Beautiful things

To close out this day, I had the unfortunate pleasure of having one of those conversations where I could not say anything right with a acquainta-friend. It was essentially... one unfortunate comment after the other, followed by did-i-really-just-say-that questions. I can only look back at that conversation and laugh and cringe at the same time. It's one of those conversations that make me think I should never try to talk to anyone ever again because holy crap, I am so awkward I might even be on the Asperger scale or something and gracious it'd be better if I just shut my mouth and not interacted with anybody.

REGARDLESS, to mitigate thinking too much, went for a run (and it was a good run, yes).

But when coming back home, it was the crisp air on my warm cheeks, night time where the street lights glow over the asphalt, and I am so acutely aware of the movements of my limbs as I walk after running for so long. I closed my eyes and was reminded of the midnight walks on the Inner Loop where it just felt like the world was empty and so large, so vast, and the quietness was inherent in the bones. And I look up and there is the night sky. It is beautiful. You might have no idea how beautiful it is tonight. But the little winks of light just hang in the dark gray sky and it is so bright. It's just breathtaking. I couldn't help myself but lie down on one of those recliners besides the pool and look up and up at the sky. The sound of lapping waves at the pool, the wind brushing the leaves, the lights ghosting the underside of each leaf, and how lovely the darkness of the sky, studded with stars - just sprinkled across the sky as if someone had scattered them by the fistful and they just landed there. The coldness at my cheeks, shiver, numbness at my bare legs, my hands tucked into my jacket, and as I stare at the endless blanket of night sky, there is Gungor whispering into my ear, You make beautiful things.

And if you strip away words and indecision and arguments about theology and apologetics and social issues and inconsistencies...
You make beautiful things.

Isn't that truth?

Surgery and Crap

Fourth art line. Second try, with a few hiccups.

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Told the anesthesiologist that I was thinking about general surgery and he gave a whole spiel about how it's really hard to be a female surgeon. He goes on and talks about a lot of surgeons's wives who are also physicians - and invariably they are internal medicine, family, peds, etc etc (i.e. not surgery). And then also a female surgeon who loved her job, fell in love, married another surgeon, and now she's a mom now. Not practicing. And the husband dude is still a surgeon. And then he says, all that training down that drain - to be a mom.

And then he says, "You know [insert other senior partner, who is a female surgeon]? She has dogs. No kids. You'd like to think you can have it all, [family and career], but..." he shrugs. "Make your choice on what you can live with."

How utterly annoying.

I get really annoyed because there's no way he'd say any of that to a male student. And it freaking pisses me off because it's not like he has had to struggle with any of that. And it seriously makes me angry because it's basically saying, what - because you have two X chromosomes and can carry a baby, you probably shouldn't go into these specific specialties - unless you just want to have dogs and no family. And it's so frustrating because it's not like he is actively trying to be rude; he was honestly trying to give advice as he sees it. But that's what his words boil down to, right?

I hear it. I do. And my response is a bit of a screw you, thanks. Because at the heart of it, maybe it's naive and crap, but that I really think I can have it all. But realistically, I know something would probably have to give. There is only so much time and energy.

It is not often that I think this, but times like these I can't help but think that it would be so much easier to be a guy.

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Stuff

Got to help amputate a knee. Very cool. Lot easier than expected. And attending let me dos lot more than I expected. Cut most of the muscle and the bone (power saw!). And the muscle flap was much easily created than expected. The wonders of modern medicine. 

Also an extremely sad case because the lady thought prayer would heal her foot, to the point where she didn't come in and get it treated u till it became gangrenous. Just ugh. 

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Third art line! This time done with the patient awake. Got on the second try :) 

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Make me think. 

Trauma call

Third trauma shift. Much busier than the other two.
There were a lot of "firsts".

