excuse4dreaming

Wow. In so many ways I feel like a different person. I can do just fine on six hours of sleep, I don't even need to be passed out for 25 straight hours on Shabbos anymore. I am incredibly proud of myself for having completely avoided a caffeine addiction, I might add.
I do have quite a few amazing/interesting/cool stories from work, but almost none of them can be repeated to just anybody, for various reasons. Either they're too gruesome or too risque or they can't be fully appreciated without knowledge of medicine etc. The gruesome ones people say they want to hear, but they really don't. Once you start to describe it they're invariably horrified and obviously have gotten more than they've bargained for. So sometimes I'll water it down, but that's no fun.
I find myself completely obsessed with money of late. I've never been one to be into money before, I'm not materialistic and when I used to work I always had some left in savings beyond my needs. I just never thought about it much. But money is one of those things that you can't help but notice it when you don't have it. Plus looking into different job offers and their salaries really brings it to the fore. I keep thinking, I just have to hold on another few months, and then I'll have all the money I need G-d willing. So I'm really down to the bare bones on spending. IE my socks have holes and most of my clothing is at least 3 sizes too big.
Which leads me (nice segue!) to the fact that I've lost quite a bit of weight. I had gained weight the year before, most likely due to eating takeout just about every day in Brooklyn, but within this last year I lost even more than I had gained. Most likely due to the dearth of kosher food at all of the hospitals I've been at; I eat what I take with me and that's it. This is truly the key to weight loss, I saw an opportunity to force feed myself (ha!) a very strict diet and I ran with it. Wow that was kinda preachy. Anyhoo...
I'm slowly starting to get some of my spirituality back. It took a major hit this past year, thank G-d not in any real external ways, but inside I feel definitely dragged down. I was afraid this would happen and I'm not sure how I could have avoided it. Like everyone else, I'm affected by the people around me, both in the presence of those who are around me and in the absence of those who are not. But hopefully this should improve as I start having more free time outside of work, to not be focused all the time on that world.
Let's see, what else? Despite many patients saying I look like a teenager, I do at this point in my life finally feel truly like an adult. I think having the patients and even the surgical residents looking to me like I must know what I'm doing gives me the confidence to prove them right. And being that the OR is a major part of my life right now, I do feel like I have something unique to contribute to society, and a specialized skill set that not many others have.
It's a shame I haven't been writing this past year. There was so much to write about so many times but I just didn't have the time or the energy. Baruch Hashem I haven't lost a patient yet. There were a couple of scary situations but those are actually good to see as a student, when there's someone else around to watch how they handle it, or for them to watch how you handle it. And, honestly, I'll always have an attending for backup anyway, and at this point I really like that idea.
What I do ends up being really more about the little things. Various things you can do to prevent nausea and vomiting. Carefully checking the position of the arms to prevent nerve injury. Paying attention to how you tape the breathing tube so the patient doesn't end up with a fat lip. How you talk to the babies as they go off to sleep so they don't freak out too much. The big things you know to avoid, but it's once you're comfortable with those that you can move on to the things that will actually make a difference in the experience the patient has and knows about.

I feel like that needs some clarification. The above paragraph is not all I do by any means. My real job is knowing what meds to give in what doses that'll be appropriate for that patient. Managing the airway, ventilating the patient appropriately. If their blood pressure goes to 60/30, as it may well do, what do you do? Well, it depends on which of a long list of things is causing it. Go through that list quickly enough to find the answer that'll save them before they code completely. If they're bleeding, would blood products be appropriate? Which ones? How do you wake the patient up? When do you begin to wake the patient up, which is different for the different surgeries. How do you prevent and recognize and treat heart attacks, which are a considerable risk for many patients during a lot of surgeries. If the patient will be on their stomach or their side under anesthesia, how will this affect their breathing and their blood circulation and what can you do to help it. Etc. etc. etc.

