Why, again, do I not live here? (Colorado Part 1)

I am LOVING vacation and LOVING Colorado. This trip out here really does make me wonder if I made the right residency choice-- I could have been living in Denver! :) No, I really like Sac. But it's been so wonderful to reconnect with friends and be around the mountains, which I absolutely adore. There's still time to move here later, right?

I started out the trip driving up to meet Cathleen in Greeley, where she now works and trains in track while still working down in Denver (about an hour south)! Actually, we met up on the highway on the way there, timing her leave from work at the same time as my leave from the rental car place at the airport-- this was cool! Anyway, she has to leave for work at like 4 a.m. and so is in bed by 8 p.m. usually, but we still had time to hang out :) She has a lovely porch pictured here.

Roomies, reunited

Some things never change. Here is her fridge. There is a similar picture posted in a distant blog from last winter, when I was stranded here in the blizzard and spent Christmas with CC.
Out to eat (2-for-1 lemon drops at altitude were a bit scary, considering Cathleen doesn't drink...)

While Cathleen was at work Thursday, I headed out to Rocky Mountain National Park west of Greeley. I have to say, this was one of the most beautiful parks I have ever visited. I think it's mostly because I adore mountains. I drove up on Old Fall River road, a one-lane unpaved "scenic" road which was so scenic and filled with tight switch-backs, I thought I was going to die.

I then jumped on Trail Ridge Road, which is the highest continuous paved highway in the U.S. (as high as 12,000 ft). and, definitely as the guidebooks say, certainly one of the most scenic. I honestly had a hard time staying on the road b/c I was so busy gaping at the scenery (below are some pics).

Here is a quote I wrote down from seeing it on a park sign, which I thought was beautiful and with whose sentiment I wholeheartedly agree:

"Without parks and outdoor life, all that is best in civilization will be smothered. To save ourselves, to prevent our perishing, to enable us to live at our best and happiest, parks are necessary. Within national parks is room – glorious room—room in which to find ourselves, in which to think and hope, to dream and plan, to rest and resolve. "– Enos Mills.

Elk!!Shadow Mountain Lake (I love lakes too :))
Long's Peak and Lily Lake

Yes, I wear this fleece every day, ok? :)

I'm running a bit short of time, so will write more and post more pics on this later (Mindy has most of them on her camera), but Friday, we left Colorado Springs for the mountains with the goal to hike two fourteeners (14000-foot peaks). Let's just say that this was HARD!!!! Mindy wants to do them all (she's done 14 of the 54 already!-- see her blog, which I also have posted at right, for all of her adventures so far)-- there's this whole culture here that aims to accomplish them all (here's the main site: http://www.14ers.com/). It was funny, because Mindy, Zach, and Jeremy (two of her friends that came with) kept referring to 13000 ft peaks, or thirteeners, as "why bothers!" We also met a guy on the trail with his two dogs, who've already done 15 each! That's nuts!

Anyway, we hiked in a bit with our packs, camped, and then headed up to Mt. Belford (14,197) and Mt. Oxford (14,153) yesterday. What craziness! I can't believe I didn't get altitude sick and die or something, but it was pretty impressive. It was pretty cold at the top and VERY windy, but we dressed smartly. Zach actually forged on ahead, and summitted another fourteener, Missouri, but we were too dead and heading down the mountains with such wobbly legs was enough for me! I think two fourteeners (in a lifetime) might be enough for me. For now, at least, until I move to Colorado and get sucked in :) I have to get Mindy's pics to share, but here are a couple of mine that turned out.

Arriving at our campsite around dusk: Mindy and Zach
Mindy and me at the summit of Mt. Oxford (with Columbia in the background)

That's all for now! A few more fun-filled days in Colorado remain before I head back to sea level. But get this-- vacation lasts till Sept. 30th! :)

Back on a bike

I wanted to congratulate my dear friends Laura and Tony (and Laura's Mom, Ellen) on their MS bike ride last weekend in New Bern, NC. They trained and were all set to ride 150 mi over two days in support of this cause and completed 80 miles of it (day 1) before tropical storm Gabrielle rained them out on day2 (bummer). That's still way more biking than I'd be able to do, so they are my heroes! I'm posting their pictures because I still "got none" to share (and, Laura, AHEM still has not started a blog of her own). And because I'm so proud of them. And because they're my heroes. And because they're cute.

