tag:blogger.com,1999:blog-146391742024-02-20T13:08:13.237+00:00The Messy MedicThe Messy Medichttp://www.blogger.com/profile/01237665687331329251noreply@blogger.comBlogger47125tag:blogger.com,1999:blog-14639174.post-11365388086979358612012-01-23T04:31:00.002+00:002012-01-23T04:43:20.949+00:00Happy New Year! I'm gonna celebrate with a Dragon Roll...Since I was late with my Happy Regular New Year, here's to Chinese New Year! New Year's resolutions: 1) blog/journal more 2) gym more 3) eat healthier (noticing some similar trends here!) 4) be more productive and stop wasting my weekends. <div><br /></div><div>I'm typing this on my ipad with the bluetooth keyboard in the Kensington Pro 2 case. Pretty awesome, I have to say but of course I'll have to buy everything all over again when they upgrade to a new model. </div><div><br /></div><div>So now that I haven't blogged in forever, I'll catch up. This week has been an EPIC WEEK! Someone rightly pointed out that I need to buy a lottery ticket to make my luck in 3's. I passed my EM written boards, I got a job offer at a prestigious place where I really want to be and where I will continue learning an incredible amount, so things have really started well so far. I can't believe how lucky I am sometimes (stable job, employment with good benefits, little debt, etc.) </div><div><br /></div><div>Fellowship so far has gone well. I don't think I'm making as much of it as I could, but there definitely doesn't seem to be too much time! I'm much more comfortable in ultrasound use than I was when graduating, and although I still have nervous energy going into critical care shifts, I've had some great days as an attending and watched some great days that my friends have had too. I don't think (I hope) I've made major mistakes yet, and I've definitely learned things I could do better but my management has not resulted in disastrous consequences. I feel my confidence growing but am fortunate to be in a specialty where you can never get complacent. I still have some growing to do, but it will come. It's great to be in a very laid back but intellectual environment. Time to put the burners on! </div><div><br /></div><div>Having more free time is great too. I've gotten to go to NYC a couple times for shows. Friends of mine visited and got a glorious few days on Fire Island this summer before we got kicked off for the hurricane. Went to London / Dublin just before Christmas and felt I never wanted to leave. Worked my ass off (9 shifts in 8 days) over Christmas and survived and also made some good moonlighting money. And now is now - we're going to Puerto Rico, Phoenix, Chicago and maybe I'll be able to swing another Dublin trip for a conference. Maybe Florida? and Australia in December? So far so good :). </div>The Messy Medichttp://www.blogger.com/profile/01237665687331329251noreply@blogger.com0tag:blogger.com,1999:blog-14639174.post-24970056867658378712011-07-06T03:43:00.002+01:002011-07-06T03:55:32.355+01:00Happy Independence Day!Reasons to feel independent: <div>1) Graduated out of residency!!! Woohooo! </div><div>2) Starting new life as an attending while having a nice transition by doing a fellowship</div><div>3) LIFE OUT OF MY NYC SHOEBOX and into my brand new apt which isn't large, but feels luxurious in comparison with my brand new furniture, awesome 46" tv, and a real bed! </div><div>4) I don't have to be chief anymore!</div><div><br /></div><div>I'm going to miss the life of NYC and being able to get anything / do anything whenever I want, but I won't miss the traffic, the paradoxical culture-less population, the people congestion, the dirtiness, etc. Already in my apartment I love the fact that I can't hear much street traffic, I've got a great view of the long island sound, I'm surrounded by unique boutiques / bookstores / art shops, and the people seem naturally happier. I definitely won't miss the drama of my old hospital (and there was tons of it in June, even up to my last week which I had to sort out as the out-going chief, even though I was on vacation) :). </div><div><br /></div><div>So I spent most of the weekend with a quiet one in, gradually sorting out my piles of clutter, building my new ikea furniture (my whole apt is best buy, ikea or bed bath and beyond) and finally making what feels like a home. My family left, which is a shame but I don't think there was much excitement on this family vacation this time. Hopefully there will be more exciting trips planned because that makes two dud vacations this year (Shanghai which we did not like, and this one where most of it was spent with graduation and me moving out of my apt, although we did have a very enjoyable massive shopping day where we all stimulated the economy) </div><div><br /></div><div>Today was my official first day of fellowship, but there's nothing clinical yet so I still have a little downtime. Met some nice folks in my apt. complex, a couple people who are ED like me and who I'll be working closely with so I now have some potential company. </div><div><br /></div><div>Things to check out: outdoor trails, and THE POOL! </div>The Messy Medichttp://www.blogger.com/profile/01237665687331329251noreply@blogger.com0tag:blogger.com,1999:blog-14639174.post-81033477155741376212011-01-15T04:05:00.003+00:002011-01-15T04:28:41.539+00:00Happy New Year 2011!First off, some resolutions (okay, 15 days late...but still... ) for the rest of the year<br /><br />1) I will <strong>not let others get to me</strong> and I will be more patient with the stupidity of others (yeah yeah I know that sounds condescending, but it's what I need to tell myself before I explode at them). Try to <strong>be more patient</strong> because patience is not my strong suit<br />2) <strong>Go to the gym more</strong> - already making progress on that one!<br />3) <strong>Eat better</strong> - ok, not making so much progress there but because of all my night shifts lately, I'm nearly down to my high school weight!<br />4) Explore and enjoy NYC more before I leave - this will have to wait until after the exams<br />5) Go snowboarding!! - haven't made it yet this season!<br />6) S<strong>tudy Study Study</strong> - congrats to me for getting an Ivy League fellowship, but I better make it stick and not look foolish up there<br />7) Find that old optimism I used to have and start each day with a clean slate and look at each relationship I have through clean glasses<br />8) Find time for creative activities so that I can feel more balanced<br /><br />I've got a lot of positive things to look forward to, especially in the first half of this year. First off, I'm going to my US fellowship at an Ivy League place full of history and tradition (I love that kind of stuff!) so already I feel I'm finally kick-starting my career.<br /><br />After 2.5 years of residency, I really do feel like I'm ready to be an attending. There's some knowledge-based things that I really need to hone up before I get there, but in terms of spirit and attitude, I'm ready to handle anything thrown at me. It's nice when your attendings tell you as well, "You looking forward to this yet? You're ready and you'll be great!" Positive feedback is always so endearing. I've just finished two weeks at Harlem. Got a great thoracotomy case (my 2nd) and this one I saw up close and personal. I have the pictures to prove it, which I can't post unfortunately for legal reasons. Got a pure inhalational smoke injury which was a fantastic case, and between Harlem and Monte, I've gotten a lot of tubes on the first attempt. Although many codes come into the ER already DOA, I feel like I know how to handle them.<br /><br />I feel like my residency has been a success, although I haven't achieved as much on the research end as I have wanted to. I'm comfortable with most cases, sick or FP-like. I'm comfortable with procedures. I'm happy with my patient through-put. I wish I had more time for reading or my elective or research, but we can't have everything. I'll get more of that during my fellowship, so c'est la vie! I definitely wish I had more time for creative venues, but that might change in the future, who knows?The Messy Medichttp://www.blogger.com/profile/01237665687331329251noreply@blogger.com0tag:blogger.com,1999:blog-14639174.post-27931186548731118812010-12-23T16:01:00.005+00:002011-01-15T04:02:32.832+00:00My last Christmas in NYC for a little while...HAPPY HOLIDAYS!!!<br /><br /><br /><br />This year, it's really chilly in NYC... and we finally got our massive blizzard / snow dump on Stephen's Day. Now all you European romanticizers know what I'm talking about! I do like NYC at Christmastime with the decorations and the constant store music blaring. But I definitely will not miss all the cursing. I'm no prude and I can be sailor-ish, but every time you hear someone on their cell phones it's always F-in this or s*** that. It'll nice to be in a place where everything is a little bit calmer and people aren't so angry.<br /><br /><br /><br />Last week I went to see Bloody Bloody Andrew Jackson ... could have done without seeing that particular musical. Nice set, but not a whole lot of substance to the actual plot and no real wit in the lyrics. Then I subwayed to Macy's - another exercise in patience re: shopping in a big city at Christmas! Every time it's a big reminder of why I should just stick to online shopping :), which I've become quite good at! (and I get to collect boxes for my move out of here!)<br /><br />I also saw Women on the Verge of a Nervous Breakdown which is based on a famous movie and also had one of my favorite broadway actresses in it (Laura Benanti). Unfortunately, the show is closing early and didn't get very good reviews but honestly, I thought it was fantastic! I was up in the mezzanine so maybe it looks less chaotic from up there, but I thought the way they put together scenes and used the set was pretty awesome. Fantastic singing and Benanti's character (the funny one) was just great. I'm going to have to buy the cast album just for that one song!<br /><br />Oh, and another thing I'm going to have to see again is the Radio City Rockettes Christmas Spectacular... I thought it was going to be mainly for the kids, and in some respects it is but great choreography and sets. I'd love to take mom! Only next time I'll shell out for the expensive seats in front cos all the coughing snotty loud kids are in the back...