Happy Thanksgiving! (and blog recycling)

Well, it's the middle o' the night and it appears that the parents of the wheezy and vomity kids and other peds ED frequenters have decided that they should keep them at home until the turkey is done rather than let an intern mess with their children (among other fun things including discovering "trepanation" of a bloody nail, I traumatically did a spinal tap on a little 2 year old earlier in the evening... in any case, I digress...).

I don't have too much to write and, at this hour (I really don't sleep very well in the day time), don't have the mental reserve to be very original or eloquent about all that I am thankful for. However, I will say that I do have very much to be thankful for.

I am thankful first of all for Wendi's wonderful news-- that the baby they will be taking home in MAY (!!!!!!) is a little growing boy in Bri's belly. This was such cool news to find out on my birthday! And I wanted to thank everyone for the bday wishes and lovely cards/assorted packages that graced my mailbox this past week :) It made me feel like being one year older isn't all that terrible, even though I haven't accomplished very much since the last birthday and am getting close to deciding to get a bunch of cats. I'm thankful that, later today, I will be reunited with my family, and with my awesome friend Lesley, who is planning to drive up to MSP from Roch to hang out with me in the airport during my layover!!!!

And so here I recycle my favorite quotes from M.J. Ryan's book Attitudes of Gratitude, on which I posted back in July of this year:

It seems to me that we often, almost sulkily, reject the good that God offers us because, at the moment, we expected some other good. -C.S. Lewis

If you haven't got all the things you want, be grateful for the things you don't have that you don't want. -Anonymous

Forgiveness leads to gratitude, and not just gratitude in general but, in a beautifully healing movement, to an outpouring of appreciation for the very things that caused such pain in the first place. Thus is our suffering redeemed.

If you look to others for fulfillment, you will never truly be fulfilled.
If your happiness depends on money, you will never be happy with yourself.
Be content with what you have; rejoice in the way things are.
When you realize there is nothing lacking, the whole world belongs to you.
- Lao Tzu

We who lived in concentration camps can remember the men who walked through the huts comforting others, giving away their last piece of bread. They may have been few in number, but they offer sufficient proof that everything can be taken from a man but one thing: the last of the human freedoms--to choose one's attitude in any given set of circumstances...
-Victor Frankl

If there is to be any peace at all, it will be through being, not having. -Henry Miller

Joy is prayer.
Joy is strength.
Joy is love.
Joy is a net of love by which you can catch souls.
She gives most who gives with joy.
-Mother Teresa

The more light you allow within you, the brighter the world you live in will be. -Shakti Gawain

Gratitude unlocks the fullness of life.
It turns what we have into enough, and more.
It turns denial into acceptance, chaos into order, confusion to clarity...
Gratitude makes sense of our past, brings peace for today, and creates a vision for tomorrow. - Melody Beattie

As you wander on through life, sister/brother, whatever be your goal, keep your eye upon the donut, and not upon the hole.
-Sign in the Mayflower Coffee Shop, Chicago

HAPPY THANKSGIVING!!!

Rocks etc

Fun weekend!

• Joined some FP residents for breakfast (I LOVE BREAKFAST) at the famous/popular Tower Cafe (assoc. with the old Tower Theater) on Saturday... pancakes were amazing!
• Worked a teeny bit Saturday at the Peds Urgent Care, where I caught one of the many viral URIs I have diagnosed in the past week. This is a bummer-- it's been a LONG time since I've been sick.
• Fell asleep watching Must Love Dogs with Kate and Amy (some things never change...), but I finished it yesterday-- pretty cute movie. As I love dogs.
• ROCK CLIMBED on Sunday. It was Amy's idea to do something as a group not involving food, so to Sacramento Pipeworks we went!

I'd only been rock climbing one time, back in college, and never learned how to belay and all that, but we all took a little class and then had fun both climbing and belaying for eachother! I am kind of wimp and had a hard time on the ones (i.e. above a 5.7) with little rocks, but it was fun! Enjoy the pics!

Starting out... Brenden looking up while Adeel looks on.

