almost anyone around you complains about anything you're perfectly justified to say "I understand, you'll never believe what my week's been like" and then suddenly everyone is silenced. But, not in a bad tearful soul-sucking kind of way... more like "yep, you win the unfortunate contest today" kind of way. (There's also something delicious in how vague I'm being, isn't there?) :)

Here's something lovely that helped reset me that I'd love to share.

And another Enjoy!

Rainbows

Hello world! It has been a while.

To update on last year’s resolutions… lets just say it was not meant to be! I’ve seen lots of bunnies and continue to celebrate their existence. This year has flown by, I’m hoping the next 4 months will continue to fly by. My weekly pediatric neuro clinics feel like getting dunked in the most refreshing pool of water and coming up to sunshine!

True, some of the kids are really sick and some of the moms are (understandably) basketcases but it’s so different from taking care of adults. This year we have to watch so many people slowly die. I have nothing but respect for Adult Neurologists, but man does it tug at the heartstrings. I still get a little weepy when I have to explain to a family that a patient has Parkinson’s, or ALS. Or a giant brainstem stroke where they likely may not recover any function. And I get even more weepy when the 90-something year old patient’s 90-something year old spouse (with a little dementia of their own) says they’ll do everything they can to help the patient through this. This is Love!

What really made me write was this gorgeous scene I saw on my way home from work. It was right after my in-service exam and it had poured all day. A really nice steady rain. It eased up as I drove home, and I saw an opening in the clouds with sun rays lighting a part of the highway about a mile away… the road looked like it was glowing! with a rainbow coming out of it! As I got closer, the water on the road sprayed up from the tires of the cars in front of me, and the water caught the rays so there looked like there were about ten miniature rainbows coming from the tires of the cars. After a lot of googling, I found this pic... it's kind of close:




Of course it was more beautiful being there... picture the above with more cars, a road that looked almost metallic, brighter light, and a bigger rainbow! Where's a camera when you need one!

And finally, This year's Resolutions (it’s never too late!):

1. try not to be so cranky post-call.
2. stay on my surfboard!
3. learn Spanish
4. juego mi guitarra mas (see #3)
5. cook more (things that involve more than two steps)
6. visit the newborn nursery more often. I have just gotten clearance from the nurses that I can feed all the babies I want!

Peace out!

Thanks King George!

Many of you acquainted with me know that I'm a strong supporter of A1 Steak Sauce, and hold that it's the only condiment that can make anything better. It beats out ketchup by a long short, and narrowly passes Salsa. (Salsa is good and yummy too, I wonder if they can be combined to a super-condiment.) I never really questioned the origin of A1, but CNN had a fun story on condiments today.

Isn't that the coolest? My sauce has history! And I have no idea what hollandaise sauce is, but now I kind of want to try it.

Bunny count has been restarted, it's now at 8. The bunnies here in California are different from St. Louis and San Antonio bunnies... they're a lot less poofy. With longer ears.... but they're still cute! Especially when their noses twitch while nibbling grass, and even more when they start hopping around. Next time I'll try to stick a picture in. Yay!

PICU Playa'

I was a little surprised at the pain meds neurosurgery ordered for a kid they admitted to the PICU last night. He had just had his skull opened and grids placed to help figure out the location of his seizures. Our ICU team was consulted to help with pain management overnight. I figured it was probably just me not being used to adult doses—he was 16—so I thought I’d try it out and follow their plan. It was this combination of frequently scheduled Toredol and Valium… and if he still had pain he could have 5mg of Morphine (big adult dose!) or Tylenol with Codeine. Neurosurgery does not mess around!

Turns out, they worked a little too well… I woke him up before examining him and saw him looking at me kind of funny while I was introducing myself. I asked him to follow my light… but instead, he just said “Woah… doc! You’re beautiful!” His mom started laughing pretty hard while I just went on with my exam, but he was like “no really—you’re really beautiful!” Nice. I had to cut back on his meds a bit. The best part was watching the reactions of any female nurse or resident who came out of his room… they all had smiles on their faces!

