Blah(g)

Blah.

That's really about all I have to say. It's freaking COLD here. COLD. Miserable cold. Seriously, I can't get warm. I'm contemplating going to the doctor, I think my internal thermostat is broken. Trust me, it's NOT my thyroid. If I hear one more person tell me to have it checked, I'll scream. Ya know how old women always seem so bundled, shawls and all, that's me!

Developmental Peds is good. I'm learning about Autism, ADD/ADHD, growth, nutrition, speech delay etc. So that means, every time I see a kid I scrutinize them. Are they hitting their developmental milestones. Do they talk enough. Are they interacting appropriately? I must say, having spent an afternoon with speech pathologists, these people are SAINTS...

As usual, the month is coming to a close, and even though this is day #12 of the rotation (I had a few vacation days at the beginning of the month), I feel like I am behind in learning for this month. Where does the time go? Seriously folks?

I took off Friday afternoon to read for pleasure. How goofy is that? I had to make time to just read. It wasn't so much reading, but rather I escaped to an old mill located by a creek, where you can hear the water inside the book mill/coffee house and just chill. This place is kind of magical. Any guess what, I had perhaps the best cup of joe in months at this place. The first sip was magical. Sitting at an old wooden table, wrapped in my shawl, listening to the water, reading. Seriously folks, that was liquid crack.

Patrick and I saw the movie "The Queen" last night. It was good. Better than I had expected it to be.

Alrighty, I need to get some work done.

Hope your 2007 is off to a good start.
-B

Home Sweet Home

It's great being back here, finally. I've seen all the fam. The kids are so big. It's been a joy just watching them play, and playing with them. The snow it pretty crazy. The tiny rental car that I have is a death trap in the snow, so that's putting a wee bit of a damper on the travel/social schedule. But really, it's been nice to just hang out with family. Patrick arrived yesterday am, on schedule. He's beginning to realize that there really are Bost traits.. I don't think he should be allowed to hang out with Nikki and Janice, they have too much inside scoop on how to manipulate Bost men...

Final Countdown

Thank god, only 3 more days to go til vacation. Honestly, I don't think I could work more than 3 more days. . . Last week really wasn't much fun. I think I'd rather stick my tongue on a frozen metal pole, repeatedly, than work this much. Looking back, I certainly can say that for the first time, I felt that I was less than professional at times. I hit a cynical low point, and at one point had to bite my tongue (I don't know why I keep coming up with ways to hurt my tongue) so that I didn't call a patient by a term normally only heard on navy vessels and at truckstops. But seriously, I had taken care of this drug seeker for a few days, and then he disrespected me. I wasn't too thrilled. . . It's been interesting to see how I deal with these times of extreme fatigue. Part of me wishes I could re-do last week to see if I could shed some of the bitterness and irritability that was pervasive.

What's keeping me going. Honestly, I can't wait to see Jordan and Ryan and Haley. It kills me that it will have been a year since I saw them. A year. A fucking year. Give me the kiddos, piper and bailey, and let me spend the days with them.

So, it's Christmas eve.. I spent a good chunk of time this evening telling a 21 year old that the reason she couldn't breathe wasn't, in fact, due to pneumonia, but rather because she has a mass in her lungs. A mass. Not a good thing. She, and her family, will wake up in the ICU on christmas day, and the ONLY THING they will be able to think is, "IS THIS CANCER?" Cancer. Is it cancer? Merry Christmas.

Jesus, it is Christmas in 30 minutes. It doesn't seem possible. I haven't seen snow this fall/winter. What's up with that? I know that you people in Denver have seen plenty of it, but I'm dying to see some of it. Snow.

I guess that's about it really. My contacts are stickying to my eyeballs. My mind wants to stay up, maybe do some work, some xmas cards, call people on the west coast. But sadly, in 7 hours I'll be headed back to work.

Honestly though, waking up on Christmas morning, alone in my apartment, isn't bad. I'm waking up healthy, maybe suffering from fatigue, but my friends, my family, and my boyfriend are all waking up healthy, and hopefully happy. Really, what else could one want for christmas??

