Friday, February 29, 2008

Trouble #1

Wow, very late.

Night #1 of trouble (not with the law). Just up to no good...

PS, if I were to get in *real* trouble (Brian in Seattle) you're going to be the first person I call...

Thursday, February 28, 2008

"Stay Outta Trouble"

The secretaries at work know me way too well.

I went to work for lunch today. Yeah, it's true. I have money on my work ID for food, and didn't have money in my wallet and if you read yesterday, you know I have no food at home. So I went to work for lunch. (I did work this morning, at the other hospital).

I was sitting with our secretaries in the office, cause they are good fun. I don't recall much of the conversation, but I think I told them I wanted a tattoo, I want to have electrolysis on my chest (there was a demo at the gym yesterday), that I have the most gorgeous niece, nephews, and godchildren (and then showed them the most recent pictures), that I found a flight to San Francisco for the weekend-but it required me to call in sick to work tomorrow and I knew that would place me on their bad side, I also told them that this area is one of the many waste-lands of America and that there were many ideas floating in my head about how to spend the next few days..

"Brian, stay outta trouble."

We'll see.

Wednesday, February 27, 2008

Emergency ACLS

The emergency is that I am *gasp* OUT OF COFFEE. I'll let you in on a dirty little secret: I am also OUT OF INSTANT coffee. There you have it. Yes me, the coffee snob/purist/addict is out of the pure form (coffee beans) and the crack form (instant). Look, I have instant because I take instant backpacking... I can't muster up the energy to go buy coffee beans. I am beginning to HATE this time of year. It's been so damn cold out that the only traveling I want to do includes going to work (well, I don't want to go to work...), going to the gym, and getting back home. Argh!

ACLS: I recertified my ACLS today. I may have mentioned that after surviving a month in the CCU, that should qualify me as recertified for ACLS. (Advanced Cardiac Life Support). Well, as I got out of the Liberty this am, who did I see walking in to the class... My attending from the CCU! Who is such a great human being, that he made the first 2 weeks of CCU fun. (Fun?being in the CCU may not have really been fun, tolerable is probably a better term for it).

Me: "You teaching today?"
Him: "Nope, they are making us recertify."

Ok, this guy isn't just a cardiologist, he is an EP specialist-electrophysiologist.. when the heart doesn't conduct right, he fixes it.. Him taking ACLS is like an engineer playing with tinker toys...

Monday, February 25, 2008

Insomnia has its benefits

I don't know why I'm still up. Sometimes it just seems pointless to sleep...

LL is BUSTED!

I told KZ last night that I was going to join AA. For the wrong reasons. I don't think I have a drinking problem, and aside from New Years Eve, I can't even recall the last time I had too much to drink. Though, maybe the reason I can't recall the last time I had too much to drink is, because, I had too much.. But one tends to not forget the hang-overs. Anyway, I am well within my 14 drinks-a-week limit of acceptability. Oh, so I wanted to join AA to meet new friends. I have plenty of friends here, but most are work related. I've kind of lost contact with most the gays that I use to be friends with--though, the grapevine keeps me well informed of who is sleeping with whom, who is backstabbing whom, and I know who has which STDs! So, Friday night I thought long and hard about my fun days in Dublin, being out til the wee hours of the morning, doing crazy shit with HW (I called to make sure we actually DID the stuff I was thinking about), and decided that it was time to meet some fun people again. I'm sure people in AA must be FUN! Or at least have great senses of humor and good stories...

So, I'm trying to figure out if the whole 12 step process is going to be a tolerable cost to getting a new group of friends, when my pager goes off.

Ah-hah.
That's why I knew it was better to waste time on-line than go to bed. Had I gone to bed, I would have been annoyed by the page I received.

I'm the on-call doc for clinic right now. I just got paged about LL. The insult is that the page identifies who the patients primary care doc is, and LL's mom (he's 2) didn't know who his doc is. IT'S ME! Didn't know because they haven't been to the CLINIC in quite some time. He's missed multiple visits. It's like a sting operation! This is good stuff. He has a cold, and she pages me at 12:30 AM for a "fever" of 99.3. Perfect time to harass them to coming back to the clinic so LL can get his missed shots, and of course to make sure he is growing/developing normally.

And now back to searching for AA groups...

Sunday, February 24, 2008

Ellis Paul

Last night, KZ and I went to see Ellis Paul perform..

It was the second time I have seen him in concert. Such an amazing experience. I sat there in awe that this guy is spending his days living his passion, doing what he wants, likely just barely getting by. Taking a risk to follow through on dreams. Living his life. That's amazing. His music is, at times, raw emotion about life, about love, about the damn inequities that fuck up the world. Pretty amazing stuff. And he's fucking great in person as well. He gets it. He wrote The Ballad of Chris McCandless, way before Into the Wild was made into a movie.

I'm turned on by people Who Get It. That life is an active process. It's about taking risks. It's about speaking out. It's about knowing what you want and going after it. It's about knowing that you may fall fucking flat on your face, but at least you tried.