Countdown to California… 25 days!

Bunny on Easter!

Today at work was brilliant. I found an Easter egg in my pocket, had homecooked lunch, talked smack to my favorite 5 year old CF friend who had to be readmitted. She likes to make funny sounds to herself in between ordering everyone around like a little diva. Kinda reminded me of that scene in Garden State when Natalie Portman's character starts talking about doing things to feel unique... that's so much like this little one- last time she was admitted I caught her dancing by herself in her bed! Hopefully she won't be in too long... she needs to be home more!

One family also brought a surprise with them... Bunny! They um, crashed their car on the way home after just getting the bunny. So all afternoon there was a baby bunny hopping along in various areas of the pediatric ER. The nurses found carrots (I wonder if bunnies actually like carrots or are resentful of that stereotype), a cup of water, abandoned wagon and blanket and we set up bunny camp. Good news- everyone was ok! They even let me take some pictures of the bunny. He was sooo tiny. :-)

Gonna hit the sack. Updates: turns out that patient's dad was just really confused, and no real damage control needed to be done (or so my colleagues tell me... maybe they are just protecting me...) My new years resolutions are doing ok: 1. I am reading. 2. Can't anymore- out of stock. 3. haven't been put to the test yet. 4. played with bunny today. 5. Holy goodness has the news gotten interesting lately. PIRATES!

m

A lovely Easter to all! :-)

"Thanks for makin me feel like a real [idiot], doctor..."

No more explaining things that already should have been explained to semi-confrontational angry dads while leaving the ER especially when I've already stayed 30 minutes past my shift. The funny thing was that I actually was starting to question his mental competence... at least he didn't punch me. I owe another resident for digging me out of that hole. It was a deep, deep hole. (I woulda punched me.)

I met my new little hero today! He was a three year old who was wandering around an appliance store, when someone opened a refrigerator door in his face. He had a pretty deep laceration on his forehead that needed stitches. If I knew enough Spanish, I woulda said to him, "Aw, buddy I know exactly how you feel! I get accidentally whacked in the face all the time!" But no need- he looked so happy to be getting all this attention. Can you believe it- he sat through lidocaine shots AND three stitches. Those parents should give classes... the whole family helped keep him calm but had to keep switching off because they'd get lightheaded.

I love being in the Pedi ER! Things seem to come in themes. Today was head vs. hard object day. Yesterday was appendicitis day. Looking forward to swallowed foreign body day (those have fun X-Rays.) And things don't "come in three's" here, more like fives or sixes in a row... all at once. Unfortunately we also seem to be having sexual assault week. I hate that theme.

But here's something super awesome- we're giving away stuffed bunnies now in honor of the holiday! We've also been having an easter egg hunt every morning for the staff. The hunt isn't the fairest of hunts since when I have trouble finding normal things like tongue depressors, how am I supposed to find eggs? Luckily, my confusion seems to be winning me some jelly bean donations. Mmm! Just like FAT BUNNIES! ;-)

Resolutions, Version 27.0

After a year of being knocked out by sleep deprivation (did I even have resolutions last year?) I thought I’d try this resolution business again. This time I’ve had more sleep, and more time to soak in the world around me. So much, that even though my call this month in the NICU is every five nights instead of the standard four, I still feel like I’m being run to the ground.

But, as self-improvement is an adventure in itself, I have some great ideas brewing. Some of my resident friends here may join me in my most ingenious idea. If it works, I shall blog about it in a year, if it ends disastrously (Wikepedia says I have an 88% chance of failure) it will still be worth writing about, as it will surely be an ingenious disaster. :-)

Here are a few other ones I came up with: (Hold me accountable!)