The trio pre-race

Are we sure about this??
I loved Laura's Dad's caption on this one, "There's no turning BACK now."Downtown New Bern swarming with bikers

There's Laura rounding the cornerGetting to the finish line Al fin!!!!Like mother, like daughter
Then, the next day.... Tony being the "weatherman" amidst the storm. This cracked me up.
I can't remember the last time I saw rain!!!!!!!! This is madness!

So, truly inspired, I decided to do a little (and the keyword is little) biking of my own today. I biked to Sac State and then jumped on the (safe portion) of the American River Bike Trail, which goes 32 miles or something along the river clear out to Folsom Lake east of here. It was nice to bike again (I'd taken about a month's break, as I had been driving to the VA and not commuting via bike, and usually running for exercise on my days off) and the weather was PERFECT. Not Lesley- or Ebby-perfect, but objectively perfect. It was in the 60s this a.m. when I started, and got up to high 70's/low 80's by around noontime. I had a very pleasant, leisurely ride along the water's edge.

I met Amy at the mall for lunch (all of us are off at the same time!) at one of her favorite places, Pluto's, which had amazing salads, and chatted it up for a few hours. I actually hadn't yet been in Arden Fair Mall, which is GIGANTIC. Not as big as MOA (Mall of America), but still, SPRAWLING. I hear you can never find weekend parking. But then again, when do I ever have weekends off? Anyway, I had to swing by Victoria's Secret for my free set of you-know-what (hey-- they send it in the mail, I take them up on it), as well as AAA for some free maps of Colorado given my upcoming (tomorrow!) trip. Some things never change. I still love free stuff.

Tonight, I gotta do some packing (which is, if you recall, my least favorite thing next to unloading the dishwasher). This time, tomorrow, I will be a mile high!

1/4 done!!!!

aah.
3 months of intern year (1/4) is DONE!!! It's hard to believe. I am soooooooooooooo excited to be on vacation! When I left the VA hospital today at 5 p.m., I was so pooped it was hard to be excited but, after a two-hour nap, some phone calls to friends, and being rested enough to comprehend the fact that I have more than 24 consecutive hours off, I'm ECSTATIC!!! It was therapeutic to be able to change my pager message to say, "I am NO LONGER at the VA; please page...." And maybe every thing is rosier in hindsight but, while there are certainly some things I WON'T miss (see below), I actually had a fairly good month and felt good about the medicine I practiced (and learned).

I will miss the patients and their families. When I told one family member today that it was my last day today, he said, "What? You mean we'll have a different doctor tomorrow?! No! We like you! Do you have to go on vacation?" (YES!!! For my mental health, I have to!) This is certainly more encouraging than poor Lesley hearing from her peds patients that they hate her (how could anyone hate Lesley?!). I've had some really wonderful interactions with some sick, but grateful, veterans and their family members.

I will not miss breaking bad news. Just this week, I have had three patients who were surprised with the diagnosis of cancer and seem to have my own personal oncology service. The first one was a spry 89 year old man who was walking 10 miles a day up until a month ago, when he started to get short of breath and noticed that his voice was hoarse. A chest xray in the ER showed white out of one lung-- he has a huge pleural effusion-- and CT/bronchoscopy showed a massive obstructing lung cancer, affecting his laryngeal nerve, as well as pain in his arm likely a result of brachial plexus (nerve) impingement from the tumor. We were awaiting the final pathology results-- it looked like small cell cancer, but it looks like he will probably go home on hospice care.

Another patient I cared for had been seen by his primary doctor for about 6 months complaining of neck pain, thought to be musculoskeletal. However, he also had weakness and weight loss; a CT done about three days ago also showed a large upper lobe lung mass with mets that was biopsied and will also probably come back as malignancy.

I admitted another man from the UrgiCenter last week, a previously healthy 68-year old on no medications, with a 1-month history of vague upper abdominal discomfort, diarrhea, and jaundice. On my exam, his liver was HUGE, with a large palpable epigastric mass, and CT showed that he has not only a gastric mass, but likely a lesion in the pancreatic head (causing the jaundice) and liver metastases. He was the second guy in a month to which I had to break the diagnosis of likely pancreatic cancer, which has a dismal prognosis.

