A not-quite-silent night

I was among the privileged few to take call on Christmas night this year. Everyone says how quiet Christmas is because no one wants to come into the ER. Blah, blah, blah. Lies, lies, lies. Any night on which the rads attending calls you to say, "That's the biggest cecum I've ever seen" is doomed to be a long one. Said cecum hit 18cm and after much agony and debate went to the MICU around 1am and ended up getting urgent decompressive colonoscopy. I'm just glad it wasn't my cecum.

The day was not a total loss, however. My sweet Nick played St. Nick and brought a little Christmas to me. He cooked a full Christmas dinner, turkey and all, and brought it to the medicine lounge. I rounded up the other bedraggled, on-call souls, and we had quite a time. I had even invited all the surgery residents I ran into that day (think Joyeux Noel); however, no surgeons took me up on my offer. After dinner I admitted two people who were both so nauseated they couldn't eat; I found it quite amusing that I had quite the opposite problem in which I ate so much I was nauseated.

The best Christmas present of all? I realized roundabout 4am as I was admitting patients #5-6 that this was my last call for 6 weeks!!! Nick is going to start wondering who the stranger in his bed is...

Feels like home

I'm on call today and have a little lull, which is the perfect opportunity to tell you this story.
The fellow called me with a mundane elective admission, and she told me, almost apologetically, that this man is primarily Spanish-speaking. Those of you who know me know that I once upon a time spoke excellent Spanish, but I now consider my vocabulary sub-par. I trotted downstairs and completed my interview and exam. For a few minutes, you would have thought I was back at the Taub; this too-familiar encounter made me miss Texas even more than usual today. I thanked my patient for his patience with my almost-decrepit Spanish, and he told me he speaks a little English but that he wishes he could practice more. I informed him I would be happy to speak English with him to help him practice.
He said, "But then how can I help you practice your Spanish?"

Pick me, pick me!

I certified my rheumatology fellowship application December 1. Since then I've been trying not to think about the whole process since I heard rumors that no one really offers interviews until January. But I got my first interview offer today! This first brought a sigh of relief that I actually submitted my application properly without too many typos. I next moved into the dancing, singing my own praises phase. UT-Houston, here I come!
Then I went into strategic planning mode. The e-mail arrived 11 minutes ago. If I reply now, will I look enthusiastic or desperate? I told myself I would wait until the afternoon before replying. But what if the date I want is filled by then? (Really? Did I really think that? Like all 14 of us applying for rheum in the nation are really going to fight for that one day?) So I held out for 2 hours and then replied.
Next came the anxiety over when the next offer might come. It was easy when I could tell myself there would be silence on the line until January 1; now, however, I wait with baited breath for new messages from myeras. It almost feels like junior high gym class all over again, hoping I'll get picked soon. This anxiety is partly assuaged by my awesome interview suit; I mean, who wouldn't want me to be their rheum fellow in my perfect Ann Taylor tropical wool single-button grey suit with the cranberry silk button-up that I will alternate with the lavender rough silk ruffle-front shirt?
Anyway, if you see any rheumatologist around over the next few weeks, put in a good word for me.

The Party's Over

I started this month expecting the worst after my demoralizing experience at the VA last year. However, November has overall been good to me. Ward service at the VA is as a general rule cruel and unusual punishment, but my team has made the best of it. For starters, we got the good schedule. I mean, the really good schedule. I won't bore you with the details, but the bottom line is that we got to skip a daytime admission call every weekend this month and on Thanksgiving. But even with fewer patients, the four walls of our 5'x10' team room would feel pretty darn small if we didn't get along so well.
I couldn't have asked for better interns and med students. The best moments of my month: Intern #1 commented on how we smile more than other teams. Intern #2 actually said he had fun on call. We know you have to laugh so you don't cry. By the way, anyone who makes my interns cry will answer to me. As an intern, you work harder than you thought possible, but people rarely pat you on the back for the hundreds of things you do right every single day. They do, however, manage to point out the one or two things you do wrong every once in a while. Having been there, I now try to let my interns know that I see how hard they're trying and appreciate their effort. And you know what? I think I actually made their month a little easier to bear.
Thank you, Lord. It's good to feel that you have placed me where I am and to know my purpose in being here.

Confessions of this Shopaholic

I love clothes. Jeans, sweaters, skirts, dresses. Especially anything shiny or anything with ruffles.** Apart from my baking, I have somehow acquired within my peer group (overworked internal medicine residents) a repututation for "good shoes." I have chosen to take this as a compliment rather than wondering if people only comment on my shoes to avoid the subject of my intellect, or lack thereof. But I digress.
Other girls exclaim how they don't understand how I wear heels all day. (Secret #1: wear clogs from the parking lot to the hospital as this is the roughest walk of the day.) I also enjoy the compliment in directly inverse proportion to how much I paid for an item. Eg, a compliment on my $50 dress is not nearly as satisfying as one on my $12 purple suede peep-toe heels. (Secret #2-3: DSW and Marshalls.) I will even add up in my head how much my outfit for the day cost just to see if I can keep it under $100, head to toe. I know I'm not alone on this next one because my college roommate admitted the same habit to me; I hold onto stuff I bought cheap/on sale even more than stuff I for which I paid full price. Some things are just such a good bargain that I want them to last forever. (Secret #4: Teach your husband not to put your clothes in the dryer. I love you, Nick!)
So warn any of your friends or loved ones in middle TN that if they end up being seen at Vanderbilt hospital to watch out for the blond doctor with good shoes. She might be planning her next assault on the Anne Taylor clearance rack while you're droning on about your runny nose.