Sean, our instructor, point things out to us

With Brenden (who I did not drop!)
With Amy (who kicked my butt big time but who did a great job belaying me while I fell off walls)...like hereThere was some good climbing, though...It's a race! (Amy and Jeremy)
Amy in action

I can belay, too! Noelle (aka superfast Spiderwoman climber) and JeremyNoelle teaching Fizzah the art of knot-tying Fizzah goes up!

Here we're on at the same time

• Then, to finish a lovely Sunday, was an FP/OB dinner for the Nov. bdays.... here with Sarah

We had awesome deep dish and thin crust pizza at Chicago Fire downtown... mmm. Don't even have to brave the midwest cold for that cheesy goodness :)

(Aline, Suzanne, Sarah, me, and Kyla)

Kyla thinks I need to have people sign release forms because they end up on my blog. See if she reads this, though :) Maybe at a later date.

As for this week... I work in the peds ED tonight, Tuesday, and Wednesday nights, and then I head to MN for Thanksgiving!!! Woo-hoo (if only I could find my coat)....

Fun factoid: this blog has been going exactly one year and one day (started 11/18/06). Wonder how long it will keep going :)

Aww

These are from Erin, and the most G-rated pictures I have ever seen passed on from her aunt. How cute are these?!

Now, time for my coffee (sans chihuahua) :)

For real?

Some random thoughts....

This schedule

I still can't get over the fact that I have real time now. I'm on a peds ED month, where we split time between the acute care (AC) center (kind of like "same-day access" for sick kiddos) and the ED. I spent Monday from about 11 -3:30 at AC. I had today off! And tomorrow and Thursday I only have to work 1-7-ish. I do have Friday all-day FP clinic and Saturday AC hours (again, 11-3), but I feel like I'm on vacation!!! I almost don't know what to do with myself! :)

Cool invention

In Time, I was reading (I have time to read!!) about the glo Pillow, which is embedded with a grid of LEDS and gradually glows to wake you up in a "natural" way and go along with your circadian rhythm! You have to check this out. I'm not sure how useful it is when one is waking up at 4 a.m., but hey. For normal people, this might be a cool gadget to have!

Help is on the way!

This evening, I went to an OB applicant dinner at Brew it Up, a local brew pup/restaurant I've been meaning to try. Not only was the food (on the OB dept., mind you, a.k.a. free) great (I still, unfortunately don't like beer-- tried some this weekend at Hoppy's, another place where some of us got together Sunday to talk about our upcoming rotations/watch football), but this gave me hope... Does the fact that applicants are here interviewing mean that intern year is almost over?!? :) I think so. Or at least we're getting there :) Anyway, it was a good time-- some nice people are interested in coming here, and it was good to hang out with some of my OB classmates.

I wish I were this talented

My cousin Amy sent me the links to these YouTube videos. I don't know how to paste the actual videos here, but check these out:

http://www.youtube.com/watch?v=kTSFhIv9bYg

http://www.youtube.com/watch?v=iDoKF1NZ8P8 (this one is particularly awesome!)

The little things in life

I found some amazing coffee creamer this weekend, when I went to the store for the first time in ages... It's peppermint mocha-flavored, and I love it! I can make little Starbucks drinks in my home :)

It's a miracle I get around

I am officially the klutziest person around. Honestly, I don't know how they let me be a doctor or get near a baby. I just spent the last half hour trying to get white-out (anyone remember this stuff?) off my desk. I used a smidgeon briefly on my pocket medicine book and kept doing USMLE ?s. Then, smelling a paint-like odor, I looked over and the little bottle was on its side in a pool of white-out! I also now have it all over my hands. I have been scrubbing frantically with isopropyl alcohol and nail-polish remover, which are helping somewhat. But I still have white-out hands. Aargh. Luckily, there exist online sites for help in white-out removal. Sigh.

Enough randomness for one night. For real.

Who would have thought...

I am done with my second month on L and D (half of this year's OB rotations completed!)! Truthfully, I am a bit sad! Whereas I was so relieved to have my first month end, exhausted from the 14-hour days and covering the gyn-onc service at night, sick of being stressed out all the time at not being able to do things fast enough, this time around, it was quite fun (who would have thought that possible?!!)

