Not my day

Today is just not my day.

Woke up late.
(had to skip breakfast >.<)
Got stuck in traffic.
Kept choosing the "wrong" lanes to merge into to avoid the traffic. (you know what i mean).
Kept forgetting to ask about recent labs.
Mangled my spanish and felt like a fool.
More traffic.
Dropped half a cup of coffee all over my white coat and my white shirt. ughhhhh.
(thereby losing my cup of coffee too. noooooo.)

... surprise laundry I guess.

Because this is cute

From one of my case studies:

"About half of the weight gained during the first 4 months of life is in the form of fat, making the 4-month-old infant the fattest healthy human, with about 25-26% of weight as fat."

Isn't that adorable? haha

First Impressions

In the first few minutes of a clinic visit, I can already tell the tone of the family. When I'm smiling and rattling off the automatic phrase of yon old medical students ("hello! my name is __ and I am a third year medical student. I'll just be asking you a few questions to get a better understanding of-), I can already tell....

If the parents care about the kid

If the kid cares about his own disease

If the mother doesn't really want to talk to me and is secretly wondering where the real doctor is

If the dad doesn't give a damn

If the kid is sweet and raised well

If it's a happy and supportive environment...

Don't you think it's crazy? Surely someone shouldn't be able to see so much in so little time. Aren't there extenuating circumstances? That I don't know the struggles or the problems behind the scenes (oh, but don't I? from past notes and the list of psych meds?). 

I've always wondered if I could transcribe a person into words, if I could be written down in black and white and a thousand little letters. I imagined, if anything, it would be a leather-bound book of stories and dreams and half-sensed allegories of the depths of each person. (If anything, I am a romantic at heart. Unfortunately.) 

But, let me just say... a medical record is pretty darn telling if the kid has been sick a lot. Social history, family history, notes about how the mother has taken away privileges, birthdays, school notes. It might not all be there, but I can almost see how some medical students have made the mistake of thinking they knew the patient before they even laid eyes on the very person. 

But oh, how much I think I know the patient!

---

And then the perspective flip.

How much can the patient know of the physician? The few minutes where I think I already know so much about the patient... does the patient think the same? 

If the physician is warm and inviting

If she is impersonal and cold

If he is smart and knowledgeable and concerned

If she cares about the patient at all?

---

Is it all just first impressions? 

thinking too much

maybe i'm dwelling on past conversations too much, but i feel like i just keep saying the wrong things. or having the wrong tone in what I say.

How I imagine some of my words to come out never seems to come out quite like so.

And then I replay it over and over, thinking oh if i didn't say that, or if i said it differently.

ugh it's only an inside-my-own-head thing. nobody comments on it, but i can just feel it going out wrong, or vaguely offending people.

Well

the problem with reading through an author's bibliography is that you generally start with their most well-known work. It may not be the best of theirs to offer, but it will be one of the best. So you read on and discover the book that you think is their best, and other couple of gems. And then you read some crap books which still has hints of the stuff you loved from their best book - but it really is not a good book. And then you can't do anything but shake your head because you really do like this author, but not this book.

It's like going in descending order, or eating your favorite bite first and trying to ignore the yuckiest stuff.

But going the other way is impossible. Because if you don't like the first book, why bother picking up another one?

Well, i guess it's all moot anyway because I don't really have the time to read anyway.

Quick Recap

This is not a real post.

1. Pedi Heme/Onc.

Not a bad first week. Pleasantly surprised that I probably have enough business-esque clothes (esp after I went out and bought a couple more pants). Unfortunately my shoes are not good enough to cut it, especially standing so much. My back and feet hurt already. Probably going to invest in some danskos or something. They're just so ugly though -___-"

Peds is not as bad as I thought. Yeah, there are screaming kids sometimes, but what can you do. But heme/onc is so sad :( we get all the cancer kids. ughhh and some of them are soooo cute. And then after chemo, they just curl up in a ball and don't want to move. And they're nauseous and can't eat anything. Ugh so sad.

Another thing about rotations is that it's so freaking early. be there by 6:30. Wake up at 5:40. ..... that means I can't sleep at midnight anymore. But i'm not tired at 10 pm.... the struggles lol.
AND even though we get there so early to round and stuff, we still have to wake up the patients. *shakes head. The poor parents have to blearily open their eyes and listen to us chat about dosing and different lab values. And they're all wrapped up in the white hospital blankets on the uncomfortable pull out couch bed. *shakes head. It sucks. I'm so sorry for the families.

It's so chill. I hate it. Okay, not true. But sometimes it feels like empty and unstructured study time. It's like... what the heck am I supposed to be doing right now? I want to be doing something. Blah.

But everyone is chill. Residents, attending, nurses. *shrug.

Oh yeah. I realize I need to learn brand names of drugs, asap. It doesn't help if I know the generic and everyone just says the brand name. why zofran, zyrtec, dilaudid? why not just be ondansetron, citirizine, hydromorphine? why? and then trim/sulfa. why are you septra AND bactrim? why?? (complain complain)

I'm really not that annoyed. It's actually pretty interesting to finally put things together with a real patient.

2. Nutrition
I am vitamin D deficient. Ughhhh. And I ought to be exercising, but I am so tired after I get back (even though I feel like I haven't done anything!). And then I have to sleep by 10!! What the heck. (complain complain complain)

3. -thoughts-
"...

                              -ide....."

I will be brave soon. Or stupid. Sometimes there's a fine line between the two. One more week, I think.

4. Grand rounds
Learned about tx legislature for pediatrics. pretty interesting.

reminisce

when i was a kid -i dunno, maybe eight or nine years old- there was a period of time where I would be excited every time it rained. Because it meant that I would be able to go out and run around in the rain in the backyard. Maybe my memory is figment of my imagination all wrapped in rose-colored haze, but I feel like I really do remember those moments. Randomly running in circles, getting grass and mud all the way up the back of my calves, hair drenched until water is running down in rivulets, and of course me just giddy and out of breath from running so much.

of course, this was when texas was in drought season and there was no rain for over 90 days or something crazy like that. so instead of running in the rain, i'd go outside whenever the sprinkles went off. jumping over the little black sprinklers, half trying to avoid the water, but not really - because that's all the fun anyway. and of course going back inside, wet and laughing and covered in grass and dirt to my mom shaking her head and pushing me towards the shower.

it doesn't matter. sitting in the library right now, next to the window - i literally just watched a storm start. from a few pitter patter sounds, to a startling boom of thunder, and then a torrential flood of rain. in the span of a few minutes, i watched the sky turn from sun-drenched yellow with a haze of clouds into the gray-blue of overcast clouds with a belly full of rain.

have you ever had that feeling? where you look at something and you think, oh yeah, i used to do something silly and fun. now i just kind of sigh and think about getting wet walking back to my car.

i want to go run in the rain.