Half Way

-one day off in the past 15 days
-one day off in the next 15 days
-an empty fridge
-topics to review
-phone calls to make
-emails to write
-a stack of unopened mail
-no time to take shirts to the dry cleaner
-why hasn't it snowed yet?
-Ireland seems like 6 months ago
-what kind of medicine do I really want to practice
-a big city, or small mountain town

I started rounding at 6am.
I am going to bed.

-B

Fucking Bitter

This is bullshit. I'm working 29 out of 31 days. I am off today, and have one day off in the next 24. What the fuck kind of bullshit is this? I went to bed at 8:30 pm last night, fucking exhausted after putting in 30 hours in 2 days. What the fuck is the purpose of having a day off? It's not enough time to do laundry, grocery shop, make calls, emails, study, let alone spend time with Patrick.

Argh! I am not a happy camper today.

Now I'm getting on-line to finish discharge summaries from the past 2 days.
b

End of November...

Which means time for a change at the hospital. I am wrapping up Adult in-patient endocrinology, and will be starting Adult General Medicine Wards. It's going to be a busy month, but am looking forward to it in a masochistic way. Going to be lots of work, but should be good learning. Sadly, I only have 2 days off until I head home, so am not going to really have much contact with the outside world. I will be in Denver Dec 28th, until the 7th.

Cheers,
Brian

Happy Thanksgiving

It's my favorite holiday. Forget all the bullshit that comes with most holidays, TG (thanksgiving) is about being with family and friends (and sadly, sometimes about working). I hate to admit it, but I'm sadly disappointed that it won't be with my family. I'll be spending with Patrick at his Dad's house in West Hartford, along with his sisters who will arrive from DC and New York, and a few other family members (totaling about 9). I'm looking forward to meeting his dad, and the one sister whom I have yet to meet, but at the same time I know that Jason and Nikki will be having their family TG in Colorado, Kevin and Karena will be having their TG in Thailand, Dad and Janice with the Bost Clan in Lockport, and that I'll be here, with Patrick and his family. Don't get me wrong, I'm excited to be with Patrick, but in my mind, I would be spending my TG meal in the company of assorted friends who don't have family here... Kind of weird, I can't really explain it. Suffice to say, that if you are reading this, then you are part of the group that I wish could all be together on TG. May you have a wonderful thanksgiving.
-Brian

Back Home

Back from Dublin. Had a grand time. Aside from reading 3 books, drinking endless coffee, tea, wine, and the savory pints of Guinness, having lunch and dinners with friends, walking aimlessly among the old stomping grounds, I didn't do much. And that's the best part. The week flew by. It was exactly what I needed, and wanted. It was great to be able to catch up in person with friends. It was great to be in the buzz of a city again. Lots of people. Lots of cafes etc...

Anyway, now back to the real world. Enjoying a bit of a slower pace at work, learning about diabetes, and other endocrine stuff. Am doing medicine night float this weekend, and that's going to be interesting..

Am keeping this brief, trying to wrap up some studying before crashing for the night.

Cheers,
B

Outta Here!

I am packed, and thrilled to be heading out of dodge for a while. More thrilled, with the thought of visiting friends whom I haven't seen in ages, and also thrilled with the thought of having down time. Time to just sit and chill, walk around an reminisce. It's going to be good..
-B

Reading Time

I just want time to read. That's the thing that I crave the most these days. I have a huge stack of magazines, a new cook book, the new Mitch Albom book plus 3 other books that I've read a few pages of, all overflowing on my night stand and the side table by my reading table. I'm making time to read. That's a lie. I'm taking a vacation to read. All I'm going to pack for my trip to Ireland next week are things to read. "What are you going to do in Ireland?" people ask with regularity. Well, honest to god I plan to spend the days in cafes reading, and the nights in pubs socializing. It'll be nice to go back to a surrogate home where there's nothing touristy to do, but really it's forced relaxation, down time to read, to chill out. Giving my brain time to recoup. Take a break from the medical world, take a break from reading about patient conditions, about ICU management (not that I ever feel like I have read enough for work), and just relax with good books. I can't wait...

