Some things don't seem fair...

David Archuleta, a sincere, sweet, and amazingly talented young (17 years old!!) pure musician (If you haven't watched him perform Imagine, please please watch the below shown movie. It gives me chills every time I hear it):

David Cook, arrogant wanna-be rocker with a scratchy, sliding, slimy voice:
In my opinion, the WRONG David won this season's American Idol. I think that thing is rigged.
What do you think?

Frustration on FP Wards

Really the only good thing that has really happened in the past week is:
I got to see my college roomie Cathleen! She was in town coaching her college track team (Univ. Northern Colorado) and I got to meet up with her and her co-coach, Melissa, at dinner on Friday (we had wonderful Thai food at a place called Thai Fusion on Howe). I think she would have been a bigger fan of California if it hadn't been...101 degrees. Yup. The weather changed, suddenly, just in time for her visit (felt so bad for her athletes!)!



Secondly, I want to wish a congratulations to my sister who, today, became "Master Arness" at her graduation from GW's Elliot School of International Affairs. Sorry I couldn't be there, sis. (And, speaking of graduations, congrats to Rachel who graduated from Dental School on Friday and Molly who is now a Mayo M.D.!).

Everything else is basically driving me crazy.

A week or so ago, it was trying to do a fundoscopic (ophthalmologic) exam on a patient admitted to rule out noncommunicating hydrocephalus to check for papilledema. She was sent over quickly from clinic to a room which did not have a wall otoscope-opthalmoscope set (some rooms do).

"Where can I find a portable ophthalmoscope?" I asked the clerk.
"Ooh," she said. "I don't think we have those on this floor."
"Hmm. Do you know a floor that does?"
"Maybe the neuro ICU has one," she offered. She tried to call a bunch of floors but they had none.
"This is a hospital. This is crazy! Even the VA hospital has them sitting around nearby. What am I going to do?" I wondered.
"Why don't you call ENT?" she suggested.
"ENT? Call the consult number just to ask about an ophthalmoscope?" (It would be ophthalmology anyway, not ENT). This seemed quite ludicrous.
I paged Michelle, who is on neuro, to see if any of her neuro buds carried around portable ones.
No luck.
30 minutes' worth of hunting later, I buckled and called the Ophtho resident on call. I felt stupid, although he was very nice.
Very nice in that he said, "I would offer to loan you mine for a quick eye exam...." .... except that he, like most ophtho residents, was not in house (why would he be? It was Friday at 2 p.m., practically the weekend!!).
He suggested taking my patient down from her room to the ER where they have some wheeled ophthalmology carts.
I wasn't a big fan of that plan. The ED at our hospital is crazy.
I realized that Tower 4 has the wall sets. I wondered if I could walk my patient over there to just "borrow" the wallset for a minute.
"No, all of our rooms are full," said the clerk. "You can't just bring her into someone else's room."
"Are there any rooms temporarily vacant while someone is at a procedure or radiology where I could just borrow the space quickly?"
"Well.... yes," said the clerk. "But you can't go in there. They are isolation rooms [for c. diff- a stool pathogen]."
"What if we don't touch anything??!!? We'll gown up and wear gloves, and everything! Please, please, please, please, please???!"
"Well- I guess it'd be okay," she relented. "But be quick."
"Thank you, thank you, thank you!"
So I walked (well, practically ran) my patient to the unit to use the on-wall set.
The scope wasn't working.
Oof. I could not believe I hadn't tested it first.
Luckily, by some miracle of God, I was able to fiddle with the neighbor's wall plug (he, by some miracle, also happened to be out of the room) and, all gowned up and everything, finally did my eye exam, which took all of 2 minutes (this was about 75 minutes later).
What a waste of time.
But there was no papilledema.


Basically, this whole month I've been frustrated by the inefficiency of the hospital system and by people not doing their jobs. I really have learned very little about medicine. It's all about coordinating w/ discharge planning, getting people home health antibiotics, figuring out the bugs in this new EMR, etc. I could tell countless more stories, from the EMR havoc when the nurses are somehow not being able to release the orders (esp. discharge orders) we've signed, to frustration on rounding every day on people in the hospital (one patient there for almost 2 months) who are only there for placement. Or the orthopedic surgeons who wouldn't take a hip fracture patient onto their service, saying "she has too many other medical issues" (like being old, having a UTI, and having a heart rate, basically). Or the people mistakenly admitted to our service who are not even family medicine patients.

It's okay when the service is light, but we've had between 8-13 people, 2-3 admissions and discharges per day, almost every day for the past 3 weeks. I am waking up at 3-4 a.m. most days to go in (sometimes to run before work; this weekend just b/c there were so many pts to see and write notes on) and worked both days this weekend since I had both days off last weekend. It's draining. It's unsustainable.

OB (my LAST month [!!!!!!] of the calendar intern year [!!!!!!- although I have some intern peds to do in the fall],which has typically been very stressful and tiring on previous times) will seem like a breeze compared to this past month, which has been really the most work and longest hours for the least yield that I can imagine. One more week of this madness. Can't wait to be done.

Love in (and lovin' ) Oregon!