Seriously, buy an Ellis Paul CD. Get a nice cup of tea (or wine) and dim the lights and just listen to the lyrics of this man. You won't be disappointed!

Friday, February 22, 2008

Normandy

A bottle of wine
Camembert cheese
Comfortable restaurant with ambiance
A bit of calvados.

That's where I'd rather be right now...

It's snowing out
I don't want to leave the cosy confines of my own apartment
I'm on jeopardy call for pediatrics
I'm not in Normandy.

Bummer.

Wednesday, February 20, 2008

5 Stars

Today is a 5 star day. (out of 5)

I had a great morning in clinic, seeing kids w/ juvenile arthritis. My attending harassed me for missing grand rounds yesterday. I guess she asked out to the audience yesterday where I was sitting, and of course I wasn't there (I was at the court house). Afterwards, she made a point of going to the Pedi program director and saying that she enjoyed having me in clinic (she is the type who would never admit it to me in person, the pedi program director told me the conversation this afternoon). But this woman is awesome. She -CARES- about her kids. And in fact we saw a kid today who came in for a second opinion, and my doc plans on taking over care of this kid because the other docs aren't doing such a great job...

Then, this afternoon I got pulled from clinic to fill in and teach second year medical students. I got to listen to pt presentations and then go to the bedside and teach physical exams. It was so fresh seeing second year med students who are eager to learn. And it was fun to be able to have dedicated time to teach.


Now I need to put away groceries and get ready for a presentation tomorrow..

Monday, February 18, 2008

Jury Duty

Yipee-

I get a day off of work to participate in Jury Duty. I have been waiting for this for a long time! I get to participate in my civil duty. I am hoping for at least a 3 week trial. I could use a mini-vacation from work.

Sunday, February 17, 2008

Sunny days, sweeping the clouds away..

Stop what you are doing
and click on
(thanks to SYC for the clip)

Shriners

I'm about half way through this month. And this month I am at one of the Shriner's Hospitals. I'm working with the pediatric rhematologist (mostly) so am seeing kids with juvenile arthritis, lupus, and other assorted conditions. Also seeing kids with osteogenesis imperfecta (aka brittle bones). I spend a bit of time in the orthopedic clinics, and see kids with other bone anomalies.

It's been a great month thus far since we don't get a whole lot of exposure to these kids elsewhere in our training. It's also nice from a med-peds perspective because the will affect these kids when they are adults.

Tuesday, February 12, 2008

A Place to Live...

A small shot of reality.

Yesterday I wired money to South Africa, and paid 2 months rent. I won't go into all the lavish details of where I'll be living.. but it looks great.

I'll confess, that I did pass up the place that has 3 times a week maid service, who does not only the washes clothes, but also IRONS! But, went for the cheaper place, which looks a bit bigger, and a friend has stayed there and so it comes highly recommended.

The only major tasks are getting my visa and buying my ticket. (There's a huge list of minor tasks...)

Good stuff.

Monday, February 11, 2008

A few pics...


Home Sweet Home

Sorry Ryan, this pic will haunt you...



(click to advance pictures)

Not Figuring It Out...

Aquarius Horoscope for week of February 7, 2008
[Courtest of Free Will Astrology]

"To be young, really young, takes a very long time," said Picasso. I agree. It's not easy to hone your ability to see the world fresh over and over again. You've got to work for years to immunize yourself against the millions of people who think they're got everything figured out. To cultivate an ingenious and fully awakened innocence, you have to continually shed your temptation to rely on habitual responses, never ceasing from the effort to greet every experience with a beginner's mind. This playful approach to life goes against the grain of every religious teaching, every political system, and every ideology, which means that only the fiercest individualists with a highly developed sense of self can summon the courage to do it. It so happens, Aquarius, that you're now primed to make rapid progress in this noble undertaking."

Wwwow.

What a great quote, and great thought.

Kind of topical right now in life. Trying to figure things out less, or trying to spend less time figuring things out, trusting that somehow life works out, and just taking time to look at things anew. Seeing people in a new light. Seeing places in a new light. Seeing future plans in a new light. Even seeing work in a new light, well thanks largely to an amazing book I read the past few days (Better, by Atul Gawande).

I have found myself recently shedding thoughts, plans, ideas that I've had for a long time. I planned a life, back before leaving for medical school. I knew what I wanted to do when I finished residency, where I wanted to live, etc etc. I thought I had it figured out. But, life has changed a lot since 2000, and only for the better. And thankfully, I'm learning how to erase long-term plans, and being open to things I hadn't ever considered...

Enough said.
It's way too late to be up.

4 Day Retreat

More to come (with pics)...

I snuck away for a few day. Well, actually had to use 2 days of vacation, so can't say I snuck away, they knew I wasn't going to be at work.

I'll get some pics up here in a few days.

Wednesday, February 06, 2008

Progress.

Finally.