1. Take time to read more often. For example, for the past year our clinic has had a shortage of the Hib (Haemophilus influenza B) vaccine. This vaccine was a breakthrough in preventing one of the most common potentially deadly illnesses and reason for hospital admission in children. Never really questioned the shortage, but after reading this, I know that Merck made a mistake, kids ARE getting sick again, and if anything this may help parents understand the importance of childhood vaccinations.

2. Get the flu vaccine. (I hope my chief residents aren't reading this... I'm gonna get it soon!)

3. Try not to suck so badly at Kareoke again. The uncomfortable silence and nervous laughter after my version of "Mr. Jones" during my friend's new year's party comes to mind...

4. Do something kid-like at least once a week. Yesterday I played basketball for the first time in years. It was with a group of men and women with an average height of like, 5’3". I know... I know... but man it felt good. ;-)

5. Stay updated on current events. Despite the instability surrounding us now, I’ve never felt so patriotic or proud of our country before for the version of leadership we’ve chosen. In the past it’s usually been an apathetic detachment, or disappointment that issues I supported (or cared enough to form opinions for) were in the minority. It’s a humbling, wonderful thing, this witnessing of who we are slowly becoming.

The NICU is a crazy place. Crazy, but always interesting. A baby with a sacrococcygeal teratoma was born today, there's a giant mass coming out of her lower back/rectal area. I wonder if there's teeth in it. Extra eyeball? :-) Ew... ok subject change... another resolution maybe?




6. Celebrate Bunnies more often! AWWWWWWW!! :-)

I am an Idiot

Note to self: do not walk into no-parking signs.

This morning after seeing patients at the JDC (Juvenile Detention Center) I was having trouble finding my parking lot. We have free resident parking a block away behind a building by some gas pumps and I think I starting walking towards the wrong set of pumps. After studying the street signs for a while I finally realized where I was and turned around… knocking the right side of my face into a metal sign. I do this kind of thing pretty frequently (accidents) but have never injured myself enough to seek medical attention.

After grabbing my eye, I realized there was some blood on my hands. It didn’t feel bad, I felt like I might have had a cut on my eyebrow so I ducked into a nearby Court building to find a bathroom and clean it off. Four guards inside graciously asked me if I needed help. Without thinking, I uncovered my eye and asked if I could find a bathroom or some gauze. After seeing my wound, one guy started shaking, asked me if I was ok and said that I should sit down. Another ran to find a first aid kit, and a third offered to call an ambulance. A woman said she saw me hit the sign and was worried about me.

So, I’m thinking “Good God, I think my eyebrow must be hanging off my face.” I put pressure on it with napkins and wondered if I could talk a colleague at the hospital into “borrowing” some Dermabond (superglue for your skin!) so I wouldn’t have to get stitches… or if it was possible to suture it closed myself. That’d actually rock.

Despite protests to move, I broke away to the bathroom to look at the damage. One of the women followed me in. I had a fairly large red mark on my cheek and a half-centimeter abrasion on my right eyebrow only worthy of a band-aid. More embarrassing if anything… I felt bad inflicting panic among such nice people, especially when one of the men said “What can I get you, Doc?” I also felt bad for having to tell them that the hydrocortisone cream in their first aid kit wasn’t the same thing as antibiotic ointment. Now that I think about it… could putting a steroid cream on an open wound possibly increase the likelihood of infection?

Thank you employees of the random courthouse I park behind! I’m sorry that I stole your only package of gauze and I hope you’re not traumatized. Thank you mostly for not laughing at me. Perhaps this election's result has inspired even more good will in us all! :-)

Thank you Colin Powell!

Colin Powell officially endorsed Obama recently and commented on a frequent belief held by some voters that Obama is Muslim:

"He's always been a Christian. But the really right answer is, what if he is? Is there something wrong with being a Muslim in this country? The answer's no, that's not America," Powell said. "Is there something wrong with some 7-year-old Muslim-American kid believing that he or she could be president?"

This makes me want to stand up and cheer. Why haven't I heard this before from either side?

