My alarm clock is going off in 7 hours. Decisions. Decisions. At one point this morning (during a somewhat painful lecture) all I could think about was crawling into bed. Which, was a bad idea because I was fighting falling asleep. It's like when you have to pee really bad and you keep thinking of running water, or how good it will feel to finally pee!
Oh, so my decision. I came home from clinic and then had a great chat with a dear friend who is in London, and soon moving to Edinburgh to take up a post in an emergency medicine training program. Then I proceeded to piss away most of the evening thinking about all the things I have to do, and how little time I seem to have right now to get things done. While I was grabbing a box to pack, I decided I needed coffee, which made me think I should go visit a friend of mine who works at Starbucks, and since I was leaving the house, decided I would go to the gym as well.
So, what I've really been doing is procrastinating. "No shit Sherlock!" I heard you think it. But, the real question is why. Well, because in my passive-aggressive nature with the bastards who live next door, I have decided that I will stay up late to finish packing, and getting my desk and tables taken apart, playing some music, and no doubtedly making noise. Pathetic, I know.
The only foolish part of this plan... I'm on call tomorrow night. Oye!
I'm going to rethink this while I make my lunch for tomorrow.. I hope that in the grownup tells the rebellious teenage to go to bed..
PS-this is my last night in the apartment.
The phone number 413-592-.... is history as if March 1.
Cheers,
B
Monday, February 27, 2006
Saturday, February 25, 2006
Free Will Astrology & Black Clouds
Aquarius Horoscope for week of February 23, 2006
There was an indignant uproar after revelations that James Frey's bestselling memoir A Million Little Pieces contains fabrications. Hearing about it prompted me to ruminate on whether there's any such thing as a completely accurate account of any person's life. My conclusion: no. In every autobiography and biography ever written, the author imaginatively strings together selectively chosen details to conjure up artificially coherent narratives rather than depict the crazy-quilt ambiguity that actually characterizes everyone's journey. If you and nine writers set out to tell your life story, you'd produce ten wildly different tales, each rife with subjective interpretation, misplaced emphasis, unintentional distortions, and exorbitant extrapolations from insufficient data. Your assignment this week, Aquarius, is to celebrate the malleability of reality. Regale listeners with stories about the time you worked as a pirate in the Indian Ocean, or rode the rails through Kansas as a hobo, or gave Donald Trump sage advice in an elevator.
Get on freewillastrology.com. It's worth the laugh. Scarily, it can be true sometimes. Even though I am post call tonight (and took a 20 minute nap at 6am), I think I need to go out tonight, break some cabin fever. I may spend the night coming up with as many tales as possible..
So, I was a black cloud again last night. 6 admissions! We'd been averaging 1 a day, occasionally 2, and yesterday a whopping 6, 3 of which were transports that I did. So, from 3pm til 1am I was mostly out of the hospital picking up kiddos. People are glad I only have one call left in the NICU!
There was an indignant uproar after revelations that James Frey's bestselling memoir A Million Little Pieces contains fabrications. Hearing about it prompted me to ruminate on whether there's any such thing as a completely accurate account of any person's life. My conclusion: no. In every autobiography and biography ever written, the author imaginatively strings together selectively chosen details to conjure up artificially coherent narratives rather than depict the crazy-quilt ambiguity that actually characterizes everyone's journey. If you and nine writers set out to tell your life story, you'd produce ten wildly different tales, each rife with subjective interpretation, misplaced emphasis, unintentional distortions, and exorbitant extrapolations from insufficient data. Your assignment this week, Aquarius, is to celebrate the malleability of reality. Regale listeners with stories about the time you worked as a pirate in the Indian Ocean, or rode the rails through Kansas as a hobo, or gave Donald Trump sage advice in an elevator.
Get on freewillastrology.com. It's worth the laugh. Scarily, it can be true sometimes. Even though I am post call tonight (and took a 20 minute nap at 6am), I think I need to go out tonight, break some cabin fever. I may spend the night coming up with as many tales as possible..
So, I was a black cloud again last night. 6 admissions! We'd been averaging 1 a day, occasionally 2, and yesterday a whopping 6, 3 of which were transports that I did. So, from 3pm til 1am I was mostly out of the hospital picking up kiddos. People are glad I only have one call left in the NICU!
Thursday, February 23, 2006
Where do the Children Play?
I was in clinic this afternoon, talking to one of my favorite 11 year old patients, and her mom. She's bilingual, and mom's english is way better than my spanish. We have a good time chatting, I like to practice my spanish, and mom likes to practice her english. Her english is better than my spanish. When I told them that I needed to improve my spanish quickly for my trip to Peru, she smiled and said that I'd be fine. (Or, at least that's how I was interpreting it. Which reminds me of a funny story from South Africa, which I don't have time to tell right now)...