Got through to my contact at the South Africa Medical Board. After almost 2 months of trying to figure out the delay in getting my medical license, only 2 things are missing. One is a document that was emailed back in the fall. The other is a fee for the license.

One last hurdle-applying for the visit... And that should be done in April.

Woah... This crazy idea that started almost 8 months ago is really going to happen.

Tuesday, February 05, 2008

Randon Quote

"The man who sticks
to his plan
will become
what he used to
want to be."
-James Richardson
Ponder that over some nice coffee folks..

Friday, February 01, 2008

Worth It

This made my NICU month worth it
2 hours last night of just holding Baby O
She was delivered on my first call this month
And she's going home today
She's healthy
And has wonderful parents

I love the NICU, but this month I took a beating. I was the resident, who because of call and clinic schedules, worked alone most days from noon onwards, managing upwards of 18 kids at the busiest. The best part of this month was watching kids get better.

Sunday, January 27, 2008

Sunday Call

It's my second to last call ever in the NICU. And I have mixed feelings.

I would rather be fast asleep in bed, and then go for coffee and read the Times and have brunch w/ friends... but weekends in the NICU (while they can be outta control) are often not too bad.

When I left on Friday, I had 15 babies. I know there have been a few more admissions since then. So, I'm sure the list it at 17 or so by now. It's going to be one of those busy days, I just have that feeling.

Wednesday, January 16, 2008

The Power of Lasagna

5:00 am- a feeling of total helplessness. A pH of 6.8 is almost not compatible with life. Holy shit this baby is about to die right in front of our eyes and our best efforts may not be enough. Work hard and fast and somehow this baby pulls though, at least as of this morning.

10:30-I'm a patient in my own clinic. More on this later. First visit to a primary care physician in years. Need a physical for my VISA application. I pick one of the clinic docs I work with. Role reversal....

1300-unwind in the gym.

1600-start prepping food for dinner tonight. Invited one friend over for dinner, and just kept inviting friends. People are tired. It's nice to just have some delicious lasagna and wine and relax. It's nice to just take a night off in the middle of the week, cook a nice meal and unwind with friends/colleagues. We all take joy in entertaining Karins 9 month old and 2 year old children.

It's one of those days which was set up with potential badness, but had ended with a group of friends taking a mid-week break and unwinding...

Maybe we should take a mid-week break more often. Maybe a Wednesday Lasagna night would go long way...

Sunday, January 13, 2008

Filling up the House

Friday, 9:30 am

"Well Doctor..." (whenever the chief of neonatology wants to banter, he calls me Doctor-we banter very well back and forth, much to the puzzlement of many of my co-residents who terribly misunderstand his great sense of humor). "you're not that busy this morning."

He wants to give us a lecture/tutorial this morning. I have raised a protest. I'm on call. The second year resident and I are covering the team, and thankfully she is here all day today.

The Chief is giving me a hard time. It's 9:30 am, and we've already admitted 2 new babies to the NICU, and Sarah is headed out in the ambulance to go pick up a newborn at a nearby hospital.

I kick into smart ass mode. "Well, I'm going to do my best to admit 7-10 babies today!! I guesstimate that we only have about 7 or 8 beds open right now. And I'm kind of in that invincible mood. I've been here a week. I have a 600 gram baby on an oscillator and a couple of kids who have other various troubling issues, a few more aren't really going to hurt!

He grins...

Friday 9:15 pm.
I am in a nearby hospital picking up a baby. This is our second trip here today. This will be our 6th admission in 12 hours.

I am NOT popular in the NICU. I hear mutterings of my black cloud returning... I also have a slight adrenaline rush every time my pager goes off. Since this am, we have been expecting a woman to deliver who is 23 weeks and 4 days pregnant. The parents want full resuscitation. I'm on the fence as to whether this is the right thing to do...

We arrive back to our NICU, baby/admission #6 in tow. "What's the rumor I hear your goal was to admit 7-10 kids today?" I can only grin. I fucking deserve it. Being a smart ass always gets me in trouble, and today I'm paying the price. It's non-stop. I'm tired. We haven't even done evening rounds.

I ask about the 23 and 4/7 baby. No word yet. Well, I profess, that will be admission number 7, then I've hit my goal for the day, and then I'm done.

Midnight. Orders from rounds are done.

3:30 am I go and look at the kids I've admitted today, and look at the babies I've been taking care of all month. It's just soothing watching sleeping babies..

I'm satisfied. And I make my way to my call-room.

My pager goes off at 6am. I don't even think, I grab my glasses and step into my clogs and start thinking what size tube I'll use to intubate this 23 and 4/7 baby. Is a 2.5 going to be too big? I'm in the hallway and I look to see what room the NICU code has been called to..

My page reads: "HI BRIAN! We're meeting in the medicine resident room and going for omelets. YUMMY! Hope you got some sleep last night. Come Join Us!" It's a page from Karin.

I page her back. I can get 15 more minutes of sleep or I can eat breakfast...

I vote for sleep.

Admission #7 didn't happen. For once, not hitting my goal is a good thing.