Here's a link to the article, from the AP

Despite occasional frustrations with people who are racist or... um, lets just call them "hesitant to trust others perceived as unlike themselves," I am ridiculously excited about how this race has been unfolding and the possible outcome of this election. Obama is a politician to whom I can actually relate, he comes across as polished--even professor-like--with the clarity of his explanations and encouragement thrown into his speeches. And his wife is so inspiring! She might be my new hero. Can she be president too?

McCain's family memoir, Faith of My Fathers, was actually really good. I respected McCain before I read the book, but now I'm humbled by him. It helped me understand the "pro-war" side (or, the anthesisis of an anti-war stance) and made me think twice about my instinct to dismiss the necessity of any war. (Unfortunately for McCain, I still hold that instinct.) It's a shame that his campaign has gone in the direction that it has.

On to Obama's book, this should be great... another one about a Father. Makes me really want to call my Dad. :-)

Ode to Water, Power, and Music.

Holy goodness... a lot has happened. Galveston was pretty much annihilated from Ike. Boo Ike... BOO! But now I know my neighbors since we were powerless for a week afterwards. The older man who lives next door to me is a professional violinist in the Houston orchestra and in a band that plays “a kind of Egyptian Jazz music.” He says that in this awesome European accent... I totally love that I can hear him practicing through my walls.

It is kind of neat that despite camping out for so long the atmosphere in houston and the hospitals was pretty upbeat the whole time, even with all the Galveston residents relocated here who lost their homes. I guess such a strange/sad situation can be pretty uniting! Apparently I qualify for some sort of government reimbursement but it’d kinda be lame to ask for it since my place was fine, I was stranded in LA of all places (yay!!), and this gave me an excuse to mooch of my friends in Houston with apartments much nicer than mine. But now a lot has changed--all the stoplights work and I don't need to leave for work an hour early anymore! I have POWER and WATER!

The music festival in Austin was awesome! There was so much good music, and much of it was new to me. The most impressive thing about ACL this year was that they really improved the sound leak between stages—that was very annoying in years past. Outside water was allowed in, and there was plenty of power... so much that my Sprint cell phone kept switching between eastern and central time! It was political at times with many artists giving shout-outs to both candidates. I was surprised when bands who mentioned their support for McCain were rewarded by silence (given that I was supposed to still be in TX) but I have to admit it was pretty funny. I do think they need to sell fewer tickets as there was very little space between crowds around stages at opposite ends of Zilker. Also, the Frisbees we threw around seemed to hit people more often. Unless you're a Russian guy with superior aim whose discs only go to Siri.

My fav: The Swell Season, with Glen Hassard and Marketa Irglova from the move ‘Once,’ who played Friday. I still can’t believe I got to see them... they sounded beautiful. I think what made the night was Glen Hassard’s attempts at philosophizing. His speeches/song explanations were usually accompanied by wild guesturing, and while some of it might be over my head he did say one profound thought. I am paraphrasing, with hopefully less rambling. "Sometimes when you have an obstacle in front of you that’s like an endless wall… and you can’t go around or over it, I've learned sometimes you can walk away from it... and keep walking so that eventually you walk around the whole f*ing world and find yourself where you wanted to be in the first place!" Genius.

Other favorites: Tristan Prettyman, Erykah Badu (this woman is phenomenal. she's also very pregnant!), Jose Gonzales, Jenny Lewis, Okerville River, Beck (yay!), and Manu Chao mostly because I figured that anyone new I saw after the Swell Season wouldn't be able to hold my attention, but I was wrong--Manu Chao was freakin amazing.. yo yo yo! I also loved a three minute moment during the Foo Fighter’s encore where they busted out with ‘Big Me,’ only after butchering my favorite Foo Fighter song ‘Monkey Wrench.’ And let's talk about this Monkey Wrench thing. I was SO looking forward to rocking out to that fun yelling thing he does at the end of the song... but where was it? Oh after the false ending and weird creative drumming and... lets pretend we're stopping the song again... oh wait no here's the rest of it.... and yes, here is that fun yelling part only I'm not going to yell with the music... and I'm going to cut the stage lights again. Not that I'm bitter. :-)

But then they played Big Me... it's the sweetest song of all time! My love is regained!