Thursday was a great last night on the service, a night like all should be. While it was crazy from the gyn-onc standpoint-- I think my pager filled up nearly twice with pages-- we had a smashing night of deliveries and more real than non-real triage complaints (triage gets really tedious unless you are actually admitting people in labor)! Around 1:50 a.m., four women came in at the same time in labor and we admitted them all in rapid fashion... then three delivered within a half hour (I only made one delivery [having just time to get on gloves to guide the baby out onto the bed-- no time to break it down!], but Brenden was in the other and the third got vacuumed by the chief). I admitted another whose baby I caught around 6 a.m., and then got one last finale delivery right at board signout-- it really is a rush!

Who would have thought... that nights, which drove me insane the first time around, are actually nicer to be on than days (I think). There are fewer people around (meaning less competition for deliveries.... he he), more deliveries definitely happen at night (I was quite bummed for a couple of weeks with not very much volume but made up for it this last week or so-- esp. that last night!), and then you don't have to come in ridiculously early to round or dictate the discharge summaries, as you're already there. When we'd have a slow hour or so and it was after midnight, I would try to scope out the rooms where I heard babies crying to get rounding on the postpartum moms out of the way :) And, until daylight savings happened, it was light both when I went into work, and when I left. I decided that I think I like working nights on L and D (better than days) :). If only I could get rid of the gyn onc pager, it would be heaven.

Who would have thought... that time goes by so quickly?! I've lived in Sac for almost 5 months now! And I still love it! There is always fun stuff to do here :) Last weekend, I was able to join some classmates for some dancing at this club called the Sandbar (who would have thought that I, less-than-fond of dancing in general would make it to a bonafide nightclub? :)). Saturday, Amy and I went to see a bluegrass group, CherryHolmes, perform at the Mondavi Performing Arts Center in Davis, which is beautiful (the concert was great, too!). And before I had to go back into work last Sunday night, we watched some quality football at Phi's.

Today, I joined Blanca (pioneer of the FP/OB program here) and her mom, Rosa, at this wreathmaking class out at Full Belly Farm, an organic farm place out about an hour from here. While I admit that I do like scrapbooking, I am NOT a crafty kind of person by any stretch of the imagination; however, this ended up being a really fun activity! The farm grows and dries all of these flowers (among many other things) and makes these beautiful wreaths to sell (see below). They also teach others how to make such wreaths!

They had all kinds of flowers, all of whose names I can't remember (sorry, JB), but which included marigolds, poppies, and others, as well as little dried chilis, cotton buds, and herbs to weave into these wire frames. It was pretty cool, but definitely took a good amount of concentration and persistence! I started to lose steam/patience at the end and thought that my wreath looked a little off-balance (full in some parts but sparse in others) and did some trimming/glue touch ups at the end, but I think it turned out well (now I just have to find a place to hang it)! (Who would have thought..)

Here's Blanca with her perfect-looking wreath in progress

Us three with our finished products

Who would have thought... that one could actually have a life in residency?! On Monday (I had today and tomorrow off!!!!), I switch to Peds ER, which looks like it's going to be CAKE, hours wise. Some days you only have to work a four-hour shift (the longest is 12 hours) and it's certainly NOT 6 or 7 days per week!! I don't know what I'm going to do with myself with an extra up-to-10-hours per day! Wow! Life is good!!!!!!

Some sunshine

"Write it on your heart that each day is the best day of the year." - Emerson

"Optimism is the faith that leads to achievement. Nothing can be done without hope and confidence." - H. Keller

"Turn your face to the sun and the shadows fall behind you." - Maori proverb

"Joy is not in things; it is within us." - R. Wagner

"Learn from yesterday, live for today, hope for tomorrow." - A. Einstein

"The pessimist sees difficulty in every opportunity. The optimist sees the opportunity in every difficulty." - W. Churchhill

So life has been going very well lately! Except for a pretty good-sized meltdown last night, when I was given pretty poor signout from the gyn onc team and got totally overwhelmed in the hours I was there (but luckily had Kyla around, on night float, to bail me out!), I have been doing much better, stress- and mood-wise, on L and D. I really have become much more comfortable with everything-- triage, the constant pages, the orders, and then my second year and chief last week got me more experience putting in IUPCs (intra-uterine pressure catheters) and FSEs (fetal scalp electrodes). I found myself really enjoying my time with the nurses, residents, and staff on labor and delivery and wondering, "why, again, did I not do straight OB?" (a good sign, I think!). I also finally got some deliveries! Nights have overall had more than days, and having some 24-hour calls on alone also helps :) There were lots of amusing situations last week, too.