Low Point...

I hit the low point on-call last night.

Things just didn't go right. I had an hour-long family meeting with hyper-attentive adult children of a 70 year old lady (I don't want to go into details, ask me in person why I NEVER WANT TO WORK WITH WHITE UPPER CLASS FUCKERS), and then got nickled-and-dimed all night long 3 pain-in-the-ass nurses (the other 7 nurses were awesome as usual) . Sorry, I usually don't speak un-highly of nurses, but last night the surgery ICU resident and myself were starting to plot revenge on a couple of nurses who were the cause of misery.

The good part: while this was the low point of the month, my initial response was not to consider quitting residency, not to throw anything, not to punch, hit, spit, nor kick, but rather to realize that I am FUCKING exhausted. Mental Fatigue. Physical Fatigue. Emotional Fatigue. And the best part is that there is this one-week mentality. When you're down to the final stretch, it's all manageable. Had I hit the low point a week ago, you can bet I would have resorted to some less than mature coping mechanisms...

Know what I can't figure out. I work "80" hours a week. I know how residents in past worked 100+ hours a week (I did work 96 hours one week last year), what kind of quality of life was there back then. What kind of lack of balance was there... Jesus, I'd be a miserable SOB if I had to work those hours for more than a month, shit more than a week or two..

So, it's almost midnight. I came home this afternoon, slept about 2 hours, then went to see the Bare Naked Ladies concert with Patrick. What a great show. We had a good time.

Ok, getting up in less than 6 hours...
Cheers,
Brian

Random Thoughts

1-End of the Golden Weekend. Been relatively relaxing. Got very intoxicated Friday night. Was worth it. Thursday night on-call was somewhat painful, with only maybe 20-30 minutes of sleep, so going out and hitting it hard on Friday was a nice release. I'm sure there are plenty of red flags in there, but... Just chilled out most of yesterday. Had dinner with some friends. Spending today trying to stay on the low-down... Have been to the gym, and am going to get outside for a while this afternoon to enjoy the gorgeous New England fall colours, but then will plan on staying in my flat chilling out..

2-ICU Month. Coming to an end. Just over a week and a half to go, 3 more calls. It's been a really good month. I think I've learned quite a bit as well. If I were going to go into a fellowship, it would be a tough competition between infectious disease and critical care. Have been taking care of two very interesting patients for most of the past week. I've spent a lot of time thinking about how aggressive I'd want to be treated if I were critically unwell. It's kind of tough to know exactly what I'd want done. I'd encourage people to think about this.

3-JP. Back on the pedi ward. Saw her briefly before I left Friday. She didn't look as bad as I'd seen her before. Her mom has made her DNR/DNI (no resuscitation), which is a decision I agree with completely.

4-Patrick. It's been a bit tough this past week or two, I've certainly had a full plate, and work is keeping him busy. I'm not sure I've been the most pleasant person to be around. We're definitely looking forward to my schedule next month when things will resemble a bit of a more normal person's schedule. I certainly am learning that relationships require a fair amount of work as well. Thankfully, we're pretty good at communicating.

That's really the bulk of my life right now. Me. Work. Dating.
B

Motions...

Some days you just feel yourself going through the motions. Not really paying attention to the finer details. You're there, but not present. Running on autopilot. That's me lately. Running on autopilot. It's the second time I have been stuck on autopilot, the last time was back in March. March was way worse though. I remember so badly needing to get away from it all then, and that's the weekend I went away, found a nice B&B and spent my golden weekend enjoying solitude. Golden weekend is when you're post-call on Friday (meaning work ends around noonish), and then you're free Saturday and Sunday. A golden weekend is GOLD. A prized possession. GOLD. Fantasies about how to spend the golden weekend crop up weeks before it arrives. Am I going away again? I fantasize about driving away, and spending Friday night in a B&B in the mountains, or on the coast. Or flying somewhere. Escaping from my current over-worked life. But then, as the time draws nearer, the work required to find a place to go, to pack, to drive all seem almost insurmountable. It's also tough to justify the cost, given that I have a real vacation in 3 weeks..