Turkey? Provolone?

I think my subconscious wanted to be a doctor more than I did. For the past several weeks, the medical world keeps finding a way to creep into my dreams. Two days ago I dreamt vividly of a four month old baby on the wards with feeding issues and that I happened to have a friend who specialized in feeding problems. (Is there really such a sub-specialty? At four months?) I decided I immediately needed to transfer care to my friend. This meant I should pick up the phone at once and call her… which I did… until I realized it was 3am and the friend that I was calling was the last person who had text paged me. Thankfully I realized this after hearing it ring on her end, so I hung up quickly. She’s actually an internal medicine resident so my dream-mind was WAY off. Does this happen when I’m on call too??

Today, in dreamland I had to undergo special training for resident leadership skills. This meant running a sandwich shop. (I think I may have been a little hungry too while dreaming this.) The nurses from the ER were my coaches. They told me that my job was to “be their friend” but to put on my “sandwich gloves” and be stern when I need to direct them to do something. So, they had me behind the counter and I had to direct the sandwich-making. One female elderly doctor had approached the table, and she had an easy request, but before we could get to it (there was a more experienced sandwich maker at the counter too since in my dream I could not make sandwiches) two older male doctors came and demanded sandwiches. They said they had to go to the OR. What did I do? I told them to go back in line! And they did. My supervisors told me I did a great job. And then… then I woke up before I got my sandwich reward!! Blast.

My floor supervisor month in July rocked. The interns are all so nice... and smart! ER has been awesome too. Foreign bodies were pulled from all kinds of orifices (my favorite… sponge up nose! that one was a surprise), friendships were maintained despite consulting pediatric surgery every five minutes, violence was avoided from angry parents (but one nurse got hit!) On the downside, babies were beaten at home, twelve year olds found out they were pregnant, and I went through two other pagers after my beloved/hated electronic companion of a year broke. But I learned more this month than I think I’ve learned in a long time, simply from the volume and diversity of patients we saw. Next month I have to do some ER shifts at the county hospital (shudder!) and work as floor supervisor at night for a week. More stories I'm sure, I may have to try and stay awake more so my real stories outnumber my dream stories! Next month will also bring two vacations, my birthday, and a possible hurricane evacuation.

Stop Gustav!

Who knew?

According to CNNMoney.com, my parents are set! No need to move anywhere else to retire in style. Check it out... my hometown is famous!

#7 America's best small cities: Round Rock, TX

I was a little disappointed that there was no mention of the world famous (I like to think) Round Rock Donuts... so I am going to mention them now. I even stole this pic off the internet, where any good world famous donut picture would be located:

Mmm! The address (if you'd like to GPS it from your respective starting points) is 106 West Liberty, Round Rock, TX, 78664. The cherry bismarks are delicious!

Also, it was an even nicer surprise to see where my new home for 2009 and beyond was ranked:

#4 America's best small cities: Irvine, CA

Score! (Ignore the fact that I am going to be very, very broke for quite some time) :-)

Woah.

It’s been a year and I’m about to have my last call of Intern year Monday… there are definitely things I’m frightened about as a second year, but all the more motivation to crack the books open again. I’ve gotten lazier about studying over the past few months so it’s payback time.

My schedule seems pretty fun. Not only do I have almost two weeks off in September (ACL music festival! Who’s with me??), but I have all the rotations I wanted: Genetics, Cardiology and even some I don't so much (Endocrine... eeeek. I had enough Endo as a med student!). I start off as a supervisor resident at the county hospital… I’m not sure which genius is responsible for this decision-- I have to oversee four interns and six medical students! But, it comes along with a nice q7 call schedule so I’ll put up with the madness gladly. :-)

Just the other day I was thinking of all the kids I’ve known who have died this year, and I was thinking how nice Pedi was that I could actually fit everyone on one hand… my medicine friends tell me about least one person a night passing away on some services. But then my friend calls me to tell me she had to call time of death on a patient I knew at MD Anderson. That makes six.