<br /><br />The rest of Christmas was pretty uneventful and all my off days were spent recuperating from work. Worked short staffed but we survived, it's snowed more this year than in any of my other years here and still you'll come up to waist-high piles of snow and all the cars are still boxed in. But it's kind of nice to see NYC blanketed in snow in the early mornings before people are trying to bustle in the streets.The Messy Medichttp://www.blogger.com/profile/01237665687331329251noreply@blogger.com0tag:blogger.com,1999:blog-14639174.post-81854864199397333982010-10-07T12:01:00.002+01:002010-10-07T12:21:31.832+01:00Chiefs have it rough!I haven't posted on here in awhile! I thought being in final year of residency with a decreased number of shifts would give me more time. It has to some degree, but all my free time is monopolized by my Chief duties! So yes yes, I'm one of my program's Chiefs this year. Technically, I'm the Chief Resident of Acadaemia, but I dabble in everything that needs to get done. What does it mean? Respect, yes. Self-pride, yes. More money, not really. A HELL OF A LOT MORE WORK! And it also means no one likes me anymore, except when they want something...<div><br /></div><div>But really, I do enjoy it. I'm not opposed to administrative stuff and it's interesting to try to plan our lectures and engage my program in useful activities. I'm not really a fan of being the end point for the whining or having to be connected to my email 24/7 though. But facilitating new ideas (whether mine or someone else's) is always good for change! </div><div><br /></div><div>Currently I'm applying for my fellowship in Ultrasound EM. I think it's a field that is becoming increasingly more important (quickly) and I want to make sure I'm "expert" in it before starting my career when I have no time to go back and do it. I could potentially see myself doing a couple fellowships actually, but of all the ones offered in EM, this one is the most important right now. I have my first interview tomorrow and one next week as well, so we'll see how it goes. </div><div><br /></div><div>We also just came back from Las Vegas ACEP, which was absolutely fantastic! Our program tries to send all the 3rd years and we lucked out that it was in LV this year. SO much fun, there was one night that there was a sponsored party in one of the hottest nightclubs on the strip, and we didn't get back to our rooms til 6 am! I've never seen so many docs on the floor (literally) before! Our program director took us out to a lovely dinner in the Venetian, and we went for a buffet in Paris as well. Walked the strip and saw the sites... LV would not be a bad place to live, I think. Can't wait for future ACEP's! </div><div><br /><div><br /></div><div><br /></div></div>The Messy Medichttp://www.blogger.com/profile/01237665687331329251noreply@blogger.com0tag:blogger.com,1999:blog-14639174.post-58953725498533124872010-07-08T03:35:00.004+01:002010-12-28T21:55:52.357+00:00Big Bad Chief RantWelcome to my last year in residency (now 1/2 year!) and to Chiefdom as well. Being Chief is about as fun as sticking a needle in your eye. I'd say since June, most of my free time has been spent poring over just one month's schedule. And I still have to do the conference schedule, arrange lecturers and assign text reading. Yikes.<br /><br />Then there are the day-to-day problems . X person calling in sick and spending hours on the phone trying to reach people to cover. (This sick call business is getting really old and we've had multiple issues over the Christmas period). Y and Z people didn't show up to their outside rotations and there goes more hours speaking with administration. Once I was called during one of my fellowship interviews to handle this stuff so I had to keep apologizing for answering my phone. Went on until 10:30 at night! Sometimes I think for a bunch of doctors who are supposed to be logical and be able to handle problems by themselves, they can be worse than the general population.<br /><br />Now it's interview season and we're short one program director, we're short attendings and so for the last month my time has been sucked into giving interviews or tours. Good thing I like meeting new people, but it means I can't really plan on things or do anything else like mini ski trips or whatever. Cramping my style, man!!!<br /><br />It's not so bad, I do enjoy being able to effect "policy" and being an "authority" (DOWN WITH AUTHORITY MAN!), and we do get paid a small stipend. But it's definitely no holiday and I've lost a lot of my free time.<br /><br />Fortunately I got through all my fellowship interviews in October / November (which was really hectic!). These days last forever, some of them from 9-5! I think I did about 7 interviews which was less than other people, and it was exhausting. I subsequently got URI sick for a month! They're pretty laid back just like regular ER interviews for residency but wow, I'd forgotten how tiring it all is. I don't think being chief really has that much bearing on your competitiveness for fellowship. It helps, but it's not going to seal a deal. I have a pretty good CV in terms of "extracurriculars" which is definitely not as extensive now as it was in medical school. Still, every little bit counts I guess. All my work has paid off, though ... I'm going to Yale for my Ultrasound Fellowship! Time to celebrate!!!The Messy Medichttp://www.blogger.com/profile/01237665687331329251noreply@blogger.com0tag:blogger.com,1999:blog-14639174.post-51892289056125164622010-03-29T16:59:00.002+01:002010-03-29T17:05:42.845+01:00One last run...Too bad snowboarding season is over, just when I started getting a little control of my board! I went back for one last run and since last week was so warm and it suddenly turned cold over the weekend, all the groomed snow was like ICE so people were catching edges all over the place. Definitely was able to control turns and start linking them without falling, and the last two runs I did there were no falls which was awesome. But before those, my knees did take a beating. I'm definitely going to have to invest in some protective gear for next season. I can't wait!<br /><br />Today I'm just cleaning stuff up, trying to pack up winter stuff and get everything clean. I'll go to OBGYN later and see if there's any evening deliveries. I need to start studying for next year since it's the big bag third year where I'm actually expected to know stuff. I also need to start saving. I need a new computer (yet again) cuz my laptop is fritzing out on me, and using this netbook is slightly annoying since I lost bluetooth when I upgraded to Win 7. DAMN WINDOWS 7 I DISLIKE YOU.The Messy Medichttp://www.blogger.com/profile/01237665687331329251noreply@blogger.com0tag:blogger.com,1999:blog-14639174.post-33378697962311130222010-03-27T17:06:00.004+00:002010-03-27T17:35:11.635+00:00Goodbye winter, happy spring!<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhqKXUj5L6kLBeQetMyhn_A272SZiSPbMmNjlLHnrSOsUbsex7Wn0kcEtSmjlf8cHvGy2xxK8qA6YE3AmgQuvFsYIRk1fFstjxoXAx_Xg3hkp4JIWccTlyd7kKtpK1XHzvkCzD3tQ/s1600/burton.jpg"><img style="MARGIN: 0px 0px 10px 10px; WIDTH: 175px; FLOAT: right; HEIGHT: 160px; CURSOR: hand" id="BLOGGER_PHOTO_ID_5453362837494685698" border="0" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhqKXUj5L6kLBeQetMyhn_A272SZiSPbMmNjlLHnrSOsUbsex7Wn0kcEtSmjlf8cHvGy2xxK8qA6YE3AmgQuvFsYIRk1fFstjxoXAx_Xg3hkp4JIWccTlyd7kKtpK1XHzvkCzD3tQ/s200/burton.jpg" /></a><br /><div><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEheG2nF8jO2jaLvCiFhRQJkxIeYI7-4qXJztde4lLCNRCMNGYeXZQ1r76R7fZqckQr0699A_fSDrgkqsr6lV9UDaK9Rp9bhb2jU50eSvEZpUzGv1U8iFCxgr4dhHN6CfajthJM6xQ/s1600/atomic+vantage.jpg"><img style="MARGIN: 0px 10px 10px 0px; WIDTH: 209px; FLOAT: left; HEIGHT: 201px; CURSOR: hand" id="BLOGGER_PHOTO_ID_5453362569481303474" border="0" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEheG2nF8jO2jaLvCiFhRQJkxIeYI7-4qXJztde4lLCNRCMNGYeXZQ1r76R7fZqckQr0699A_fSDrgkqsr6lV9UDaK9Rp9bhb2jU50eSvEZpUzGv1U8iFCxgr4dhHN6CfajthJM6xQ/s320/atomic+vantage.jpg" /></a><br /><br /></div><div>Now the winter months are nearly over and usually I'm happy about this, but now I've found a new love - snowboarding! Too bad I didn't discover this sport sooner, I'm addicted...can't get enough. I've only been out about 3 times, but I'm already purchasing two boards (that I got on massive sale of course). One is the Burton Feel Good with Escapade EST bindings, which is just way too advanced for me right now (didn't quite realize this before I bought it). Can't wait til the day I'm good enough to handle it! And then I got the Atomic Vantage board which is more a beginner-intermediate board. Yeah, it's a men's board but with my height and large feet, there we go. I just love its design. Will have to tell you more about how they ride next year. Hell, I might even just start my own snowboarding blog! </div><div> </div><div>Anyway, in Jan I went on vacation to Australia / NZ which was awesome awesome awesome. I'm seriously thinking of moving there to practice after residency and fellowship. Definitely a sorely needed va-cay, as my residency was getting extremely puerile and tempers were exploding all over the place. Visited my friend (another doc) in the Coromandel part of the North Island, which is very pretty. Unfortunately it rained the whole time but we did some sea kayaking and Zorbed (they stick you in a ball with warm water and roll you down a hill) in Rotorua. We also drove through Tauranga, which seems absolutely lovely and has a mountain and a beachside resort. Sounds like the kind of place I'd like to live! We stayed a few days in Auckland too, seems like a happenin place but more expensive than elsewhere. </div><div> </div><div>Visited a friend in Brisbane and it was nice to see them after about 10 years (omg it's been 10 years since I saw them last), got to hug some koalas and managed for once to take some gorgeous not-quite-photogenic-photos-but-better-than-I-usually-take ones. We also got some beach time in, but this trip actually wasn't beach-heavy. Finally made it to Melbourne, with some good shopping and hanging out with my sis's friends done, and found a new favorite wine - Moscato! MMMMM. And always a highlight, the Aussie Open! It was a scorcher this year because we were sitting right under the sun, and saw roddick beaten by cilic :[. Also caught a great show with Geoffrey Rush called The Drunken Chaperone, very funny, we kept repeating lines for days afterwards!