Blah. That's the scoop. It's almost 8pm, and I may be going to bed in a few minutes. Not to mention that I dozed on and off all day today while we were in the car. I've even avoided caffeine to make sure I sleep soundly tonight.

That's my story.

FALL (pt 2)

I know I already gushed about fall.. but really, it's so beautiful out. I was post call yesterday so pick up Patrick and we went for a drive to some of the smaller towns around here, and enjoyed the changing colors. The weather was just wonderful. Able to just sit outside on benches, watching people, enjoying the cloudless skies. Then today, we met a few other residents for brekky, and then went hiking, and then went for ice-cream. It's not anything like "Grey's Anatomy." Don't let them fool you, our lives are MUCH MORE BORING than on the TV show. We talk more about sleep than we do about sex. We enjoy getting a free minute and getting outdoors. Don't get me wrong, we're happy to hang out in the pub too. Anyway, I do miss Colorado.. Something about seeing the Aspens change...

ICU is not too bad. Feel like there is so much to learn, and I'm not good at making time right now to sit down and read. For example, I really haven't been home since Friday night. Here I am, home, and am exhausted. Feel like there are a ton of things to do: email, phone calls, laundry, clean, READ READ READ. I've had a movie at my apartment from BLockbuster for a MONTH NOW and haven't read it. The stack of magazines are outdated as well. Blah blah blah....

I guess that's about it really. Thinking of all the things I want to get done, I all of a sudden feel motivated to get off the computer and get some work done.

Cheers. B

ICU & JP

ICU:
I had my first overnight call in the ICU last night. Similar to my first call in the CCU last year, there was no break, up for 30 hours. Although, it wasn't really that bad, and the only thing I didn't like was being so freaking tired.. I dare even say it was nice to be able to think for myself a bit, and then be able to page my senior resident when I needed help. I'm working with a resident in my med-peds class, and we're committed to having some fun at work. Yes, it is possible to have fun in the ICU.

JP:
Ready for some fucking depressing news? We have a diagnosis. It took 5 months for this horrible disease process to wreak enough damage in her brain to show some changes on MRI, and now the disease entity has a name, JP has a diagnosis to explain what's been going on. A disease which carries a fatal prognosis-in 2-5 years. And NO QUALITY OF LIFE til then. Dear god help this mom who will lose one child tomorrow and another one in the near future.

-B

FALL

Last night was the real first fall night. Driving back from looking at the changing colors, the air was crisp. It got dark early. There was just that fall feeling in the air. A day spent buying warm clothes at the factory outlets. Having soup for dinner. Seeing the pumpkins out for sale. It all screams fall. I think everybody should do a little happy fall dance, crunch some leaves, buy a pumpkin.

Out of the PICU now. JP ended up in the PICU a few nights before I left. Not good. Diagnosis, which seemed so close, is now elusive, again. I dunno. I just don't know.

Am starting in the adult ICU. Another month of every 4th night overnight call. I'm looking forward to the month cause I am hoping to really learn a lot, and it'll be nice to have this month over in the sense that I think it will help me be better at managing certain problems when I am back on medicine wards in December.

I am definitely looking forward to November 4th, when it's off to Ireland... Going to be great to be back and see people. It's forced vacation. No touristy stuff, just hanging out, reading for pleasure, evenings in the pub catching up. The pleasure of walking places, and not being in a car..