I was at an M&M (morbidity and mortality) conference of another patient I knew who had died from complications following heart surgery to remove an enormous abscess. Most of the people in the room knew him; one of my friends was giving the talk since she took care of him on the floor when he coded. (Way to stay strong Di! You didn’t see me tearing up in the back row…) Was it a diseased heart that was inevitably going to fail? Was it the telemetry monitors that didn’t make his arrhythmias clear? Was it us? These are all such hard questions with no answers. But, it seems to have resulted in the hospital completely changing the way it cares for post-op heart patients on monitors.

It’s wild to think that in two weeks, interns will come to me with questions. Like, how do you write for Tylenol? What do I do if my pager falls in the toilet? (this has almost happened to me once while I was carrying four different pagers) Why do the nurses call me at 2am with normal lab values? Why does pharmacy never trust what I write for?* Why does this lack of trust always happen during nighttime hours? Why do I have dreams of rounding on my patients when I’m not on call and why do I start answering my regular phone as “Hello, this is Dr. _____"?

While I can't quite help with these (well, ok I can help with the Tylenol...), I can offer four very helpful pieces of advice: trust no one, know what you don't know, know who to ask for help, and when in doubt use Google. I too shall heed by this.

Welcome new interns! THANK YOU for being here. :-)


(*disclaimer- pharmacy has definitely prevented me from accidentally hurting patients on more than one occasion, and for that I am grateful. But, the ratio of good phone calls to useless phone calls at Hermann is <<<1, and this fact is universally agreed upon by most residents.)

Rocket-Science ;-)

Watching the Rockets play is like watching little kids playing with art supplies… sometimes they figure it out and it’s brilliant, but sometimes they try to get creative and end up with a giant mess…

That said, I’m a new Rockets fan! Secondary to the Spurs of course, I can’t help being an NBA fan after living in SA for 4 years. The Spurs make the city so happy! And I want to hug Tim Duncan everytime I see him play. Since they always win games and usually play great it's always fun to cheer them on (except for one loss to the Rockets earlier this season which I’m still a little bitter about, but have chosen to overlook for now.) The Rockets, however are another story. No one is really sure how they made it to the playoffs, but they’re sticking in there! I’m watching game 6 now… Utah has a big lead and I think the Rockets are starting to get nervous. C’mon Rockets! Ummm they can come back from Utah’s 26 point lead right?

I’d also like to celebrate my new footwear addition—new running shoes again! These are light blue Nike’s which have really nice padding in the front… never really appreciated how great sprinting can feel when your toes have something to bounce off of! Not that I’m a sprinter, but if I were ever to flee an attacker, I know I’m well equipped. These are the bounciest shoes ever, and if you look closely you can see little hearts and stick runner figures on the laces. Wooo! I heart you Nikes! (don’t tell my Adidas shoes…)

Holy goodness!! The Rockets have tightened it up…. pretty freakin incredible! So I’m going to get back to the game. But here are my pretty shoes!

Next time I'll try and add some more hospital stories. I'm at MD Anderson in the Oncology ward, after a month of Infectious Diseases. After last month, I probably know more than I ever wanted to know about diarrhea, just short of experiencing it myself (thankfully!) Moral of ID month: Don't play with live crawfish, and wash your hands. This month will be good, especially from a pedi neuro perspective... though emotionally it will be quite the test with the terminally ill patients. Cancer sucks.

Hmm... and speaking of sucking the Rockets are doing that thing again when they're getting outscored... I think they need my full attention now. Since this might not end so well tonight (unless they surprise us...) here's a happy pic!