</div><div></div><br /><div>Then back to work, exams, study (meh) and now I'm coming to the close of a rather useless OBGYN rotation. Ah, at least I've got snowboarding to distract me for at least one more weekend! That's the great thing about NYC. You have beaches an hour away and mountains 2 hours away. Seems like a great blend, thinking about staying here for a good while! </div><div> </div><div><br /> </div><div></div>The Messy Medichttp://www.blogger.com/profile/01237665687331329251noreply@blogger.com0tag:blogger.com,1999:blog-14639174.post-88940832611597611202009-12-09T06:52:00.002+00:002009-12-09T07:08:09.821+00:00A Belated Thanksgiving!I'd set my 2 week holidays for the end of November, in prepping for a dinner I help organize over in Ireland for my alma mater rowing club. Unfortunately, the dinner fell through due to lack of interest this year (and funds), so we decided to cancel the dinner and I cancelled my trip to Ireland. A shame because I was looking forward to catching up with people, but c'est la vie!<br /><br />So instead of using my time productively, I went in nearly every day to help my program out with interviews and to talk to the interviewees. I like doing it so I didn't mind, but there went my plans of trying to catch up on some work! Hopefully I can try to put my head down this month and do some study / reading, but it hasn't started out well :).<br /><br />Then I had a few days at home with the folks for Thanksgiving. I have now realized that Banana Republic, Ann Taylor Loft, and BCBG Maxaria are my ultimate favorite stores and my credit card statements are skewed in those directions :). I figure I deserve it...somehow... ? Although I spent a significant amount of time at home attempting the unsurmountable task of cleaning the house for my parents, we had a nice dinner out at the Cincinnati Marriot hotel for turkey day. Why anyone would choose to cook and clean when they could have an inexpensive fantastic Thanksgiving dinner is beyond me :). So now that I'm nearly done with my 20's, I have a few things to be Thankful for.<br /><br />1) Of course, the good health and not too many problems in life so far, knock on wood.<br />2) A stable career which isn't an office job, a career where I can actually help people and feel some satisfaction with on a daily basis (to combat the daily abuses), and a career where it seems I can be successful to the point of recognition in. And of course it helps that it is a financially fulfilling career when compared to most people.<br />3) I am much happier now than I was this time last year. There's much I can gripe about, but I think I'm used to culture here again and I have a bit more creative time.<br />4) I passed Step 3 comfortably and never have to do any of those again!!!<br /><br />Starting December 1st, I'm back in the ER and it didn't take me too long to pick it up again after being on off-service rotations for awhile. There's some times when it's painful, but I'm happy I'm able to truck along quite quickly and so far have been able to clear out the rack, even if I'm the only resident on my side. If I could only do that with my personal projects and my studying ... :).The Messy Medichttp://www.blogger.com/profile/01237665687331329251noreply@blogger.com0tag:blogger.com,1999:blog-14639174.post-3491136158001735452009-11-20T03:49:00.002+00:002009-11-20T04:25:23.301+00:00It's play time!So after the Step 3, the first thing I did was rent a lot of books from the library and see a ton of shows. This is why I can't move out of my 500 euro / month hole in the wall that is my room, because I keep spending money on other things!<br /><br />Here's my brief synopses of the ones I saw:<br />1) After Miss Julie with Sienna Miller - interesting play, not my type of thing but interesting nonetheless. She's this young aristocrat who seduces one of her servants and the ensuing emotional turmoil begins between them as the dynamic between them shifts. Fairly good acting on her part, it must be difficult doing such an emotionally exhaustive role.<br /><br />2) Oleanna with Julia Stiles and Bill Pullman - again, very good acting, and the concepts discussed throughout the play are provocative, but not really my thing. A little bit wordy and far-reaching. She plays this student who goes to her professor (Bill Pullman) for help, but as he tries to help her she misconstrues his words into sexual harrassment and ends up ruining his life. Her character is quite annoying, but that's the emotion this play is trying to provoke.<br /><br />3) The Understudy - Julie White, Justin Kirk, Mark Paul-Gosselaar (hottie!) . This play was really funny, and very witty. Not as creative as 33 Variations but very cool anyway. This was about two actors (one understudy to an understudy essentially) and a stage manager trying to produce of kafka play, so there's all these Kafka references which are pretty amusing. I like "intelligent" plays that are funnier if you know what the jokes elude to. Very good acting as well, a little overdone on the cursing but cest la vie.<br /><br />4) A Steady Rain - Hugh Jackman and Daniel Craig (both hotties!) . Interesting play, again not quite my thing but good acting. Very verbal play, not much action. It was a sort of "human" play too as both actors messed up lines or tripped over their tongue occasionally, but hey, they were forced to do American accents for 90 minutes. What was hilarious though was that after the show, they were trying to promote donations for Broadway cares, so they ended up unbuttoning their shirts and displaying their wifebeaters. Daniel Craig had marked his right and left breasts on his wifebeater, and then they auctioned their wifebeaters off for the crowd - an actual auction in the theater. And both wifebeaters went for $7000! They raised $14000 for broadway cares (damn!) and watching this was really funny / exciting. Then they invited people to come backstage to take pictures with them for a mere donation of $2000. Damn...some day I might have that kind of money to throw around...jeez.<br /><br />5) In the Next Room or The vibrator Play - Laura Benanti (always one of my favorites), Michael Cerveris. This was a really creative play, and the character Benanti plays is brilliant. She's this really enthusiastic, curious young wife with tons of personality. Her husband is a doctor who basically ends up inventing these vibrators to help people overcome "hysteria" / depression / etc. in an age when no one even had a notion of orgasms. So he treats all these patients who obviously love this treatment and she's very curious but he won't really discuss it with her because she's not sick. It ends up delving into the fabric of their relationship . At the end for some rather funny reason it ends up with this make out scene and him ending up completely butt naked. Anyway, it was good.<br /><br />Oh, and I also went with one of my friends to see the Rob Thomas concert, which was pretty good of course, he's got a great voice. And he pulled John McEnroe (yes the tennis player) on stage to play one of his riffs!! And he was really good, who knew John McEnroe could play guitar well!<br /><br />So I guess seeing all these makes up for no travel for vacation. I'm going home for Thanskgiving next week. And I get to catch up with some things around here (woo) although I'm not doing a very good job of it!<br /><br />I've also blown a crapload of moolah on toys for myself, got an awesome dslr to start playing with so hopefully I can have fantastic photos of NZ / Oz when I go in January and shoot happily around central park. Also got some of those fancy noise-cancelling headphones that I wish I'd had during Step 3 study in Barnes and Noble. Wooo.The Messy Medichttp://www.blogger.com/profile/01237665687331329251noreply@blogger.com0tag:blogger.com,1999:blog-14639174.post-82181352297214713952009-11-12T05:37:00.003+00:002009-11-20T03:46:44.002+00:00FREE FROM THE USMLE!! (I hope?!)The last couple months have been a whirlwind. I just finished sitting Step 3, and honestly, those USMLE people need some help. I take objection to being the subject of some sexually-repressed exam writers who felt it necessary to shove very graphic displays of every penile or vaginal wart possible on my screen with some chancres thrown in for good measure. Obviously 1-2 questions are inevitable, but come on, 15+ ? I really really really do not need to see 15 nasty members of genitalia on my exam, with the new technologically advanced screens they have in the Prometric centers. Nor did I really need to see that xray of a very Sex-and-the-City-ish object shoved some place where it just did not belong, and which I'm sure had a very disturbing story behind how it got there. Nor did I need to be placed right by the door so that every single person entering or exiting the room could glance at my screen. Yes, I did hear an "OH THAT'S SO GROSS" at one point. I'm thinking of writing in to those people and filing a complaint against my excessively obscene exam. I can't believe this is what passes as a medical licensing exam these days!<br /><br /><br /><br />Anyway, I'm on Ortho rotation now, which I'm finding very disappointing. It's like med school again where you're watching the consultant do history and physical and some very boring pathological findings. And this is coming from me, who absolutely loves Ortho. So needless to say, my attendance has waned.<br /><br /><br /><br />In October, I did PICU (peds ICU) at one of our peripheral hospitals. Before going into that rotation I was apprehensive because I wasn't that comfortably handling very sick kids. The exposure was good, treating kids with diseases I've never even heard of before. But I found their way of running the PICU and "teaching" residents management of kids was a bit odd - a lot of times it was like trial by fire. My fellow residents were pretty cool and I did not in any way feel like my knowledge was sub-par, and there was one particular resident who annoyed the hell out of me (and her hair really really really reeked too). I hear she's book smart but wow, clinically that really did not come out. The q4 long call was pretty exhausting and there were times I didn't sleep because of coding kids (that was pretty awful). Definitely glad to have my call rotations out of the way and no more WCMC! I really enjoyed my time at WCMC and the pathology is great, but not having to commute and live up there for months at a time is awesome.