Anyway, the whole family (mom/dad/bro/sis) are from Puerto Rico, and have had quite a few struggles, but they are so happy, and nice. My pt (pt=patient), is, quite frankly, obese. Her BMI last time I checked was 40 or so. We were exploring how she could be more active. She takes the bus to school. She can't play outside because they live in an unsafe neighborhood. Mom doesn't even want her walking up to the top of the apartment building for exercise because there are some shady characters in the building... I sat there thinking two thoughts. 1) when we were kids we went everywhere outside, how lucky were we. Remember riding bikes to Chatfield Reservoir? 2) What kind of fucking society are we living in where kids can't get outside to play safely. Poverty. That's a fucking societal disease. Obesity is one of its many byproducts. ARGH!
[Where do the Children Play? => Cat Stevens Song]
Anyway, the whole family (mom/dad/bro/sis) are from Puerto Rico, and have had quite a few struggles, but they are so happy, and nice. My pt (pt=patient), is, quite frankly, obese. Her BMI last time I checked was 40 or so. We were exploring how she could be more active. She takes the bus to school. She can't play outside because they live in an unsafe neighborhood. Mom doesn't even want her walking up to the top of the apartment building for exercise because there are some shady characters in the building... I sat there thinking two thoughts. 1) when we were kids we went everywhere outside, how lucky were we. Remember riding bikes to Chatfield Reservoir? 2) What kind of fucking society are we living in where kids can't get outside to play safely. Poverty. That's a fucking societal disease. Obesity is one of its many byproducts. ARGH!
[Where do the Children Play? => Cat Stevens Song]
Tuesday, February 21, 2006
Not Going to be a Neonatologist
Why I’m not going to be a Neonatologist.
2 years ago, I thought there was a chance I may be interested in neonatology...
Kids are great. I like seeing kids--in clinic, on the pediatric ward, running through departments stores causing holy terror (I was that kid). For me, the best part of working in medicine are the people. That’s what I love about my program, the people here are genuine. American. Polish. Mexican. Russian. Puerto Rican. Somali. White. Black. Male. Female. Infant. Elderly. Teens. Gay. Straight. Homeless. Poor. Middle class. Upper class. And everything in-between. They ALL have a story to tell. My last ward month, the attending would ask, “What the story with your MI rule out in bed 352?” That “MI rule out in bed 352” was a recent Egyptian immigrant who was unemployed, trying to provide for himself, his wife, and his daughter, and was worried sick that this hospital visit was going to further ruin his meager financial picture. My attending didn’t know this. I did, I wanted to know WHO this guy was that I was taking care of. With kids, it’s a short story, and you get the parent’s story as well.
That’s the problem with the NICU. These kids don’t have a story. Well, they do, it just happens to be short. (Hi, I’m bobby. I was conceived 7 months ago after a drunken night on the town, my mom had high blood pressure while pregnant, and I was born way too early. I’ve been in the NICU for 45 days). Granted, the parents have a story, but I find it hard to connect with the parents in the same way that I can connect with the parents of kids on the pediatric ward, or the parents of kids I see in clinic. And for this reason, I’m not going to be a neonatologist, I couldn’t do this stuff daily for the rest of my life. I do, however, want to be a doc who is competent and comfortable stabilizing these kiddos until I can get them to a NICU...
Realizing this issue last night brought quite a bit of clarity.
2 years ago, I thought there was a chance I may be interested in neonatology...
Kids are great. I like seeing kids--in clinic, on the pediatric ward, running through departments stores causing holy terror (I was that kid). For me, the best part of working in medicine are the people. That’s what I love about my program, the people here are genuine. American. Polish. Mexican. Russian. Puerto Rican. Somali. White. Black. Male. Female. Infant. Elderly. Teens. Gay. Straight. Homeless. Poor. Middle class. Upper class. And everything in-between. They ALL have a story to tell. My last ward month, the attending would ask, “What the story with your MI rule out in bed 352?” That “MI rule out in bed 352” was a recent Egyptian immigrant who was unemployed, trying to provide for himself, his wife, and his daughter, and was worried sick that this hospital visit was going to further ruin his meager financial picture. My attending didn’t know this. I did, I wanted to know WHO this guy was that I was taking care of. With kids, it’s a short story, and you get the parent’s story as well.