This was from StL (home of the lovely April daffodils)... reunionizing was awesome and I really miss the ones who couldn't make it... so here is a daffodil for you! :-)

Surviving the Petri Dish

Yay! My ER month is over. It was really cool and inspired many a' ponderings:

1. It's impossible to work more than two 12-hour shifts in a row without getting sick! I bet I'm colonized with a nice variety of bugs now... luckily they're the "upper" kind and not the "lower" kind.

2. Completely well children in the ER are really fun to see, despite the trees killed to meet their paperwork requirements.

3. Completely well children who listen to people's bottoms with stethoscopes cause they're not tall enough to reach your lungs are even more fun!

4. Teaching med students how to suture is AWESOME. I feel so useful now! Want me to suture you??

5. When you pick up a chart, and it says "vaginal bleeder" it's ok to put the chart back and walk away slowly. You can even use the speculums in self defense!

6. Working nights is kind of strange, because halfway through at midnight you have to switch the dates. So, when I'm there during days I start switching the date at noon which stirs up all kinds of trouble. Although, it makes time move twice as fast. :-)

7. Splinting is totally cool and fuels the part of me that always wanted to do Ortho. (I think it's a small part. Can we splint and cast brains?)

8. All ER attendings are crazy. I think you really kind of have to be, and admittedly some are crazy in more endearing ways than others. My favorite is the attending who writes "Stop using Drugs or You'll DIE!!!"on her discharge papers for kids who come in with drug overdoses. She'll underline the "DIE!!" too, and write it really big. And under the 'home meds' section she'll put "None-- you have already had too much!"

9. This same attending did a throat swab on me after I asked her how to do one. Good thing I didn't ask for a refresher on a Gonococcal/ Chlamydia probe...

10. Mia Bella's (off Lexington and Shepard) has half priced drinks and appetizers all day Wednesday and free dessert coupons on Citysearch.com. AND the food is delish! This doesn't have so much to do with the ER, but it's my new favorite restaurant in Houston! MMM!

I'd like to thank my asthmatic patients on the Hermann floors for once again allowing me to update my blog. I can't really sleep since I have to check on two of them every hour or so, so this is great. I will miss not having call, but it's nice being back here... these kids are so cute! One patient who looked like the girl from little miss sunshine kept making pooping noises at me. (She really wanted to poop because she hadn't in a while.) And another toddler who had two butt abscesses drained was still running around her room laughing.

Bye bye pregnant teenagers! :-)

It's like, MY life! :-)

“And here’s a hit from ‘98” the radio DJ said as Green Day’s Time of Your Life started playing. I turned it up to sing along to, then realized that 1998 was TEN YEARS AGO! Holy Goodness.

Which is a nice segway into my new obsess—er, discovery. For some reason (the same reason I like to think caused me to miss shows like Saved by the Bell and the Wonder Years… gasp!) I never watched My So Called Life when it came out. I think I woulda been in the eighth grade, I totally watched shows like Party of Five, even Dawson’s and Felicity (quality show!) but sadly MSCL missed me. And I never did have MTV to catch up either. So when abc.com started playing past episodes, I started watching.

First, the show is fantastic!! Even now I can relate to it, and I think people of all maturity levels can. I have a huge appreciation for Angela’s character… as creator Winnie Holzman describes, the quiet girl at the back of English class who turns in everything on time and does everything right, who has so much more going on inside than she expresses. And I think that’s fun to see—her head is in the clouds almost as much as mine was (a trait I’m still trying to outgrow.) Jared Leto Rocks!! I love the fact Angela can laugh in Jordan Catalano--Jared Leto's--face when he asks her to have sex with him and then walk away. Speaking of Jordan Catalano—he totally reminds me of MY high school crush… but um, slower. (And I don't think I got past saying eight sentences to him in those four years. Some of which I still remember.) :-)

I’ve seen far too many 14 and 15 year old girls this month on the OB floors who didn’t make that decision to walk away, or the decision to use protection, and now have to take care of a baby instead of being a kid and going to school. I wonder if it’s because of shows depicting high school in less realistic ways—glamorous sex lives, expensive cars, tube tops, who knows. MSCL handled that topic—and more—awesomely, and honestly. I’d say we should make new episodes, but really… would it be the same now? MTV had it right-- just replay the old ones! Whatever happened to Juliana Hatfield?! Her music was incredible!