Another one of my patients, a guy admitted after a fall but with a UTI, lower extremity ulcers and bad peripheral vascular disease, acute renal failure, and possible small bowel obstruction, got pretty sick overnight before I saw him Friday morning. I thought he looked much worse when I rounded--sweaty, hypotensive, and with some mental status changes, and rapidly started the transfer to the ICU, but he actually went into respiratory arrest on the floor before they could get him down there, ended up on pressors to keep his bp up, and died the next morning, which was a big shock to all of us. We had had him on broad-spectrum antibiotics, were hydrating him and cleaning his wounds, so it was a bit of a shocker and we are not sure what could/should have been done differently, but it was still very very sad. I will not miss having patients of mine die.

I will miss the learning environment. Although I was quite worn thin, I learned a lot about medical management that will help me in every other rotation (including when I have to cross-cover on those crazy sick gyn-onc post-op patients on OB!). I'm realizing that FP residency is very hard, because you are supposed to know a lot about a lot of different things-- OB, peds, internal medicine, etc. At times, the challenge seems really daunting, and it is frustrating to constantly be on a service where you don't spend as much time as the other (categorical) residents (i.e. I will never know as much about medicine as the medicine residents or as much about labor and delivery as the OB residents!) and where you constantly feel slightly incompetent at first, having to rotate through and juggle the info. from so many different fields. However, I do like the challenge and I do like learning about medicine and keeping up (like Les) with the physiology. I wish I had more time to do it systematically, rather than on the fly, but it is what it is.

I will not miss the hours I kept. On Friday night, I stayed at work until about 10:45 p.m. finishing up work and discharge summaries, which made for an almost-18-hour day. I was back Saturday morning at 6 a.m. for another 15-hour stint. This is my excuse for not being in touch. Sorry! The funny thing is that these hours were better than my previous month, on OB (which I actually think was more physically, mentally, and emotionally draining and to which I return after vacation and block time. I only cried TWICE on this medicine VA month! :))

I will not miss rounding until 1 p.m. We had a new attending last week who was, shall we say, very thorough and meticulous. Rounds would take us four to five hours, which made it so we could never get work done and consults in on time! I truly hate rounds, although feel like work rounds are much better than walking around for hours and hours.

I will miss the people I worked with. There were two medicine teams, and Brenden, my co-intern, was great in keeping me calm and in helping me figure out the VA system. My senior residents were good, and the people from the other teams and services-- medicine interns, fellows, and med students (which I wish we'd had on our team to scut out!)-- were very fun people to be around! We were always joking and chatting it up in the residents' room (when we were not working, that is).

I will not miss discharge summaries. AAAAAAARGH. These take SOOOOOOOOOOO long. While generally, discharging people is great b/c that means you don't have to round on them the next day, discharge summaries take forever. Especially when you try (trying to not violate work hours) to do them at home, on a laptop with a little rolly pad instead of a mouse, which makes cutting and pasting labs, radiology reports, etc. harder, and with a slow remote-access connection. One day I discharged four people within 2 hours and it was horrendous! This is an intern job which I will be GLAD to get rid of come next year.

I will not miss carrying my pager. While I finally got used to it going off constantly and stopped having baby seizures/panic attacks each time, I am so glad to be rid of that thing for a while :) It is so, so, so annyoing to constantly have to answer the phone while trying to get work done and seeing patients. I don't really like the phone that much anyway.

I will miss wearing scrubs every day. I don't know how I'm going to do with having to pick something (matching) to wear every day, it's been so long!

I will NOT miss getting up early. I am so looking forward to sleeping in tomorrow!

I leave for Colorado on Wednesday. I am soooooooooooooooooooooooooooooooo excited!!!!!!
I'm not sure what kind of mischief I will be up to these next few days, but it will NOT BE WORKING! :)

Trying to get out (not very successfully)

Sorry for not blogging, Wendi!
My excuse has to do with the fact that I'm working every day of the week but one. This has been my schedule the last few days:

Sunday, 9/9/07:

6:30 a.m. to 7:15 p.m. Work. More or less a normal day, for a resident, that is.