My awesome Wards senior, Daniel, let me take a "golden" weekend (2 days off in a row!) this weekend so that I could go with Shomir to his great friend's Henning's wedding (to Elissa) in Oregon!

Although Friday was a pretty crazy day in the hospital, we were able to signout at five and make it to the airport for our flight (only an hour and a half) to Portland (this week was great-- Shomir's on a rotation called MIC [maternal/infant care, where he takes care of laboring/postpartum moms and babies] while I'm, obviously, on the FP inpatient service; we have the same attending and so attend rounds together as well as cross paths in the call/workroom all the time!).

After we landed, and picked up our rental car, we headed to Newberg, OR (about an hour or so south of Portland) to stay with Elissa's family on the night before the big day!

Henning is a friend of Shomir's from grad school in Cincinnati. He is also German, grew up some in Africa and has been living in Scotland for the past 5 years ago. Elissa also spent time in Zaire as a child and teaching English in Korea. It was quite the international wedding, with Rachel, the maid of honor, flying from China, and Martin, one of the groomsman, coming all the way from Glasgow (complete w/ his kilt!). After the wedding, the couple planned to honeymoon in Finland and then move to Singapore for Henning's new post-doc! Wow!

Saturday was the wedding, which was held in the afternoon at Elk Cove Vineyard, a beautiful winery in the Willamette Valley foothills. Although the weather forecasted a bit of a dreary day, the sun came out in time for what was an absolutely gorgeous ceremony! Here are some pics from the event!

Elissa posing for pre-wedding bridal pictures Shomir rehearsing for his piece
The ceremony
Shom singing, "In Christ Alone"

The kiss!

The recessional (don't they look sooooooooo happy?!)
The vineyard (sorry 'bout the lil' head shadow)
The groom's party (Martin in the kilt, Elissa, Henning, Erik, and Shomir)

The reception was also fabulous! Great wine, as you can imagine, as well as great food and an awesome DJ. (Have I mentioned that I just adore weddings.?!I think I could be a professional wedding-attender!). There was even Scottish dancing, led by Martin. And here's the garter madness.

Henning, taking it off...

Shomir, catching it

Looking kinda cheerful!

(No, I did not catch the bouquet. And I don't think this has any significance-- "I have caught the garter like 3 times," says Shomir.)

Sunday, we slept in (I needed to, for I'm working and probably getting up around 4-4:30 a.m. for the next 12-13 days straight!), helped return the folding chairs to church, and then hit a couple of other wineries in the valley which is known for its Pinots (oh, and we had to change our flat tire, too) before returning to the airport.

Here's us with a very beautiful "upside-down tree"! Isn't it cool looking?!
More pretty blossoms in Dundee Hills mmm....

Pretty fountain

Horsies!

This sign (posted in Lange's Winery restroom) cracked me up (it only makes sense if you have seen those other silly signs posted in shops and in restaurants warning about alcohol use in pregnancy)!

In any case, we're back now in Sac and about to start another week (well, a long stretch of work for me). I almost felt like a "normal" person at times this weekend, forgetting about patient care and all the work I'd face when I'd return on Monday. Ah, I will just have to look fwd to the days when residency is over... with that, it's definitely bedtime...

I miss...

Reading...

I'm not sure how I found time to read this book but, on Cathleen's recommendation, finally got it (long ago requested) from the library and devoured it over the course of several days. It was fantastic. The personal story of a woman who spends a year finding pleasure again in Italy, India, and Indonesia, it was funny, thoughtful, and real. I recommend it to everyone! (Great message of a title, too!) Fluting...
Oh my gosh. You have to check out this video that Eva forwarded me. I love this Bach suite movement, and these two guys playing on one flute is just amazing (she quipped, "maybe we should have done this for our recital together!").

Sleeping....

Waking up at 4 a.m.... just.... sucks. Luckily we discharged a bunch of people today and the attending on FP wards this week is okay with rounding at 8 a.m. Sometimes I feel like I have no life...

Movies (or, er, staying awake @ movies....)

Amy and I saw "Made of Honor" this weekend, which was great! I miss chick flicks and movies in general! The most sleep deprived I've ever been, I'm even worse now than I used to be at successfully staying awake, if you can believe it, and am even more hesitant to watch a movie starting after 7 p.m.. But this (a 7:20 movie [!] was met with success! It was so cute, too! :)

Traveling...

My Mom sends me this email yesterday, "Hi T & V, We're relaxing at a beautiful resort on the beach in Kerala (India). Coconut trees, fresh seafood, Kerala dishes I haven't eaten since I was a little girl...."
Argh! Actually, Shomir and I got word we have the same vacation block next year in October, and we're tossing around ideas of exotic places to go.... S. America/ C. America/ maybe Indonesia. Ideas? :)

Non-itchy eyes

Let me say no more. Pollen in Sacramento is torturous. I have never had such terrible allergies... anywhere, anytime. I want to tear my eyes out. I am on allegra, flonase, and millions of eye drops but it is still not controlled. Suggestions?

Friends

I miss you guys! I finally caught up w/ Molly this past weekend and it was so great to hear from her. I am so excited for Hans and Rachel's wedding in June when I can catch up with my MN peeps! :) ONE MONTH! :) (and maybe we'll be lucky and it will get above freezing! :)).