Ok, going to do something totally unheard of, and be in BED by 10 PM!
Cheers,
B

PICU & JP

PICU-SLAMMED yesterday. Crawled into bed at 330 am, out of bed at 4am, and never made it back. Had breakfast with Amy (The Pedi Ward Senior who got us dinner at 11pm!), and the Pedi Surgery resident, who kept rubbing it in that she had gone to bed at 9pm! So, it was really hectic, a few sick kids, but overall it was a great day for learning. At one point the PICU was closed to admission cause we FILLED IT UP! Kids with trachs with chronic respiratory problems, 2 head injury kids (one who kept me up all night), hemopericardium for unknown causes, aplastic anemia and sick, lupus nephritis and hypertension. Honestly, it doesn't get better. But know what was great, at about 5am, a sense of calm settled over the PICU. The guy with the really bad head injury started to settle down, the girl with the really bad fever started to look a bit better, the girl with really bad hypertension seemed to finally settle down, the kid who had the stroke was awake and talking (although he has lost his vision). And at 5am, there was a little joy, in knowing that kids were better. A few would be transferred out of the PICU, a few would go home. It was also good cause I got to finally think on my own, learned quite a bit as well..

JP... JP is a kid slightly less than a year old whom I have taken care of in July on the pedi ward and again earlier this month in the PICU. She is "my girl." I know this kid well, think about her regularly when she's not in the hospital, get updates regularly from her specialists. She is chronically unwell. If you saw her in the grocery store, you'd think she was maybe 3 months old. When I was in the ED last night I saw her down there , and my heart sunk. (She almost came to the PICU, but ended up on the floor where she was almost constantly observed by us neurotic residents and nurses who care about this precious girl). I can't even describe how shitty this situation is. Nobody knows why this kids is sick, some metabolic/genetic/endocrine disorder. Talking to mom last night (who just learned that her pregnancy is going to be terminated due to a non-viable fetus) she broke down and has finally realized that JP is not going to make it. My gut feeling changed yesterday too, and I don't think JP is going to make it. I'm convinced that we're slowly watching her die. And while I think it is horrible for me to watch her die, it breaks my fucking heart to watch her mom who knows that she's losing 2 kids. I can't even imagine...

PICU Part Two

2:30 am. just finished tucking in the kid I just admitted. interesting day. Like running a neurosurgical service. broken heads today. bleeds in the brains. two 20 y/o girls, and now a 2 year old boy. girls were preventable. bike helmets are a good thing. not driving drunk is a good thing. having a 2 year old with a brain mass is not a good thing. nice people today. great nurses. It's been a pretty decent month. I hate to complain cause on the one hand i know that next month is going to kick my ass (when I'm in the Adult ICU working more hours than any human should), whereas this month the work has been actually mellow, but I don't think I'm learning as much as I had hoped. partly my fully, of course, haven't really had the time/motivation to read much outside of work.

Anyway, life is really good right now. It's going to be a crazy few month (on-call 3 of the next 4 months), with a vacation to Ireland, and then home for New Years.

Ok, going to get some much needed precious sleep now. Oh, funny thing, we had a lecture on sleep deprivation earlier in the week, would have been nice had they allowed us to take a nap instead of going to a conference on sleep deprivation.

Neurotic Friends

First of all, I'm the neurotic friend. Well, that's a total lie, cause "birds of a feather..." yeah, you know the rest of the saying. However, as of late, I'd just like to thank my friends for putting up with my neurotic issues (life, love, and the pursuit of happiness), cause god love the people who I have called multiple times to hash out a few things going on in my life recently. You know who you are, and all I can say is thanks. And I might add that I listened, for once. This post won't make sense to many of you at this time. C'est La Vie.
-BPB

Mountains Beyond Mountains

I had the chance tonight to hear one of my heroes speak. Maybe "Mentor-By-Proxy" is a better term. If I've never tried to convince you to read the book Mountains Beyond Mountains about the work of Paul Farmer, have a look at THIS SITE on the group Partners in Health and find a copy of the book (or come visit me and read mine). It's a medically oriented book, but everybody I know who is non-medical has been inspired. So really, drop the smut novel, and read some real chicken soup for mankind kind of book. Really, trust me on this one... PICU is good. My favorite kiddo got transferred to the pedi ward today. Will miss seeing her, but will keep tabs on her.

g'night, it's very late.
B