<br /><br />In September, part of my month was Ultrasound. I covered night shift sick call frequently so therefore missed most of it. So I really am not comfortably with my level of ultrasound knowledge at this stage. This is something I'm going to have to work on.<br /><br />Anyway, am now on vacation and free for a little bit. I was all set to go back to Dublin for yet another DULBC dinner, and I was realy looking forward to it. But unfortunately not enough alumni replied, we couldn't get the funds and after a stressful weekend of phone calls and emails, we had to cancel the even to avoid a 1000 euro loss. So after we made this decision, I cancelled my flights to Dublin... there's no point going and spending the money for catching up with one or two people. Such a shame. So now I'm spending my vacation time helping out my program for interview season. And of course, seeing a ton of shows!The Messy Medichttp://www.blogger.com/profile/01237665687331329251noreply@blogger.com1tag:blogger.com,1999:blog-14639174.post-30663190052565668992009-08-01T04:29:00.003+01:002009-08-01T04:53:49.870+01:00I'm a PGY-2!I finished MICU in June with no further difficulties. Had a relatively laid-back time and found after the Dublin ordeal, I was able to have much more collected thoughts and I'm glad I went for that sense of closure. Unfortunately, I had a case that I'll remember for the rest of my life where one of my patients, a young lady, died from the dreaded Swine Flu (she was immunocompromised as she had just delivered a baby). She developed ARDS, pneumomediastinum requiring bilateral chest tube placement, we placed her on a rotaprone bed with nitrous oxide therapy and at one point were considering ECMO. But it became more and more futile, which was of course very hard for the family to accept. And one of my nights on call, she became very bradycardic which we managed to resus for a few hours, before she coded. I had to call all the family to tell them to rush in, and try to get it into their heads that there was not going to be a miracle, and ask them to let her go peacefully. It was absolutely heart-wrenching, but interesting from a personal standpoint how to think of ways to get them to understand that we had done everything and have the mother sign the DNR. I think eventually what made them understand was that I explained we were not treating her, but treating numbers. I nearly cried at several points, but people seemed to think I was being very strong. But I was also really angry that I was the INTERN who should NOT have the responsibility of doing this. It should have been the senior residents. But, c'est la vie.<br /><br />This last month was my trauma month in Harlem. I think it was a pretty good month for me, I don't know what I've missed because I didn't get any TICU exposure, but I got a couple chest tubes and some intubations, so I'm happy. Hopefully I'll get more when I go back for my regular ER month in April. I enjoyed it, which I'm pleased about because it's been awhile since I've really enjoyed my ER job. I was worried (and still am) that I have made the wrong career choice, and I still do feel to some degree that I've reached this goal and now I'm bored of it and want something else. But I think maybe as an attending, perhaps I'll be able to do my clinical shifts and who knows, make some money doing something completely different (ie. more creative)? We'll see. I don't think I want to do more than 14-16 shifts a month, but what made it better was that people seemed to value my work at Harlem (patients and attendings alike) and that sense of reward is satisfying. I'm just wary that I fell into this job because I happen to be good at it, not because I have a passion for it.<br /><br />Summer has really not been summer yet, there have been a couple hot days but many more cold very thundery drizzly days. But I managed to catch a great warm weekend and spent it learning how to sail. The doing is not as difficult as figuring out where your point of sail is, and in that I need much more practice. If it wasn't so expensive I'd be continuing it a bit more this summer, but I need to save more and maybe I'll sign up for the dinghy class later. It was liberating though, although I probably enjoy rowing more. Cycling there gave me a chance to explore a new bike path adjacent to the hudson river though, which was pretty awesome.<br /><br />I also recently went on my first "date" via match.com, which finally paired me with an attractive intelligent guy instead of a definitely-not-my-type 60 year old....we went the Coffee shop in union square and it was absolutely downpouring. He seems quite interesting, so we'll see where it goes !The Messy Medichttp://www.blogger.com/profile/01237665687331329251noreply@blogger.com0tag:blogger.com,1999:blog-14639174.post-24138855172684198732009-08-01T04:20:00.002+01:002009-08-01T04:22:17.376+01:00Argh.Well, I typed out a description of the rest of the services and my impromptu trip to Ireland, but something in blogspot messed up and I lost the post. I don't have the energy to retype it. Maybe I will later. Suffice it to say that two months after the incident, words still fail to describe all the emotions and details.The Messy Medichttp://www.blogger.com/profile/01237665687331329251noreply@blogger.com0tag:blogger.com,1999:blog-14639174.post-52497549718712232202009-08-01T04:09:00.003+01:002009-08-01T04:27:23.056+01:00ContinuedOh, here it is.<br /><br />I don't really feel like writing down every last detail, but I'll remember June 1st 2009 for the rest of my life.<br /><br />The Butler's reception afterwards was simply amazing, and extremely detailed to dot what would have been Aisling's last I's. The next day in Dublin, it was the Trinity service. Many of us in the class met in the Pav together so we could go en masse to the Chapel, and again it was nice to have strength in numbers. The music I thought was quite somber, so it was very emotional. But Gra and Fergal gave fantastic speeches about the girls, there were professors there that we had not seen for awhile, and representatives of Air France, Brazil and France, and the President of Ireland were there. There was a nice reception in the Dining Hall afterwards, then headed to the Bailey for a commemorative drink for the girls, then the Deasy's had an absolutely lovely reception at their house afterwards as well. I mean, this was just so heartening to see people pulled together. At the Deasy's, a lot of the professors were there and it was nice catching up as well.<br /><br />Had a couple days respite and just got to hang out with my rowing friends for a few days, which was really nice. I'm really glad I have friends outside of medicine to connect me to my second home. But being back made me really wish I had never left, and although I will never want to work for the HSE again, I loved living in Europe.<br /><br />That Sunday was Eithne's service in Belfast, and at the reception afterwards there was a really lovely slideshow of photos.<br /><br />That's all I'll say about that now. It's been two months since it happened, and words still fail to describe all the emotions and details. I'm not a very good descriptive writer, though. The only good thing to come out of this trip besides being with everyone again was a terrific amount of drinking. Peter and I went to a lovely tapas bar on the Friday night (very late as he got out of work late) and drank a hell of a lot of wine and cocktails. Then saturday night, I took him to this really fancy extraordinarily expensive dinner at Shanahans on Stephens Green where the decor is absolutely amazing.The Messy Medichttp://www.blogger.com/profile/01237665687331329251noreply@blogger.com0tag:blogger.com,1999:blog-14639174.post-60532980137003751552009-06-16T00:59:00.005+01:002009-08-01T04:09:38.599+01:00A difficult month...<p>In Pace Requiescat - Dr. Aisling Butler, Dr. Jane Deasy, Dr. Eithne Walls - June 1, 2009. </p><br /><br /><p>The passing of these three beloved friends and classmates is still a shock to us, and the last two weeks have been very trying, exhausting and emotional. If we felt this way, I cannot imagine what their families are going through. Especially as there's still no clear idea what happened to the Air France plane, all the hurt and anger about the airline knowing about faulty parts, and there's no clear idea where their bodies / belongings are. All we can do is draw strength from continuing to remembering their bright, lively and fun-loving personalities, their ambition and optimism. </p><br /><p>I was told about this by one of my best Irish friends / classmates before it broke in the news, and I immediately told the rest of the Americans in our class. The girls were on their way to Paris, where Et's boyfriend (someone I'd known casually before they started being a couple) was waiting at the airport. No names were released or confirmed until June 2nd, and waking up to find their photos plastered all over the papers, internet, CNN was difficult. But as soon as it was confirmed, we knew we had to be in Dublin to support others in our class, mourn with each other and pay respects to their families. And in remembering them, it would let us gain strength and have some closure regarding this terrible loss. </p><br /><p>I'm doing MICU at one of our peripheral hospitals, and fortunately not on a very busy service. My program director was very understanding and likened this situation to 911, not at the scale of it, but because of all the uncertainty and suddenness of the situation. She immediately put in a call to the program director at the other hospital, who was very good about granting me time off to go back. I tried not to be too emotional at work, but I was not able to focus and what's worse, did not care at all about my patients (that has never happened to me before). I was on the phone 24/7 to friends overseas (phone bill is going to be exorbitant), not eating and definitely not sleeping. We tried, but it was impossible to avoid - thinking of what their