First time..
seeing a CPR code.
seeing a doctor call time of death
doing an ABG
washing a degloved hand (4th and 5th finger crushed. i could feel the bits of bone)
hearing first-hand inter-department drama (in which ortho and surgery gets mad each other and the chiefs call each other out and voices are raised in the workroom)
cleaning someone's wound while their parents are watching (omg no. never again please)
suturing someone's face
suturing someone's face when they're awake
(thank goodness for Ativan and local anesthetic) 
- 8 simple interrupted stitches with 5-0 vycril; instrument tie.

second time getting an arterial line.

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I have so much respect for specific med students who actively try to help each other out and split up tasks evenly. Trauma shift is kinda weird in that there are students who have trauma as their surgery rotation. But the other students (like me!) just have trauma call - so I'm put into gen surg and only have a shift in trauma about once a week. So I can see how the trauma call students can be seen as intruding on the trauma rotation students' space. But man, there is just such a difference in attitudes that I've seen.

There's a super cool dude who was incredibly generous the entire night: gave up his OR time because someone hadn't seen anything but urology stuff (this boggles the mind a bit because cool dude also rarely gets to go into the OR); offered minor procedural tasks to other students; incredibly helpful without being condescending. So much respect.

And then contrasting... quite a bit of disdain for the one(s) who always end up hogging procedures and/or trying to push "boring" tasks on other people. Maybe I just value fairness too much.

Practice

I put in an arterial line by myself today!!!!!!!!  I put in a central line too!!! YES. Today is such a win. 

And I got to more in a laparoscopy than usual because I was with a fellow. Put in a trochar, cut the cystic duct, insert the contrast, close. 

And I got to see some IR today too! Which was way cool. 

Got to close a for a hernia, and did it rather well, if I do say so myself. 

I still suck at interrupted subcuticuar stitches. (Even though I'm moderately okay at running subcuticuar). Need more practice. 

Win of the day.

I ran for 50 minutes without stopping today. 

Because I could. And can. So I did. 

This is mind boggling to me. 

It really is mind over matter. 

And it really is a matter of working up to it. 

My goal is inversions though. 

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I always said that I wasn't a marathon runner, but a sprinter. But truth be told, I was more like a lazy walker that occasionally moved a bit faster to pretend like I was a sprinter. I'm still not a marathon runner. But I kinda see how it works now. At a certain point, your muscles just realize, well that's just how it's gonna be, and they keep on going. And I think I could literally close my eyes and my arms and legs will keep on moving. 

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Anyways. 

I'm tired. And I need to study. 

Food. Then shower. Then books. Then bed. 

Maybe I'll sneak in a cookie or two as well. 

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ALSO. Today I got freaking QUIZZED on what movies I've seen in my childhood (like... None at all because I'm a book girl, not a movie girl, and my dad always hogged the tv for basketball so I never watched tv shows and I don't like watching movies by myself and fine I guess I might have had socially deprived childhood). But NO I did not see Clueless (or even know about that movie), or Dumb and Dumber, or Forest Gump, or Scary Movie, or [insert a million other movies and tv shows]. No I don't know those actors or actresses. No I didn't really watch The Price is Right or Jeopardy or know who the hosts are/were. NO, okay?? And asking me about other ones is not going to change that!!!

And their reactions were just pure disbelief.

They literally said this, verbatim. 

 "I'm surprised you're so normal"

"It's like she's never seen a tv."

WELL. Excuse me! 

Ask me a book question instead. 

(I know. I'm a nerd). 

I want to read a book for fun now. 

Un Lun Dun. 

Ring true

Do you think that things in life just happen?
Do you think that everything falls into your lap?

"Passive people have the life that happens to them.
Outspoken people have the life they build and fight for."

Only semi-true. Of course there are qualifiers and other extraneous factors that muddle the waters a bit. But there is some truth in there.

Be bold. Be bold. Be bold.

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At the essence of it, even though I am still figuring it all out, I know myself.
None of this changes the core of me.  

Tired

How much are you supposed to love your job? Job Career. Career Job. ??

Talking to a surgery attending... he talks about going above and beyond. Scrubbing into as many cases as possible and staying until way late into the night voluntarily. Picking up cases that aren't his. Being eager.