One: a "BOA" (birth on arrival) in triage, which I missed, because I tend to avoid triage unless I'm called there. A woman came in and said that "no one believed" that she was in labor but that she just felt like she had to push! Before they could even call me, the intern, to triage, the baby just started crowning! Mike, the chief, just happened to be walking by and threw on some gloves to grab the baby and deliver the placenta... they even have a "BOA" tray in the triage drawer for such occurrences! I walked by and heard a baby crying and was like, "WHAT is going on here?!" Babies aren't usually born in triage. I was cracking up because Brenden started filling out the "admission" paperwork (which is generally done when people are being admitted FOR labor, not after the fact) and under "chief complaint," he wrote, "I GOTTA PUSH!!!" :) I just love the idea of being able to just jump in and catch a baby anywhere... Exciting stuff.

Another amusing conversation, with a very whiny/bratty and high-maintenance patient who was being induced for postdates, went something like this:

Mike, instructing me as I placed the IUPC catheter: "Now once you have the sheath past the cervix around the baby's head, just thread the catheter through gently up to the fundus until you see a bit of fluid come out."

The patient: "Is she some kind of a trainee or something?! I don't want any trainees in here!" (Despite my having placed her miso[prostol; cervical ripening agent] and done her cervical checks until that point!)

Nadine, the nurse: "She's a physician, honey. All these physicians are part of the team taking care of you."

The patient: "Are you sure???!"

Nadine: "Yes, I'm sure." (Me, to myself, "Did I not go through medical school?! I know I doubt my own confidence at times, so it's not real helpful for patients to be doing the same! ) In any case, the IUPC went in successfully.

Then, when she was complete(ly dilated) and pushing, "Is a trainee going to be delivering my baby? I don't want a trainee!"

Mike (chief): "Then you can't have me. We all work together here."

The delivery, too, went fine, without complications. I don't think, in the end, she minded that "the intern" did the delivery. I refrained from joking with her by saying something along the lines of, "This is the first baby I've ever delivered!"

But now, when the nurses ask for orders on various patients back in the birthing rooms, I joke that I'm not sure I can do that because i'm "just a trainee." :)

Other good news:

I spoke to my grandmother earlier this week and she mentioned that Duane and Marilyn might be having a big Thanksgiving celebration Friday instead of Thursday, just so that I could be there (I arrive late Thursday night). How sweet is that?!

I heard back from the YMCA that my poor resident status qualified me for a waiver of the joining fee and a reduced monthly membership. Woo-hoo! So I have joined the YMCA for $100/3 months and hope to get back in fitting-into-my-clothes shape :)

I am going to have a visitor (very exciting news-- I don't have enough to make a whole running blog post about this!)-- Molly is interviewing out here for general surgery residency on December 7th, which is only about a short month away. I am sooooooooooooooooo excited to have a friend here to share Cali with!

We had a FP inservice exam this afternoon (it's been ages since I've taken a test!) but I'm OFF till Sunday night (the beauty of having front-loaded weekend call is that I have this [plus an extra daylight savings hour!] and next weekend off! And then I go onto peds ER, which is a much less busy month!). I don't really want to sleep it away by trying to stay on a nights schedule, but we'll see how I do. I'm going to try to find some fun things to do :)

Halloween pets

I hope Scrubs wasn't subjected to any of this :)
Some pics someone forwarded to me last year, pre-blog, which I thought I'd share.

I wonder what wacky things can happen Halloween night on L and D.... into work I head...

HAPPY HALLOWEEN!!!