final moments must have been like as a plane literally breaks apart in front of you. Although knowing the girls, they probably took some zopiclone and had a few drinks so were probably sleeping. And it was comforting to know that they were seated together. </p><br /><p>The rest of the residents on my rotation sympathized, but I don't think some of them understood at all (although they hardly knew me). They were more concerned that my leaving increased their call time and their work load. To which I say, whatever. In times like those, work is completely trivial, but medicine is one of the most unforgiving professions. Doctors are never "allowed" to be sick, doctors are never treated like normal humans, doctors are not "allowed" to have outside issues (kids sick, housing closures, even doctor's appointments, etc etc etc). But another thing that may be difficult for them to understand, and something that I loved about my training overseas which seems to be missing in the US, is that as a class we grow up together. As a class, we are very close. Medical school is demanding everywhere, but in the UK system the oral examinations are much more intense and the classes are together for longer. It's like a family and although you have your injurious spats and there's hurt and betrayal, what's done to one spurs emotion in all. Even though we're thousands of miles apart now, we still need and draw strength from each other, and will probably continue to do so for the rest of our lives. </p><br /><p>So the few of us Americans who were able booked rush flights to make it to Dublin for services which were held for the girls. I think all of us were a little bit wary of flying as we were still empathizing, but a beer (some ambien would have been nice) calmed me down. One of my best rowing friends (not in my class but also now a doctor and a world-class athlete) picked me up, and after a nap we went into town to meet another of my rowing friends (the three musketeers reunited) for lunch in Avoca and it was fantastic catching up. Then went into College (Trinity) to meet a sports admin friend for coffee, back to Kilmainham for a rowing meeting (!) which lasted for ages. Finally, I got to meet up with one of my best friends from my class (Peter), and he and I proceeded to have a fantastic French dinner by Dublin castle (where they wouldn't give us a second bottle of wine) and proceeded to get very very drunk at The Bank bar in town. Had a fantastic night, I don't think I've ever had such a cathartic drinking session! </p><br /><p>The next day, we Three Musketeers had brunch in the tea rooms in Phoenix Park, then legged it over to Peter's with my stuff, changed into my dress (amazed I remembered to bring everything to look presentable) and then met two others in my class so we could drive down to Roscrea in Co. Tipperary for Aisling's service. Beforehand, we met up with the others in my class at a hotel near to the church, and seeing them all for the first time in a long time was brilliant. Obviously everyone was quite sad and emotional, but the one good thing is that it reunited us all and allowed us to feel that connection with each other again. We walked over to the church and it was very moving to see it completely fill, spilling out the sides with her friends and communities. The newspaper the next day said about a thousand people were there. The service was beautiful. what touches me most about services is the music, and the music was absolutely gorgeous, not too somber but very tasteful, and the soloist(s) were fantastic. </p><br /><p></p>The Messy Medichttp://www.blogger.com/profile/01237665687331329251noreply@blogger.com0tag:blogger.com,1999:blog-14639174.post-60863277198234117052009-04-13T03:02:00.002+01:002009-04-13T03:15:05.674+01:00Spring!<p>I'm really happy it's starting to get a bit warmer and the days are longer. Have been really good about getting to the gym and doing some weights / running, even though I'm half-commuting to Westchester for my ER rotation (which is fantastic). The teaching is great, procedures are great...too bad we can't have an environment like this at my home hospital. I'd love working at a place like that. In the last two weeks I've gotten to do a very clean lumbar puncture (brilliant, took me all of 5 minutes, they never go like that for me!), a shoulder reduction with arthrocentesis, seen two chest tube placements. That's pretty awesome. </p><p>Have continued my theater splurge and since seen 33 Variations (with Jane Fonda), which is absolutely brilliant. So ingenious, it amazes me how Kaufman can have the clarity to think like that, make connections between a speculation on why Beethoven wrote his 33 Variations and the modern-day life of his musicologist, and life in general. I might have to see it again, or get the script for it. I love really intelligent plays like that. I've also seen the new musical "Next to Normal," which is creative but I can't really understand why everyone is raving about it. I don't really like the music in these new musicals. Bar one, "Invisible Girl and Super boy," I don't really like the music although some of the lyrics are kind of funny. Same as in Wicked, I don't really like the music except "Defying Gravity." Maybe I'm old-fashioned, but bring back the Gershwin / Hammerstein music. At least Sondheim's music makes sense, he's probably the only contemporary composer who makes good musical music. </p><p>This Wednesday I'm going on my first eharmony match date. Still a little wary of meeting someone off a dating website, but seeing as how it's nearly impossible to meet anyone when you're working, and that people don't approach each other in gyms and whatnot like they do in movies (never mind the fact that I still tower over all the boys in the gym) that's the only way to go. So dinner and then seeing Waiting for Godot with Nathan Lane...that alone should guarantee a good night! </p><p>I'm glad I'm in WMC ER right now with such a good experience so far. It reaffirms my part-desire to be a doctor and help people, and when I'm at work I enjoy it. I still know that being a doctor isn't the only thing that I want to have happen in my life and I'm still going to explore other options, but now I'm not as depressed as I was a couple weeks ago and it's a good job to be a "baseline" job. I still need to work a lot and study, but still having time for a theatre habit so that's not too bad! And I'm starting to work at creative endeavors with writing ideas and buying a guitar off amazon ;). We'll see if it can get me more content! </p>The Messy Medichttp://www.blogger.com/profile/01237665687331329251noreply@blogger.com0tag:blogger.com,1999:blog-14639174.post-70175781403557420322009-03-25T04:49:00.004+00:002009-04-02T16:31:15.013+01:00More fun in the big city!Man, my vacation was hectic and went way too fast :)!<br /><br />Spent the first week of it in our condo in Vegas, where we had a family reunion with my grandmother and my sis (wooo!). Didn't really do much except eat, took a load of silly photos at the Valley of Fire park and flower shows in Bellagio. Only walked 1/2 of the strip once, because a day got wasted by sis getting sick >:(. And of course, buffet in Paris where I managed not to eat the whole dessert area like I did last time.<br /><br />After leaving Vegas (having to get up at 3 am for the flight) and landing in NYC many hours later, saw an Ionesco play called Exit the King on Broadway (with Susan Sarandon, Geoffrey Rush, Lauren Ambrose) which was possibly not the best choice to end a long day. Not only was it dark and slightly depressing although there were a few funny bits in the first half, the second half was full of dragging monologues and esoteric dialogue which put everyone to sleep. We were in the 4th row from stage and in front of us this lady started snoring, and her friend with her gave her a huge elbow nudge, to which the sleeping lady jumped a foot in her chair and everyone behind her started snickering right in the middle of this death epiphany by Geoffrey Rush. Man, that was a head-banger.<br /><br /><br /><br />Then Saturday we saw Blithe Spirit (Rupert everett, Angela Lansbury) and it was fantastic. The whole play is so witty and funny and Lansbury yet again is great at playing eccentric characters. Ate at Sardi's which was lovely and atmosphere is fantastic with all those actors' caricatures. Then we saw the Ibsen play, Hedda Gabler (Mary Louise Parker), and I wish we'd reversed the order of seeing these two because while well-performed, it was quite dark and bleek. I'll also try to avoid the American Airlines theater (roundtree) in the future because if you sit on the right side, it's adjacent to some alleyway in times square and you can hear all the immature teenage passerbys and lorries honking horns. <br /><br />Sunday, we spent basically the whole day shopping at Woodbury Commons. Obviously spent loads of money and were wrecked by the end of it! We'd been up til 4 am the night before as we couldn't sleep, but somehow we managed to plod through the piles of clothes and Coach bags!<br /><br />Monday, my friend from Ireland came and so we had a nice easy day of it, met up with a couple friends at my local bar and we managed to seriously bore my sis and my friend with all the medicine talk. I really need to find more non-medical friends!<br /><br />Tuesday was the museum day and we raced through the Guggenheim, Metropolitan and Natural History museums. Man, that was a whirlwind and I won't be back to those for awhile! Think i might buy membership to the Met museum and just sit in the conservatory to read. Then Bubba Gumps for dinner in Times Square, which was a lot of fun and loads of silly pictures ;).<br /><br />Wednesday we saw West Side Story on Broadway, which was good. This production is different because they've sung some of the songs in Spanish. I think that concept is interesting, but at the same time, I didn't like spending 120 dollars on tickets to not understand what they were saying. The lead guy of the jets started the opening song off key though he corrected himself. And the men weren't quite macho enough, in my opinion - i mean, i know west side story has some ballet style dance in it, but perhaps a little too effeminate casting. Good singing from the leads though.