So yesterday I left the house at 7:30 am to be in school from 9-2. Work called at like 1 if I could come in 3-11 and I was like Y'know what, I'm feeling pretty good, got no specific plans for today, why not? So I drove straight in, changed clothes in the locker room (keep an extra set in my trunk) and worked the rest of the day. Drove back after, got home like 12:30, had some macaroni as my first meal in 12 hours, and got into bed at like 1:30. And I was thinking on my way home, This was actually nice, I kinda like the spontaneity. The supervisor at work asked me why I don't put in a regular schedule for myself, they're so busy right now that they need me basically whenever I agree to work anyway, but I told her that I don't think I'd end up putting in for any time at all. I need that push of someone calling me on the phone asking me to work to get me over the hump of Oh I don't really need to work today, why should I? Plus just the way that things work out on my unit if I were on the schedule in advance I would probably get worse assignments.

Last night I had to give a patient 150 mg of amiodarone IV from a bottle that had 900 mg in 500 mL of fluid. And I never did that before so I checked my math like 3 times first. Then this morning I was reading in a nursing magazine about how such horrible mistakes can happen with tired nurses. It's really pretty scary.

Y'know when you have one of those hashgacha pratis stories that makes you think, Man, I REALLY hope I'm not using all of my zechuyos for THIS. Well...

I was on my way home today and as I was gonna get off the exit, the snow on the mountains looked so beautiful and I had the thought that it's such a nice day that the snow's all melting and for sure this is my last opportunity to see snow like that this year. So I just kept on driving, turned up the music, got up to like 90, and it was just beautiful. Had the thought that I really should get off an exit because they become much less frequent, but I was enjoying myself so I kept going. Ended up at Woodbury. Figured, Well, I just spent 75(hey there's no cent sign) to turn around so I might as well stop in, even though I was kinda hungry and not in the mood for shopping. So I pull in by Banana Republic, got the closest possible spot, y'know those ones that are even closer than the handicapped ones? Well. I go into Banana and there they have these absolutely perfect short flairy sporty skirts. For $5. I should mention that a short junk skirt has been hovering near the top of my shopping list for several months now. They're not that easy to find. Plus I hate shopping so I haven't really been looking too hard, but still.

Moral #1: Just follow where the good L-rd sends you.
Moral #2: If you need a short flairy grey skirt, for $5, they have tons of them at Banana Republic in Woodbury.

But they're dry clean only.

So I bought 2.

Got Lasik on Thursday and thank G-d I think the results are gonna be great. They say it takes like 2 weeks so that's what I'm gonna give it. Was sitting in class this morning barely able to read. Seeing crystal clear generally, just mildly illiterate. Felt like a really bad case of astigmatism, v'ha'maven yavin (remember that?). Anyway, after a couple of hours I was seeing just fine again. Shabbos morning also, woke up and could see perfectly out of the right eye while the left was completely blurry. Went away after about an hour but it was scary as heck.

I've noticed that I'm kind of stingy with the pronouns.

Went to a high school performance tonight. Serious drama about a girl being enticed into the wider world by the evils of the Internet. Was pointed out to me that in my old school they wouldn't even have dared to broach such a sinful subject. Not to mention that I was in high school in just the very early days of the Internet. Man I feel old.

But this play was seriously cringeworthy. I kept wondering what the AV guy sitting there watching this thing was thinking. And I remember when I was in high school, actually in these things, I used to also wonder about what other people would think of the stuff we were doing. But at least I used to feel that while it might be a little nerdy at least it was an honest effort at representing something that's important. But now watching this thing I kept thinking about how misguided and out of touch with the world it really is. But I think that says more about society than about truth.

What worries me is that I remember that I used to notice those people who would snicker at these things and I would think that that was so horrible, even if you don't agree with the hashkofos at least acknowledge that there are people out there who really do try to live their lives this way and that's a beautiful thing. And I think that among the many ways I've changed since high school, some of them have been changes for the worse.

It's funny that this keyboard I'm typing on contains all the knowledge ever known to mankind. Every deepest feeling, every bit of truth. Infinity. Though true infinity may be still slightly beyond its grasp.

Everything, all of it, condensed into 26 letters in very often pre-regimented combinations. For where would thought be without communication. Indeed how would our thoughts themselves form and coalesce at all.