Monday, 9/10/07:
5:00 wake up
6:00 (I tried to get there earlier because I was feeling so behind on work other mornings recently b/c of the patient load) gather vitals, preround, and start hospital notes, go over pts with the senior resident
9:00 round with team
12:30 rush off to drive to UCD for clinic, drive around looking for parking
12:30-6: run around seeing patients, including one who showed up 45 minutes late and I was told had a "foot problem" (so I said "okay, squeeze her in"), but ended up, ontop of her mmp (multiple medical problems) including CHF (congestive heart failure), hypertension, arthritis, etc., being there not for a "foot problem" but generally for "just not feeling well," with headache, nausea, shortness of breath, abdominal pain, and the works. She's also seen in our clinic about every week and hospitalized about once a month. "You're not going to fix her," said Dr. B, who staffed her with me. That kind of threw my whole afternoon off and made me superlate for the other patients, which I hate, hate, hate. I don't think that I will agree to any more squeezing those pts in from now on. My clinic, which generally I enjoy because it's more laid back than hospital medicine, turned into a very stressful afternoon, dealing with (a) patient(s) that may very well belong in the hospital that I left earlier in the day (except that she was female :)).
6:00 - 11 p.m.: Work on electronic clinic notes from my patients, respond to messages in my clinic inbox (I hate, hate, hate this), get signout from the senior about what happened in the hospital in my absence, do VA discharge summaries from home. I don't know which is more depressing-- staying at work late, or doing work like this from home.
11:30- 4 a.m: (a glorious 4.5 hours of) Sleep

Tuesday, 9/11/07:
5 a.m. I'm back at the VA hospital, finishing electronic d/c summaries at work and reading up to pick up a patient who was admitted the day before while I was at clinic, but then became "mine" to follow
6:00 a.m.- 7:00 p.m.: spent prerounding, ordering, rounding, writing consults, following up tests, admitting.
7:00- 8:30 p.m.: doing discharge summaries from that day at work
9:00- 9:45 p.m.: reading my friends' blogs, personal, and ucdavis e-mails
9:50- 9 a.m. Sleeping.

Why was I able to sleep in until 9 a.m. today? It was hard to even make myself get out of bed at that time! It's because I have my day off today! I actually was supposed to have Friday off, and give a noon case presentation today, but I realized that I couldn't make it through the week without a break, and I worked it out with the other interns to switch presentation days so that I could have a "mental health" day to stave off a meltdown from the pace. And knowing that I would have just one day to sleep in made all the difference yesterday and was the only thing getting me through the afternoon. I truly get giddy with the thought of a day off. My fourth day off in four weeks. Now I just have to make it through Thursday, Friday, Saturday, and Sunday of work before VACATION starts. I have never looked forward to anything, I think, as much as I am looking forward to this vacation for the sole reason that I need a break.

Yesterday, I was asked two very interesting, and telling questions.

One was from Danny, the GI fellow, when I said I was there every day, all day: "How's that for your personal life??:

Me: "Do you really want me to answer that?"

And from one of the nurses around 8 p.m. last night, when I ran to get some graham crackers for sustenance as a break from working on my notes:

"Oh, Dr. Arness. You're back, huh?"

Me: "Um. Not really. I just haven't actually left to go home yet."

My question is-- how does this work with the whole work-hours thing? With the day and night float system in place, you really not supposed to stay past 7 p.m. or come in before 7 a.m. But honestly, there is no way to round on everyone and get the work done in those hours. I've been told that work from home does not count towards work hours-- so that, even though I spent like 6 hours after normal "clinic" hours doing stuff on Monday, I should not log it. Even though I came in at 5 a.m. and didn't leave until 8:30 because I was doing hospital work-- notes and d/c summaries, it apparently doesn't "count" for the work-hours thing b/c I could have done it at home. This seems a bit screwy to me, because what does the "on the job" work hours limitations do for you and your quality of life if you're working more, but just from home? Anyone? Sometimes I wonder if going back to a overnight call system would be better. It's kind of demoralizing to leave work or stop working really late and then just know that you have to do the commute, and come back in at the crack of dawn the next day... to start over. All I know is that the work is exhausting and I feel like I have no time.

Okay, so there's my venting. Onto other things.

I know I'm slacking big-time on the pictures, but here is one from my one social outing from the last week, which was "Second Saturday," a monthly event held year-round in Sac, where galleries and shops in midtown open their doors for people to walk in and view the art and other things, people set up music and food stands all around the midtown area, and everything is very lively. Kate, Amy, Amy's friend Katherine, and I all checked it out this past weekend, which was very cool! I love seeing so many (young) people out and about! This might have to be a monthly thing. There are also things going, like concerts, on for "fourth Sunday" and "third Thursday," but I can not keep those straight! I'll depend on others to suggest going out to those things:)

Here's a pic from a long-ago Thai dinner. Jeremy is putting together a Picasa site where we can all dump our collective pictures, which I just checked out and from which I stole this pic and those that follow. Here is Adeel and me. I have no idea why the pic is so small.