I am interested. But I don't know if I am eager. Is that enough?
I like everything I've seen so far. But to be a good doctor/surgeon/physician/health care worker, do you need to immerse yourself in it?

If my "official work time" is over, sometimes I just want to go home and lay on the couch and not scrub into another gallbladder. Or if I'm sitting in the control room watching intermittent radiographs of a AAA, bored as hell because I literally can't do anything... and it's already 6 pm and they're probably going to take another 2-3 hours... and they say you can leave if you want....(even though it's a case you probably won't see for a really long time, and it's the first one done in this hospital with this type of endograft, and you don't want to miss this! etc etc)
Do I still need to stay to impress them???

If I leave... Is that laziness or just common sense?

How much of this is supposed to consume your life?

Or am I just lazy/tired/a bad student?

ughhhhhh

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and the flip side argument.
I am here to learn. I am actually paying to learn.
Why wouldn't I want to take advantage of everything I see right now?
Shouldn't I be excited to go into all of these things?
Think of all the hoops a pre-med student would have to jump just to observe these things, much less first assist or close.
And wouldn't you rather learn your mistakes now than later?

ughhhhhhh

positivity

everything is a benefit, a plus, a bonus.
nothing is "expected".
nothing is taken for granted.

Ugh

An attending was talking about his imminent hunting trip this weekend so we got to talking about guns and such. Told him I shot at a range once, but couldn't tell him what gun or what bullets. 

He goes, typical girl. 

... Very irritating. 

Food for thought.

"If all your prayers were answered, would it change the world or just yours?"

BREAKDOWN

1. EVERYONE HAS PROBLEMS.
- nobody knows the behind the scenes of another person's life. struggles are inevitable. people have different problems.
- your difficulties are not necessarily easier not more difficult than anyone else's.
- their difficulties do not invalidate yours. If their happiness does not invalidate your happiness, why should their difficulties? Struggles are not a competition. 

2. EXPECTATIONS
- work hard, expect little.
- plan for the worst, hope for the best.
- realize that my own expectations for myself are practically delusional. be hopeful, but realistic. 
- don't be too hard on yourself when things don't go to plan.

3. BE INTERESTED
- to be interesting, one must first be interested [currently, i am realizing how boring i am. clearly i must rectify this.]
- i need to lose my self-consciousness, my fear of the unknown, my desire to not look stupid, my inability to go try new things by myself.
- be bold.

4. DELAYED GRATIFICATION
- two cookies if you wait 15 minutes
- I CAN DO THIS.

The mantra to repeat:
I CAN DO THIS.
THIS IS DOABLE.
EVERYTHING I AM DOING IS WORTH DOING.
THIS IS INTERESTING. I WANT TO PUT MY TIME HERE.
IT WILL BE WORTH IT.

have i convinced myself yet?

Surgery Notes

Quick jot down before studying:

- Got to scrub into a vascular surgery today (pop to LE fistula). Super intricate, (6-0 vycril!) And the attending was pretty darn amazing. I would want to be like him however many years from now. Slight sarcastic, but jokey, good humor, not mean, enjoys what he does, confident in his ability, willing to help out other attendings and medical students.

- when talking about applying, be absolutely certain. There's a 40% drop out rate in surgery, even with 80h limits. You will be "molded" .

- the worst decision is no decision. people die from indecision (i whole-heartedly agree).

- good clinical judgment is the most important thing. even for surgeons

- Know how you function under pressure.

Life of the Beloved

I decided to skip church today. Out of tiredness and laziness and also a touch of faithlessness. But I sighed and decided it is ridiculous to skip something that is meant to counteract those things. (Give you rest, call to action, deepen your faith, etcetera).

So I picked up Life of the Beloved by Henri Nouwen that was conveniently sitting on my bookshelf, given by a beloved friend a year or so ago.

And its very foundation states that we are beloved, we are chosen by God and that he will give you rest. All the moments where you think that you are not good enough, He is there to say you are my beloved.

I think that these are not my answers or my questions.

God, soften this hardened heart.