I recently got a haircut. Took about 3 washings to get it to curl normally again. Isn't that weird? I guess the top part (now the whole part) was so used to being weighted down that it needed a little coaxing. But now I really like it.

This is me blogging about my hair. Apparently I'm a little dangerous with access to the Internet when my date's 2 minutes late.

Y'know how sometimes it's like I'm fat and I'm hungry and to BEEP with it I'm gonna eat EVERYTHING I SEE?
Well, it's like that.

Y'know how sometimes it's like I hate this and I hate that and to BEEP with it I'm gonna just GET IT ALL OUT?
Well, it's like that.

Y'know how sometimes it's like I'm totally broken out and I haven't looked like this since I was BEEPIN' 15 YEARS OLD?
Well, it's like that.

And that, my dear friends, is what it's like.

Love me my snowman. Those big, dark eyes. Nice 'n tall. Always ready to listen without interrupting. Can be molded into the perfect form. Made up of cells of G-d's own creation, each one perfect.
Typical that he's being so slow to appear.

Here's an old one that recently popped into my head again. I was doing a clinical rotation at Cornell and walked thru a pretty nice Upper East Side neighborhood every day. Found a preponderance of two kinds of fellow pedestrians: nannies walking babies, and very well-heeled looking people walking very tiny little dogs. And every day I had the same thought, These people would rather walk their dogs than their babies.

Caveat: I know that this is probably unfair. But it was definitely a very commonly seen scene.

Random snippets....

While waiting at a light in Brooklyn, an elderly woman crossed the street in front of me. Wearing a leopard print coat. With a walker. With a little dog perched on top of the walker seat. Wearing a matching leopard print doggie sweater.

Stopped at another light, next to a small construction site. All boarded up so you couldn't see inside, but with one board missing, through which you could see massive piles of debris and a crane at work. Chassidic man peering through and watching. He walks away. Another Chassidic man happens along. Peers through the open board. Stops and watches.

Oldie but goodie I happened across again, still funny. Sorry, no idea who to credit for this one, though it's definitely not my own original work. I found it at rantorama.com.

Welcome to the psychiatric hotline.

If you are obsessive-compulsive, please press 1 repeatedly.

If you are co-dependent, please ask someone to press 2.

If you have multiple personalities, please press 3, 4, 5, and 6.

If you are paranoid, we know who you are and what you want. Just stay on the line so we can trace the call.

If you are schizophrenic, listen carefully and a little voice will tell you which number to press.

If you are depressed, it doesn't matter which number you press. No one will answer.

If you are delusional, press 7 and your call will be transferred to the mother ship.

If you have a nervous disorder, please fidget with the pound key until a representative comes on the line.

If you have amnesia, press 8 and state your name, address, telephone number, date of birth, social security number, and your mother's maiden name.

If you have bi-polar disorder, please leave a message after the beep, or before the beep, or after the beep. Please wait for the beep.

If you have short-term memory loss, press 9.

If you have short-term memory loss, press 9.

If you have short-term memory loss, press 9.

If you have short-term memory loss, press 9.

If you have low self esteem, please hang up, all operators are too busy to talk to you.

If you would like to speak to a physician, pleased be advised that your plan requires a second opinion and a 30 day waiting period before you can receive this service, which has been designated nonessential.

Well, it's become kind of traditional for me to write about my dying patients, so here it is:
I'm not gonna get into the classic sepsis issues or the drain sticking out of his abdomen that put out over six liters in 3 hours. (And yes, that is a lot.) What I wanna talk about is his wife. Now this is an old man and she is a little old lady who's been at his bedside every day, crying. Today she says that she can't take it any more, she wants nobody to touch him, that's it just let him die in peace. Problem is, in the ensuing conversation, it turns out she isn't his wife, but she's been living with him for the last 12 years. Turns out he does have a wife who he's separated from, but they never got divorced. And they've had no correspondence or anything at all for over a decade. And obviously he's not able to speak for himself anymore.
And when I heard this, my reaction in my head was this is totally a situation straight out of a TV medical drama.