<br /><br />That night, we went to the Knicks game, which was really exciting in the end even though now I can't remember who won...I think the Knicks did. They came out really strongly, but then let it go in the 2nd quarter and had to play catch up. My friend caught one of those tshirts that they shoot into the crowd, heh!<br /><br />Thursday we drove to the Bronx Botanical Gardens which was nice (my Irish mate is into botany and all) and took silly photos of cacti and orchids. Had a nice chat before driving her to the airport. And then on the way back from JFK, got completely lost (in the dark) with my sis needing to pee really badly. Finally got the GPS working (woo for GPS!) and made it back before she had an "accident" in the car.<br /><br />Friday we got TKTS to see 39 steps, which was hilarious. Very creative as 4 people play multiple parts. I love the theater!<br /><br />Saturday, woke up early to stand in the TKTS line again hoping to see In the Heights (but it wasn't out yet) and then we met up with a couple high school friends (awesome!) for brunch in Greenwich. It's always nice catching up. Saw Reasons to be Pretty (Piper Perabo, Steven Pasquale even though neither of those two are the lead characters) which was interesting as you watched how a minor comment spirals into a huge life event, and was mildly amusing. A little too much cursing for me though. Then, my sis was curious about August: Osage county so we went back to the TKTS line and got tickets, and it was brilliant. Very funny watching this dysfunctional but normal ? family with most social taboos worked in! we were way up in the mezzanine though, so some parts were a little hard to hear. I'm just making notes for myself for other performances i try to see in the same theaters. I definitely have become a very avid theater-goer!<br /><br />Then after getting very little sleep, Viv left for LaGuardia at like 5 am . :( . Damn, I wish we were at the stage in our lives where we could get the big house / apartment together like we always planned. We've been apart for nearly 8 years now after spending every single day together and I thought I'd welcome the change (and I have to some degree), but now I at least want her around to do stuff with, since my social network is still in Ireland .<br /><br />Then this past Tuesday, I took myself to see the new Durang play (Why torture is wrong) mainly because I wanted to see Laura Benanti act again (I saw her in Gypsy). It was definitely interesting, made a few funny jabs, and the actress who plays the mother is hilarious! I think some roles had a little overacting going on, but I just find there's something very engaging about Ms. Benanti that's captivating. I spent the rest of the vacation downloading and watching episodes of True Blood, I'm not really certain why!<br /><br />I've been feeling pretty down lately, which is something new for me. I've never felt this way before, and it's not pleasant, especially when I'm supposed to be on vacation relaxing! Maybe it's because my twin left. I just feel like there's something really missing in my life, I'm not enjoying my work and it's not exciting me to go into work. I like the idea of being a doctor, and I like acquiring the skills. But it's not a culmination for me, I don't feel like I have achieved anything. It's funny how people measure success as they grow older. Some would think I've done a lot and am a very successful individual at this age, and I thought I would feel that way too. But I don't...I want something more and I'm not sure what that something is.<br /><br />Maybe it's the fact that to get to this point, I was involved in so many things and now those have just been cut out due to work committments, and I don't like my life just being medicine. I'd love to get into more creative endeavors, I think at the very least I'll start a little writing again (even though my thoughts are so jumbled I feel I don't know where to begin). But right now I'm questioning my life / career choice, and if I had to opt differently, I wonder what it would have been like to pursue one of the possibilities I was thinking of when I was 18 to be a musician / performing artist, although that would have been the less stable route. Although if I didn't do medicine, I never would have gone overseas to Trinity and met my wonderful friends there. Maybe I have too many unrealistic ambitions, but I still feel like a young kid who wants to get out there and do everything and make a mark in the world!The Messy Medichttp://www.blogger.com/profile/01237665687331329251noreply@blogger.com0tag:blogger.com,1999:blog-14639174.post-7321635289471712322009-03-20T03:42:00.002+00:002009-03-20T03:58:45.266+00:00Vegas!!Have done quite a bit of nothing (besides work) these last couple weeks, and now am just finishing a couple days in Vegas, where we're having a family reunion at the condo. It's been really nice, gorgeous weather in the 80s and I love the sun! I'd love moving here except for the lack of water. We spent several hours at the Valley of Fire state park which had gorgeous red rock and stone formations. We missed seeing petroglyphs because my parents/grandmother weren't keen on hiking to those spots, but we amused ourselves by taking silly photos anyway! Who else can I take silly photos with except my twin :) :) ?<br /><br />Then Wednesday we took some photos in a lovely flower exhibit at the Bellagio (more silly photos), they're always very creative in making their displays. We wandered around the strip more but only got halfway. Did some fake sword-fighting in Excalibur and rode the hideously expensive New York New York roller coaster where we had to wait for front row seats, of course. Fun enough and scenery is cool, but the pictures they take are kinda crappy and don't even include the taxi-cab-looking cars. Then spent hours in M&M world and coke world so Viv could find gifts for friends. Coke world have made these cool shirts which smell like their products, but they're too sweet-smelling and would definitely attract all sorts of interesting bugs in the summer. Good thing we think practically cuz otherwise I'd buy everything under the sun! Then had dinner at Rainforest cafe which is always a blast. I think Viv ate something bad though cuz she spent all last night and today running for the porcelain god....<br /><br />...which sucked because we were hoping to go back to the Strip and finish off the rest of the half (I love Caesars Palace), but it wasn't to be. She's feeling a little bit better now, but my family ignored my doctory advice and tried pushing some herbal medications which I've never heard of before.<br /><br />Anyway, to Manhattan tomorrow so I can show my sis and friends the dazzle of NYC!<br /><br />I think I'm becoming more financially educated, having done my taxes (and paid HR Block an enormous sum to do it for me and fix my errors), and looking up all these Roth IRA companies online, and trying to come to grips with the funds in my 403(b) / TDA. I should take a class one day. But I think anyone who is or will be a resident should try to max out their Roth IRA each year of their residency before we become ineligible when earning an attending salary. I only have 3 years to do that unless I do a fellowship. So word to those who know nothing like me: INVEST IN A ROTH IRA NOW! The market is falling so your money will buy you more shares which will compound more interest when they start rising again.The Messy Medichttp://www.blogger.com/profile/01237665687331329251noreply@blogger.com0tag:blogger.com,1999:blog-14639174.post-34771159961859022092009-03-02T07:04:00.004+00:002009-03-20T03:40:09.885+00:00Well, last month was busy! Everyone was just so tired. You have to cram nearly the same amount of shifts (one shift less) into a short month. A bit insane, even though you can get more coverage during a day. I came in on a week of nights and was hit with a thoracotomy (I came too late so couldn't get into the action) and we spent the whole night trying to recover from it although it was cool seeing it. A GSW that transected the descending aorta unfortunately. The third year resident was too busy doing paperwork for the police so I ended up taking all the sign outs. I don't really know if a first year has done that before at my program. It was tough following everything and trying to deal with incomplete signouts, and meanwhile the chart rack remains overflowing. But no matter how bad a shift seems, I've learned it doesn't kill you and you survive.<br /><br /><br /><br />Then we had our inservice. Have to say didn't study for it as much as I wanted to, but we'll see. .. 1st years generally don't pass, but the questions seemed manageable. Had a nice post inservice party! It's so nice when nearly all the residents and some attendings can be together. And we learned our ER chief of service has a fantastic apartment ;).<br /><br /><br /><br />Now trying to figure out how to do my taxes. I don't think I'm doing something right cuz I keep getting it saying I'm making a negative operating loss. I think I may need to get a financial advisor, sigh.The Messy Medichttp://www.blogger.com/profile/01237665687331329251noreply@blogger.com0tag:blogger.com,1999:blog-14639174.post-79269809414767417652009-01-19T20:07:00.002+00:002009-01-19T20:23:18.473+00:00Snow Snow Snow!On the eve of our seemingly savior President's inauguration, I've never seen so much snow coming down as now. I'm not from a snow-shy state either, but walking home last night, so much snow caked on my head that it actually weighed me down!<br /><br />Right now doing my medicine floors month in Valhalla at one of our sister hospitals. I will be so glad when it's done. Just not my cup of tea, and I never thought I'd say this, but I like the way the St. James's (Dublin) medicine teams run a lot more. I'd forgotten how on floors you never ever get out on time, doesn't matter whether you're in surgery or medicine, you can't possibly enjoy your life like that. At least with ER you know you end at such-and-such time and get definite days off. I've talked to many disgruntled people over the last few weeks, including the superstar residents, high-ranked surgeons...they definitely don't tell you this crap when you're a young doctor hopeful.