And, as lame as this is, here I will share some pics from Apple Picking last Saturday, which I hoped to be able to go to (by getting out early on our "good," non-admitting day at the VA), but which didn't happen. Jeremy, Noelle, Anika, Oliver (who are now engaged!), and Kristen all had a fun time! They ate all kinds of apple goodies, including apple beer, caramel apples, and more... I had to live vicariously through their pictures (and, lamely, post them on my blog). Some people do get out once in a while! I'm so jealous!

I hear the caramel apples were amazing!! I think Noelle needs a few more to fatten her up a bit.

Now the debate is.... whether to do something (including getting a jump on my presentation or d/c summaries for people that may leave the hospital today [that I was following, even though I'm off!] or tomorrow), running (need to go for a long one), or sleeping.... I try to get out sometimes, really!

What color are you?

So I'd be surprised if these types of quizzes haven't shown up yet on Wendi's or some other blog-savvy person's blog, but with all the free time that graces the life of an intern on a medicine service, what do you think I have been doing? I've been taking color quizzes online!! :)

The color-quiz activity was something that the OB residents did during orientation and which I missed b/c I was at some other activity. However, I periodically do get asked by the attendings and other residents (as we're trying to get to know one another and our "styles"), "What color are you?" So I decided to do some research... at the most reputable of research sites, otherwise known as google.com. I'm not sure which one of these quizzes actually correlates best with the OB activity (I think those color categories were red/green/yellow/blue)--but here are a few I tried. I am almost universally a BLUE!! What color are you??!!!

From The Color Code, whose description I feel is, eerily and honestly, right-on:

BLUES are motivated by INTIMACY. They seek to genuinely connect with others, and need to be understood and appreciated. Everything they do is quality-based. They are loyal friends, employers, and employees. Whatever or whomever they commit to is their sole (and soul) focus. They love to serve and give themselves freely in order to nurture others' lives. BLUES have distinct preferences and have the most controlling personality (yikes!!!). Their personal code of ethics is remarkably strong and they expect others to live honest, committed lives as well. They enjoy meaningful moments in conversation as well as paying close attention to special life events (e.g. birthdays and anniversaries).

BLUES are dependable, thoughtful, and analytical; but can also be self-righteous, worry-prone (who, me?!), and moody (what?! I don't wildly vacillate between joy and sadness!). They are "sainted pit-bulls" (I don't even LIKE pit bulls) who never let go of something or someone, once they are committed (what?! who honestly thinks I have a hard time letting go?! ;)). When you deal with a BLUE, be sincere and make a genuine effort to understand and appreciate them.

Another:
"The Color Personality" quiz on gURL.com
My personality is... blue You're a cool and collected blue... According to color psychology, you're the very picture of serenity. You're probably great at keeping calm and clear-headed when others are freaking out... (umm... not so sure about this-- I'm anything BUT calm at work these days and freak out quite often, actually).

Spacefem
you are paleturquoise
Your dominant hues are green and blue. You're smart and you know it (hah! Residency makes anyone feel like a complete idiot most of the time), and want to use your power to help people and relate to others. Even though you tend to battle with yourself, you solve other people's conflicts well. Your saturation level is low - You stay out of stressful situations and advise others to do the same (I really don't do well with stress). You may not be the go-to person when something really needs done, but you know never to blow things out of proportion (oh yeah, I never exaggerate). Your outlook on life is bright (I wish. I've become really cynical and pessimistic). You see good things in situations where others may not be able to, and it frustrates you to see them get down on everything.

Quizfarm
You scored as Blue, Sharing its hue with the endless skies above and the mysterious depths of the ocean, it s no wonder why the color blue has been used to represent wisdom. Knowledge is important to those with the blue personality. They enjoy pursuing an understand of all that is around them. But with understanding comes sadness, which may hover around the blue personality (uh oh).

I guess I'm a Smurf from now on!!

WHAT COLOR ARE YOU??

Learning new things every day

While on the medicine VA service, not only am I learning fascinating tidbits all the while such as how to: accurately read PPDs (I discharged someone today with hemoptysis [coughing up blood] and a 18mm reaction, going home on quadruple anti-TB therapy), dose all kinds of drugs and replacement electrolytes, accounting for renal failure and the like, achieve optimal rate control for people's afib, as well as order things the correct way (the most important learning point of all!), but I gleaned a new word from my perusing of Time magazine earlier this evening:

"\smext-ing\v. The act of sending text messages during a cigarette break outdoors."