That’s the problem with the NICU. These kids don’t have a story. Well, they do, it just happens to be short. (Hi, I’m bobby. I was conceived 7 months ago after a drunken night on the town, my mom had high blood pressure while pregnant, and I was born way too early. I’ve been in the NICU for 45 days). Granted, the parents have a story, but I find it hard to connect with the parents in the same way that I can connect with the parents of kids on the pediatric ward, or the parents of kids I see in clinic. And for this reason, I’m not going to be a neonatologist, I couldn’t do this stuff daily for the rest of my life. I do, however, want to be a doc who is competent and comfortable stabilizing these kiddos until I can get them to a NICU...
Realizing this issue last night brought quite a bit of clarity.
Post-Call Mania (PCM for short)
I love being post call. It's the best part of being on call. The thought of working 24-30 hour shifts brings to mind images of pain and suffering of junior doctors. And while there may be lots of pain and suffering during those hours (hopefully on the part of the doctors, not the patients), post-call can be pleasant. For instance, I get PCM. I bet people released form prison or a bad evening with their in-laws get the same feeling. FREEDOM! I've suffered for X hours with little contact with the outside world, in an environment, which I may or may not like, but one which restricts my freedom. Now that I'm free, I'm going to make up for "wasted" time. (I say "wasted" cause while I don't consider being on call "wasted" time, it is time at work, and in my mind that's time that I can't be doing all the other things that I could be doing if I were a trustifarian. PS, Dad if you're reading this, I'm not bitter about not being a trustifarian).
So, this is how my mind works. Regardless of how much or how little sleep I get on call, about an hour before freedom, I begin to make a mental list of all the things I can get done as soon I get in my Jeep. This can be difficult when nurses are trying to interrupt me to tell me that some kiddo looks kind of blue, but being a doctor is all about multi-tasking...
So, today this is my list:
1) Run home, get gym bag and first load of stuff to take to new flat
2) Get coffee
3) Drop off stuff in new flat
4) Organize, in my mind, how I'm going to arrange furniture in the new flat
5) Go to the gym
6) Check PO Box
7) Wonder where to get coffee next
8) Back to work (ARGH!) to pick up a box of oranges that I ordered
9) Still thinking about coffee
10) Call Jay and Jen-partners in crime, make plans for coffee, shopping, lunch.
11) Update blog
12) Write down rest of things to do: Buy shoes, clean apartment, make lunch for tomorrow, research peru trip, work on international health project for work, go out for coffee, read all of my 2000 page pediatric text, read all of my 1700 page medicine text book, go out for coffee, clear out my email inboxes, write a few letters, read the 4 books that I've been meaning to read for ages-while having more coffee, develop film, find a marathon to run, write a letter to my former dentist telling him he has no ethics. And this is just the list BEFORE dinner.
See! PCM! What's going to really happen... not much :)
Cheers,
PS, I just realized today is TUESDAY!
So, this is how my mind works. Regardless of how much or how little sleep I get on call, about an hour before freedom, I begin to make a mental list of all the things I can get done as soon I get in my Jeep. This can be difficult when nurses are trying to interrupt me to tell me that some kiddo looks kind of blue, but being a doctor is all about multi-tasking...
So, today this is my list:
1) Run home, get gym bag and first load of stuff to take to new flat
2) Get coffee
3) Drop off stuff in new flat
4) Organize, in my mind, how I'm going to arrange furniture in the new flat
5) Go to the gym
6) Check PO Box
7) Wonder where to get coffee next
8) Back to work (ARGH!) to pick up a box of oranges that I ordered
9) Still thinking about coffee
10) Call Jay and Jen-partners in crime, make plans for coffee, shopping, lunch.
11) Update blog
12) Write down rest of things to do: Buy shoes, clean apartment, make lunch for tomorrow, research peru trip, work on international health project for work, go out for coffee, read all of my 2000 page pediatric text, read all of my 1700 page medicine text book, go out for coffee, clear out my email inboxes, write a few letters, read the 4 books that I've been meaning to read for ages-while having more coffee, develop film, find a marathon to run, write a letter to my former dentist telling him he has no ethics. And this is just the list BEFORE dinner.
See! PCM! What's going to really happen... not much :)
Cheers,
PS, I just realized today is TUESDAY!
Friday, February 17, 2006
Moving
Moving #1:
So, I'm moving out of my flat. It's like a relationship gone bad. Love at first sight, then realized there were a lot of things I can't stand. I can't stand the noise from my neighbors, nor the cost of heating this place (flashbacks of Dublin). So, I'm breaking my lease and have found a top floor apartment with no neighbors, and only one person below me. Moving is going to be a drag.. C'est La Vie. The location is nice, it's about 10 minutes to work, and about 3 minutes to the gym. A bar close by boasts being one of the areas greatest pubs.. I'm a bit skeptical, but what the hell, it serves Guinness!