<br /><br />Although residency is tough on everyone and so many 12 hr. shifts in first year really kills your spirit, I'm so glad I'm in ER. There's fewer arrogant assholes. I wish patients in hospital could see what their residents have to go through and how what seems like a small simple task is actually the result of someone scurrying high and low, begging, yelling, crying to accomplish it. Then on top of that everything is complicated by the state of health care in this country, medicaid and medicare limiting doctor's options, etc. Makes me more tempted to become an ex-patriate again!<br /><br />But aside from all that, I think I'm disgruntled because I'm lacking a creative outlet . You spend time doing all these extracurriculars and excelling in all these activities to make you a well-rounded person because that's what med schools and residency programs want (well you do too but you know what I mean). Then when you get into residency, all of a sudden all those extra things are taken away from you and your whole life is just medicine when you've gotten used to being able to do and balance everything. can't wait for more time to just enjoy other things.<br /><br />I'm starting to realize that medicine is just a job like everything else, and although for me it's a more preferable, safe stable job than others, it's just acquiring a set of skills like a mechanic or electrician. I always thought that loving your job was to love your life, and that medicine was the only job that I could like, but now I want to spend all my free time not doing medicine! It could be worse, but am definitely longing for the day when I can feel balanced again.<br /><br />We'll see what changes our new president can instigate. I'd definitely love the pressure to be relieved from the ERs.<br /><br />Apart from all this medicine mumbo jumbo, have checked out a couple restaurants for NYC's winter restaurant week. Went to a quite nice cozy French place last night, and checking out a Scandanavian restaurant tonight! Woo! I don't know how but somehow have lost like 6 pounds ... by eating!The Messy Medichttp://www.blogger.com/profile/01237665687331329251noreply@blogger.com0tag:blogger.com,1999:blog-14639174.post-77229585761984921882008-12-29T03:14:00.003+00:002008-12-29T03:49:28.757+00:00heh.I treated a patient today who got bitten by a squirrel. X saw a squirrel outside the house looking "in distress," and decided to take some vital signs on it. How on earth you take vital signs on a squirrel I have no idea, but it obviously didn't really work so well for X because all X got for it was a good CHOMP on the hand. While I was struggling very hard not to laugh at the image of near CPR on a squirrel, X supplied that X got far enough to determine that the poor squirrel was indeed in respiratory distress. Now, how high a squirrel's blood pressure should be or how fast a squirrel breathes is beyond my depth of knowledge. But I rewarded X with a Good Samaritan award from our hospital on the discharge paper!<br /><br />You definitely see some strange things in this line of work!<br /><br />Oh, I also learned today that "toast" means "gun." Y was mugged and reported that there was some toast involved on the assailant's part. Here I was thinking "Oh sure, ok there was a scuffle at the shop and some food fight was involved and somehow he got some toast." My attending even asked specifically if there was a gun involved and I was like "Oh not at all, only fists." Didn't I feel like an idiot when my attending questioned Y and came back to me and was like, "Um...did you know that "toast / belt / heater" means "gun?" I mean seriously come on, like that's intuitive. How am I supposed to know that?! Everyone's laughter (including my Y's and Y's family) followed me to the phone while I called NYPD.The Messy Medichttp://www.blogger.com/profile/01237665687331329251noreply@blogger.com0tag:blogger.com,1999:blog-14639174.post-74171267331000633732008-11-30T23:37:00.004+00:002008-12-01T00:40:44.506+00:00This holiday makes me wonder when I got the medicine bug and why couldn't I have chosen something simpler where I don't have to study and I can schedule more time off? :) . I know every doctor thinks about that multiple times in their careers, and it's gonna take me a little while to get the "yeah, this is the only thing for me" feeling back.<br /><br />The first week of my holiday I spent in Dublin, visiting friends and attending an alumni dinner for my old rowing club. I stayed in the Hilton Hotel for the weekend which I'd recommend to anybody, and then for a few days after, stayed in some friends' apts. It was nice, was like I never left and I was free to do whatever I wanted (ie. some training, even sculled for a trip!) like the times before I started working. I ran and cycled around phoenix park which was just like old times, and phoenix park is much bigger than central park so it was nice to get back to that.<br /><br />I really miss sports and being able to train as much as I used to. Definitely have a few squishier spots now that I want to get rid of, but doing 2-4 hours training a day is now not possible!<br /><br />Then for the second week of holidays, one of my Irish friends and another good Norwegian friend (both through rowing!) came over to visit. The first night, went to a Knicks vs. Wizards game which was boring for the first half but much more exciting the second half, so I'm glad they got to experience the atmosphere of Madison Sq. Garden even though they were both horribly jetlagged.<br /><br />The next day, did the NY Movie and Tv tour, which was interesting and informative, took us through most parts of NY, but I don't think any of us were that into it and it took a good 3.5 hours. Our finishing point was the Palace hotel, which we went into to look at the christmas decorations, and a guy there gave us free tickets to see this year's Gypsy reprisal! Great seats, was an interesting musical (not my favorite sondheim even though everyone raved about it) a little funny on the plot (but i'd never really seen/heard about it before), but I thought the acting was amazing, especially by Laura Benanti who transforms from a tomboy into this gorgeous burlesque dancer / stripper. Well she's won herself a new fan anyway!<br /><br />Unfortunately, one of my friends became ill and we came back early after wandering Times Square a little (I love Times Square, all the lights! I wouldn't even want to see their electricity bills!). Two of us went to this lovely euro-caribbean restaurant near me and then slept off more jet lag. Up early the next morning to the Statue of Liberty which we felt we had to go to just to satisfy the tourist requirement, so now we've done it and we didn't bother with Ellis Island. Then shopping up 5th avenue! After playing in FAO Schwartz, we were starving so had a great burger at Mickey Mantle's. I don't think my friends had been in that kind of sports restaurant before!<br /><br />Took my friends to see the Guggenheim (interesting exhibits), and one of them became museum'ed out fairly early so she took off for some shopping while the rest of us went to the Metropolitan museum. I'm not an art connoiseur but I definitely am not really a fan of the Dutch style painting. Perked up a bit when we got to the more modern sections, and then came across a fabulous exhibit of modern British prints (including rowing!) which we loved. Made a hasty bee-line for the exit, then wandered around Soho for a bit and the outskirts of chinatown, chilled in a nice Soho bar then walked in search of food to the west end where we found some dodgy steak outfit where the waitress couldn't describe the food to us. I found this hilarious, but then again I was drunk off two glasses of wine in the soho bar, so I couldn't talk.<br /><br />After a lie in on wednesday, we returned to the theatre district to see Wicked, which is a fantastic production. Not a huge fan of the music (I must have an "older" musical music taste), but the story line, setting / props and dance were terrific! It made funny allusions to the wizard of oz and the plot / dialogue was quite clever. I'm sure it was amazingly fun to write the play and see it pan out on stage! I'd love to know how to do that! Then went up to the top of the Rockefeller center, which is a terrific view, a little more shopping and then to the Hudson Hotel for dinner (they do lovely steaks, and the dessert portions are enormous!). The rest of the night was a little dodgy, as we went to two bars on different sides of town but they weren't very club-y. A friend of mine joined us, as well as one of the more laid back attendings and some lads also on vacation who my Irish friend knew.<br /><br />Thursday - Thanksgiving, hurrah! We stayed in bed the whole morning, didn't even watch any of the Macy's parade, had a bit of brunch and I went back to sleep while the two girls trudged through central park. Had Thanksgiving dinner at Tavern on the Green, which I was glad to go to as the decor was interesting / funky / a little tawdry?, but don't think I'll be going back there again. The queue for those who had reservations was 45 minutes! On the way out, i got waylaid by a lady who said I had terrific karma (what does that mean exactly?!) and gave me her business card, for some tarot / psychic thing. But perhaps it was true because the Chase 1 in 500 free worked to my advantage that night!<br /><br />We chilled for a little, and then I thought it'd be a great idea to go to woodbury commons for some black friday midnight shopping. Well apparently, so did a million other people because traffic to there was nearly standstill for about 3 hours. It took us 4.5 hours in the car to get to this place and there's no where to turn around to go back! On a normal day would take 1 hour. So after getting there at 3:30 am, at least my friends got tons of shopping done and everyone came back wrecked, but happy. That is definitely something i will avoid in the future, I will pay higher prices like everyone else :).<br /><br />After coming home at 9 am, we slept for a couple hours and back to 5th ave / madison ave for some further shopping (notice a theme here?). New York is absolutely amazing for shopping, you can basically find everything here! since being here, I have definitely contributed to the profit margins of Bed Bath and Beyond and well as Banana republic (I must like B's) I've spent so much it's ridiculous! and I still don't have all the christmas presents ready! From what I saw and the amount my friends got, america is not going into recession this Christmas at least! Then we had dinner at this absolutely fabulous westernized asian/fusion place called Phillipe's, which I am definitely going back to.