I kid you not. This is in Time magazine, and the "context" is the following:

"Banished from pubs and offices, bored smokers find themselves filling the minutes by tapping out wireless messages. Experts have dubbed the new activity "smexting." The practice is so popular that British cell-phone company Orange reported a surge of 7.5 million messages sent during the first two weeks of July, just after smoking was banned from indoor public places in England.

The emergence of smexting--as both a new word and a practice-- is more evidence of the growing ostracism of nicotine addicts. Some English smextrers say they have turned to texting since the ban as a way of seeking the support of friends in an effort to quite smoking. It's more fun than the patch."

Bizarro. Even though I'm all for communication while being ostracised (during breaks from the work hours that are residency).

It's true....

Yesterday (precisely the 1st of September), I was dog-sitting Lefty again, as Kyla and Ben went to a wedding in Palo Alto and Kate's still out of town. What did I (generally a fairly responsible person) realize, while chillin' out with the pooch? That I hadn't paid my rent for the month! Yikes!!!!! I quickly checked my bank account to make sure I had enough to write a quick check (glad that UC Davis payday had come precisely at the same time:)) and, since I figured that Lefty (and I too!) could do with some additional exercise, decided to just walk the mile and a half or so to my place with the intent to just pop in, write a quick check, drop it in my landlord's mailbox, and head back to Kate's. This did not work out quite as planned.

When I arrived at the "outer" door to my four-plex building, I inserted the key, opened the door, tried to remove the key...... and couldn't. This was very puzzling to me, until I realized that I had inserted the WRONG key into my outside door lock-- the one to the hospital bike cage where, when I have to go to work there (rather than at the VA where I am currently), I lock my seat-leash-sporting-bike. The wrong key opened the door just fine (weird...). But then it jammed.

Who would have thought this was possible?! I spent about 10 minutes of frustration trying to jiggle it out of the lock before I admitted defeat and, sheepishly, decided to call Paul (landlord) to come bail me out. If only I hadn't tried to pay my rent without delay (he's very nice, though, and probably wouldn't have even cared if it was a bit late). Anyway, he came with some pliers, as well as some tartness...

"Aren't you a doctor or something?!" he said with a grin. "How'd you manage to do this?!"

Me (in my head): "Umm... I guess it's because there are no not-inserting-and-jamming-wrong-keys-in-doors tests you have to pass before graduating medical school."

Me (aloud). "I'm just not sure. I just, hurriedly, shoved the wrong key in" (in my current trend of doing everything very hastily).

Paul: "How badly do you need this (wrong) key?" he asked.

Me: "Well--I think I could get another one without a problem" (although this would have meant that, until I made it over to transportation services or wherever, I'd have to risk parking my seat-leash-sporting bike out in the open rather than in the uber-safe bike cage).

Fortunately, with just a quick yank with the pliers, he got the key out (without damage- cool!).

"Why don't you put that one on a different key chain from now on?" he suggested.

"Good plan," I responded (as Lefty and I made our embarrassed exit back to Kate's house). Yeah, I'm a doctor.

Anyways, there was that, and there are other things possible that I didn't think were so:

• It is possible for me, even when sleep-deprived, to stay awake at an evening movie! Amy and I went to see Becoming Jane the other night (good flick!), and I made it through without nodding off even once!
• It is possible to make it through two weeks of a rotation without breaking down. Yes, folks. I am halfway through my first Medicine month and I haven't cried even ONCE!
• It is possible for Tia to have a bad attitude! I finally got a chance to catch up with her today, and she's even having a tough time staying positive during residency in Boston. It sounds rough-- she seems to be working even longer hours than I am, and also dreads going in, dreads taking call, thinks every day about how glorious life would be to not be a resident any more, etc. I can't picture Tia down or bitter or miserable. Shows what residency can do to a (extremely positive) person (which makes the rest of us doomed!).
• It is possible for my reading of choice to be reduced to two types of materials: People magazine (I am now obsessed with the Jolie-Pitt clan!) and the blue Pocket Medicine book that every intern and medicine resident carries around. I can't even remember the last book I read, it was so long ago :(

Yes, anything is possible...