Thank you Meyling for supplying my addiction (Meyling: I UNDERSTAND!!! I UNDERSTAND!!) :-) Only now I’m feeling an insane amount of withdrawal! The series ends with the worst cliffhanger of all time, second only to… Wow I can’t think of any bad cliffhangers. Which is good because then I’d ruin another show for you. :-) It’s funny though I know exactly how I want it to end now, but 15 years ago I would have wanted it to end in the completely opposite way. Maybe this is WISDOM! Who knows, in 15 more years I’ll want there to be robots and exploding things. :-)

And did we really wear so much flannel back then?


“There are so many different ways to be connected to people. There are the people you feel this unspoken connection to, even though there’s not a real word for it. There's the people who you’ve known forever who know you in this way that other people can’t because they’ve seen you change. They’ve let you change” ~ Angela, My So Called Life

Ode to Spaces (and babies!)

This month will end in 12 days! I'm in the newborn nursery and don't get me wrong, I love babies... and love the fact I have no call this month. But the PAPERWORK! There's got to be a better way. We have to collect information from everywhere (three different sources not counting the babies themselves) and fill out these papers. It's quite repetitive. So much of my time is spent doing this, I'm starting to have bad handwriting! I thought I was immune, but alas. Residency takes what wasn't already sucked out of us in Med school. :-)

Strangly enough, being around newborns is triggering maternal urges I never knew I had. Lucky for the babies, they all have security devices which go off if they get too close to the elevators or if someone illegally takes off with one. I'm trying to become more responsible in caring for other life forms. Over Christmas and New Years, I took care of my neighbor's plants... and they survived! One day I will have my own plant... then I shall work upward from there. (and steal cute babies.)

More thoughts: I am getting to know the nurses on the floors better, and they rock! One of them, I'll call 'Mama G' (she's so wonderful!) was telling me about her husband... and how for the past 38 or so years she wakes up to "oh honey, you're so beautiful!" and hears "I'm such a lucky man for marrying such a kind and generous lady" on a fairly regular basis. She said at first she thought it strange and it took a while to get used to, but now she thinks it's great! He even notices her haircuts. :-) Mama G told this story much better, and she definitely raises the bar for the menfolk in this world: Men everywhere- take note! Verbalize!

I just got back from a friend's place-- her apartment complex had a pizza-movie night (Transformers!) and along with the group, there were 5 or6 toddlers there. They were from 3 different families... each maybe 2 or 3 years old, and I had as much fun watching them socialize as actually watching the movie. One little girl was trying to join a group of three kids--two boys and one girl--sitting on a couch in front of the TV. The boys were all about including her in their Transformers talk-- I think she was asking them in Spanish too. The girl however seemed a bit protective of her friend circle and just kept saying "NO! NO!"The boys didn't care, and one even moved over so the newcomer could sit next to him. The other girl however, came over and smacked her!! That girls' dad and mom ran over alarmed and pulled her away... then later she comes back and says "I'm sorry" to the girl she just hit. As if that weren't cute enough, the girl who got hit (who may or may not have understood the English) hugged her. It was like... real life hallmark!!!

Also, I need to fix my space bar. Here's how it looks like, I've trained my thumb to hit the little white rubber thing in the middle. Only it came off too! I put it back on, but it pops off. Poorspacebar! As youcansee, I also am missing a white plastic part on the right... I hope my vacuum cleaner didn't eat it up! Anyone have a spare spacebar (or glue?) lying around?