<br /><br />Unfortunately, the holiday came to a close and after some last minute shopping, my friends returned home with very full bags and emptier wallets. But we fit in some tourist attractions, sight-seeing, good restaurants, Broadway shows and a lot of shopping, so all-in-all a very productive trip! I wish I didn't have to work so I could just spend all my days going to see all the Broadway (and off-Broadway) shows, museums, wandering around central park and doing some training for once, but 'tis not to be. At least I'm in the city where everything happens, so maybe eventually!<br /><br />Back to it tomorrow...dun dun dun....The Messy Medichttp://www.blogger.com/profile/01237665687331329251noreply@blogger.com0tag:blogger.com,1999:blog-14639174.post-31803761564022448022008-11-30T23:24:00.003+00:002008-11-30T23:37:49.753+00:00Nuts!I spent the first two weeks of November at in Harlem for my first rotation there. That place gets nuts! The first day wasn't actually too bad, as it was the day of the NYC Marathon and surprisingly, we didn't get that many patients.<br /><br />However, that was the only quiet day. But even though it got hectic, most attendings took everything in stride and handled the patient load well. They've got some people who can run an ED well, and it makes such a difference. They have a sicker population, which was interesting. Did a few NG lavages which became a funny situation, as they recently got a supply of new equipment and it took ages to try to figure out how to get suction, so we're running through all different scenarios while this guy has a tube hanging out his nose.<br /><br />I had an interesting patient who was perfectly lovely except for seeing demons / creatures on the walls. I actually became irritated at the attendant who kept repeating "the pt's crazy, everyone knows it, the family knows it, just crazy!" But the patient was very with it except for the seeing "evil," poor person. I hope they found a cause.<br /><br />My last shift was absolutely pressing panic buttons. All was grand until about mid-morning when all of a sudden, sick patients were coming in at the same time. I was looking after a patient who I realized could be very pausibly having a brain bleed as I was interviewing him/her, and the attending at the time (who I get along well with and said some nice things about me) also had a couple sickies and as we were making plans, the CT machine went down. So then I spent about 3 hours trying to transfer them to another facility to have a CT, meanwhile checking every 5 minutes to see whether my possible brain bleed was still stable and the attending and I debating on whether we should do the LP or not without a confirmed bleed. We ended up doing the lumbar puncture with no complications, to our great relief.<br /><br />And then I dashed home to hop on a plane to Dublin for the beginning of my holiday!The Messy Medichttp://www.blogger.com/profile/01237665687331329251noreply@blogger.com0tag:blogger.com,1999:blog-14639174.post-80767278581758037922008-11-30T22:53:00.002+00:002008-11-30T23:24:02.175+00:00I don't want to do medicine anymore!... just kidding, but I'm just finished two weeks of holidays and the thoughts of going back to work are depressing!<br /><br />In October, I was doing ER at my home hospital, which can be not-so-pleasant for a number of reasons. First, I need to do a lot more reading and studying because there are some areas I don't feel very comfortable in, but having time to do said studying is proving impossible since first years are assigned 20 shifts a month. A lot of your "days off" are actually spent trying to recover from night shift before you have to switch schedules again. I don't mind shiftwork, but it can make it difficult to plan things and use your time as effectively as if you had a patterned week.<br /><br />Also, I'm finding myself beginning to get cynical, especially with regards to my home hospital and society in general. I think it's a bit scary, especially as I'm only 5 months into residency. The patient population here I find can be a little irritating. Probably a lot of things I write are going to be quite un-PC, but c'est la vie. I am constantly amazed by the number of people who do nothing to help themselves. This varies from refusal to learn English even after being in this country for a number of years (then wondering why doctors have no clue what they're trying to say, even with those damn interpreter phones which I am startin to hate) to coming in with severe asthma exacerbations because they ran out of medications 2 weeks ago (why they hell didn't you see your doctor 2 weeks ago and save yourself this mess?!) to foul-smelling nearly gangrenous cellulitic legs which are going to need amputation but could have been saved had they presented when it first started. When asked why, all you get is a shrug of the shoulders and a non-committal "I dunno." I feel we should make billboards telling the general public that medicine is not a magic wand, there are no quick fixes and we can't make their serious conditions disappear without any consequences.<br /><br />Also, a hell of a lot of people flood the EDs for no reason. What part of "emergency" do people not understand? The cold that started yesterday does not warrant a visit! No, we do not give medicine to everybody! Your papercut is not a fucking emergency! Then they start complaining about the long waits or the fact that we aren't "doing" anything because they were expecting some pill. Wish we could hand out placebo pills. Wish we could turn people away at the door for things that do not need to be seen. And to top it off, the hospital gives free subway cards to patients on request, so some even make up conditions just to get the card! I just really can't stand it that these people are getting free healthcare and are the most ungrateful people I have seen, looking for the next free thing they can get from the hospital and complaining while they do so.<br /><br />My friends know that one of the things I value most in people is if they treat others well, have a bit of ambition and put a little effort in to achieve their goals. The exact opposite is what I see on a daily basis and it's grating to constantly see that society and have words fall on deaf ears. Some of it is miscommunication between doctors and patients, but at the same time, we cannot make people look after their own health / life.<br /><br />Anyway, when the free emergency healthcare system works for patients who actually need it, it is very rewarding. I estimate that happens about 60% of the time and 40% was probably preventableThe Messy Medichttp://www.blogger.com/profile/01237665687331329251noreply@blogger.com0tag:blogger.com,1999:blog-14639174.post-35343730704888261462008-10-01T02:48:00.002+01:002008-10-01T03:04:34.803+01:00Things are better and brighter!<p>Mainly because I think I rid myself mostly of the roach problem :). I still see a couple sometimes, but I figure I just have to fog every once in awhile and it'll be ok. </p><p>So I'm now two rotations down, but I fear they were my easiest ones! </p><p>August was Peds ER which I surprisingly found myself enjoying, since as a student I held kids out at arms length and didn't want them near me! But I had fun for the most part, except when asked to stay 1.5 hours overtime to "supervise" the other peds residents doing lacs (how f-in ridiculous! just because I'm 2 months into ER does not mean I'm expert at lacs, and why the hell can't the more senior residents or the attending supervise?!). And also when playing mind games with some of the peds residents who get lazy and try not to see any patients and shove it on you, or when they don't manage ER cases properly. Once, I actually shouted at one of the residents, took 3 of his cases from him and told him which case to take, then took another 2 at the same time and cleared the ED in an hour after that. The attending loved it, but I was like "That is NOT my job, that's YOURS." Of course I didn't say that :). I was lucky with nurses too cuz one of them would shout publically, "You're not to take that case, there are other people SUPPOSEDLY working here too!" hehehehe!</p><p>But I'm just venting. Most of my frustrating with peds was working with my co-workers, not the actual cases coming in. It's nice and chilled in our peds ED although it can get really hectic at times. Still, it's got a more uplifting feel than our adult ED, and I don't know why that is. Maybe because you can have a quicker flow and faster dispositions in peds. I really enjoyed playing with the kids and using little tricks to get them to respond to you. It's especially rewarding when they wrap their cute little arms around your legs to give you a hug afterwards. </p><p>Then in September, I had CCU at one of our peripheral hospitals. That was pretty chill too with downtime during the day (most days). The only problem is that it's a long commute. At least 40 minutes in the car, about 2 hours by public transport. Fortunately I was able to grab a lift from a friend of mine (who was late more often than not, heh!) but I was getting up at 5:30 to be there for 7, and when I had to get public transport, I got up at 4:30 and wouldn't get home til 9. The first couple weeks were tough because I didn't really know my job description and didn't seem to be having any responsibility, plus learning an outdated computer system. But definitely the last two weeks I could see my input into the team and pre-empt orders, etc. I learned a bit, but I'm not sure how much was relevant to my own training. Some on pressure support, swan-ganz which i still need to read on, but what was really cool was learning how to do a bedside Echo. </p><p>Anyway, back to ER at my home city hospital and I've got a fairly good schedule - mix of nights, peds, etc. And no getting up ass early and leaving really late! Hopefully I'll now have more time for gym and study. I just bought a new bike too so I can't wait to have a go in central park! </p><p></p>The Messy Medichttp://www.blogger.com/profile/01237665687331329251noreply@blogger.com1