Moving #2:
I went on my first NICU transport this morning (1 am). Smaller hospitals call us to go pick up sick newborns and take them by ambulance to our hospital. I thought I was just going along for the ride, since it was my first transport. Well, I was a bit freaked to find out (once I was in the ambulance on the way to the other hospital) that I was going to be running the show, and that the senior resident was there for moral support. It was one of those moments that made me remember that I am a doctor. I tend to forget this fact when going about the daily grind. Of course, what you have to realize is that this kiddo was relatively stable (though he did get dopamine when we got back), short transport time (30 minutes), and that the nurse and respiratory therapist are sharp! So it all went smoothly. The rest of the night was steady. I laid down in bed 3 times, but for never more than 5-10 minutes. Ah well..
I think that's about it for now.
Cheers,
B
So, I'm moving out of my flat. It's like a relationship gone bad. Love at first sight, then realized there were a lot of things I can't stand. I can't stand the noise from my neighbors, nor the cost of heating this place (flashbacks of Dublin). So, I'm breaking my lease and have found a top floor apartment with no neighbors, and only one person below me. Moving is going to be a drag.. C'est La Vie. The location is nice, it's about 10 minutes to work, and about 3 minutes to the gym. A bar close by boasts being one of the areas greatest pubs.. I'm a bit skeptical, but what the hell, it serves Guinness!
Moving #2:
I went on my first NICU transport this morning (1 am). Smaller hospitals call us to go pick up sick newborns and take them by ambulance to our hospital. I thought I was just going along for the ride, since it was my first transport. Well, I was a bit freaked to find out (once I was in the ambulance on the way to the other hospital) that I was going to be running the show, and that the senior resident was there for moral support. It was one of those moments that made me remember that I am a doctor. I tend to forget this fact when going about the daily grind. Of course, what you have to realize is that this kiddo was relatively stable (though he did get dopamine when we got back), short transport time (30 minutes), and that the nurse and respiratory therapist are sharp! So it all went smoothly. The rest of the night was steady. I laid down in bed 3 times, but for never more than 5-10 minutes. Ah well..
I think that's about it for now.
Cheers,
B
Sunday, February 05, 2006
NICU Black Cloud
So... The NICU staff have determined that I was the black cloud for yesterday. Apparently it's not normal to be called to 11 deliveries in one 24 hour period. That's how the day went. Granted, some of those babies were fine, but quite a few made the trip up to the NICU. It was a long 25 hours, but I did manage to get a tad more than an hour of sleep.
The thing I don't like about being on call on Saturday is that it kind of ruins the weekend. I have a bunch of errands to get done today, not too sure it will be a productive day though. Ah well.. I usually try to stay up on my post-call days, and then just hit the sack early, but can already feel the fatigue setting in.
Cheers,
B
The thing I don't like about being on call on Saturday is that it kind of ruins the weekend. I have a bunch of errands to get done today, not too sure it will be a productive day though. Ah well.. I usually try to stay up on my post-call days, and then just hit the sack early, but can already feel the fatigue setting in.
Cheers,
B
Friday, February 03, 2006
Running, Skiing, NICU
I went running, outside last night. I haven't done that in ages. Couldn't fight traffic to get to the gym, and needed to get out, run, expend energy, clear my mind, get an endorphin release. A while ago I decided I would run outside once a week, and well, this was the fist time that I was did it. It wasn't the same as dublin. I pictured myself running down familiar roads in Dublin. Watching people on buses. Running past people in the rain, knowing they looked at me as if I was crazy. I haven't done much "running" lately. The treadmill at the gym, to me, doesn't count. Sure I can run sprints and nice uphill stretches, but I'd rather be running in a city. Or a trail.
I went skiing Tuesday and Wednesday at Mt. Stowe in Vermont. A friend of mine busted his leg, and needed his condo cleared out, so I was happy to head up there with some friends for a few days of skiing. It was great. Beautiful mountains. Hard skiing. Going to bed exhausted, body still feeling like I was on the slopes...
I started in the NICU today. It's going to take a few days to get use it. Should be interesting. Lots to learn. I'm on call tomorrow, so it may be a bit of a long day.
This is short. I need to get some reading done to hopefully make tomorrow a bit smoother.
Cheers,
B
I went skiing Tuesday and Wednesday at Mt. Stowe in Vermont. A friend of mine busted his leg, and needed his condo cleared out, so I was happy to head up there with some friends for a few days of skiing. It was great. Beautiful mountains. Hard skiing. Going to bed exhausted, body still feeling like I was on the slopes...
I started in the NICU today. It's going to take a few days to get use it. Should be interesting. Lots to learn. I'm on call tomorrow, so it may be a bit of a long day.
This is short. I need to get some reading done to hopefully make tomorrow a bit smoother.
Cheers,
B
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