**Disclaimer: I do not recommend dabbling in shiny things that are also ruffly if you are a ruffle novice.

Oooooo, heaven is a place on earth

Hello, all you out there in cyberland! Good news! Nashville just got a little closer to Heaven, by which I mean Texas. CHUY'S HAS ARRIVED! Jen told me of a rumor that the best Tex-Mex in the world was headed to Tennessee, but my dreams became reality when I passed by the almost completed building a couple weeks ago. Nick and I ate there last week, and it was wonderful!! I'm convinced the creamy jalapeno ranch may hold the cure for cancer.

I informed intern #1 (also from Texas) about the arrival of Chuy's, much to her delight. Intern #2 then commented how he is in the mood for a chimichanga. The humor is audible: it's chimich-ah-nga, not chimich-aaa-nga. After having a good laugh at the Yankee's expense, intern #1 and I decided we'll have to introduce him to real-deal Tex-Mex this month. Don't you wish you could come to team dinner?!

This is a stick-up!

You can't make this stuff up. I was threatened today by one of my patients. He didn't want to talk to me or anyone else, let alone take his medications. It fell to me to convince him to cooperate, which I attempted. After telling me how annoying I was, he proceeded to ask the nurse for a gun so he could dispose of me. Aside from the fact that this man is very ill and that I could outrun him in my heels, that was rude and completely uncalled for. Maybe the VA needs a metal detector at the door...

Put on a happy face

Ah, it's November, and that only means one thing... Interview season! Last year I attended interview dinners and lunches with a battle-weary air. Having interns recruit is like the walking wounded troops returning from the front lines slapping the approaching reinforcements on the back, telling them, "It's not that bad" as they hobble on home. You smile with sweet, false reassurance and talk brightly about work as if to say, "Who wouldn't wanna be me?"

Only anyone in his right mind. But I made it through, and they will, too.

A little help, please?

Last night I was the ever-so-lucky chosen one to be on call the night before the rotation switch. I would not, however, have missed this for the world. I'd spent my night shopping online, getting Ben and Jerry's, etc. You know, life or death kinda stuff. Then (I kid you not) I got the following page: "I am stuck on the elevator on the 4th floor. Could u please help get me out? This is not a joke." Well of course it's a joke, but I decide to check, just in case. I head downstairs and hear the muffled sounds of pounding fists from inside one of the elevators. Yes, it is my intern. Stuck. I call maintenance, who upon finally arrives informs me that yep, he can open the elevator, but nope he can't. There is a new rule that they cannot open the elevators for trapped passengers. We must call some outside maintenance company, who estimates their representative will arrive in an hour. Are you kidding? It's almost midnight! I yell through the crack that he should fake a code, to which he replies, "I'm having chest pain!" After some haggling, I ultimately told the maintenance man that Dr. ____'s patient is crashing downstairs and needs him right now. This is in fact true, but I decline to mention that I am actually in charge of Dr. ___ and perfectly capable of handling the situation myself. This works, and presto chango, with the twist of an elevator key (who knew they even had those?), my intern is again a free man. The rest of the night was uneventful, but I hear he had a little incident with a blue highlighter and his white coat the next morning. Moral of the story: take the stairs.

And you may be wondering why he bothered calling me rather than using the emergency phone inside the elevator. Well, bless his heart, he did try the phone first. 911 hung up on him.

Step Up, Down, All Around

So I'm taking Step 3 today and tomorrow, which is the third and final installment of the USMLE's standardized testing requirements. Before one earns the title of "LICENSED PHYSICIAN," one must undergo the cruelty of 5 days and $2000 dedicated to proving one's superiority at multiple choice questions (in the case of CS, pretending to be nice to impostor patients for a day). But Steps 1 and 2 are dead and buried, as far as I'm concerned; let's talk about Step 3.
This is a 2-day ordeal covering potentially every topic in every specialty as far as the eye can see. Including babies. And pregnant women. And adolescents. And did I mention babies? Seeing as I keep a 15' radius from anyone under the age of 18 (that includes unborn children and therefore their pregnant mothers), this seems unnecessary. But USMLE knows best, so take the test I shall.
I don't know how, but the testing facility to which I was assigned somehow acquired a collection of the world's squeakiest, creakiest chairs. By the end of the day, everyone has the test-taking fidgets, and we practically have a dysharmonic symphony going on. And the climate control alternates at 30-minute intervals between frozen tundra and sweltering desert. But the best part in my humble opinion is that you have to prove your pockets are empty every time you walk back into the room from a break by turning them inside-out. Yes, folks, you heard right. Turning your pockets inside-out. Now I suppose this could be sensible for men, seeing as their pockets are deeper than the Mariana Trench. (I discovered this after I got married and first checked Nick's pockets before tossing his jeans in the wash.) However, women's jean pockets are merely for show; no one ever expects to actually put anything in them. I think it's a princess-and-the-pea sort of thing. But I obliged and emptied my pocket lint onto the floor for my proctor. And don't even get me started on the finger-printing...

Hello, world!

Bienvenidos to my blog. Don't come here expecting elegant writing or stories of poignant moments with my patients. There will be little to none of such elements because all my creativity gets expended putting my outfit together every day. Anyhoo, I finally decided to be one of those people who blog mostly so my long-lost friends can know I am still alive and what I'm up to. And this is easier and less time-consuming than individually crafted e-mails or phone calls (and I can do this at 3am without un-making any friends).

For anyone who may have forgotten, Nick and I moved to Nashville, TN, in 2008 for my internal medicine residency at Vanderbilt. This is mostly working out for us. Except for the part where I'm really tired all the time, and that other part where Nick can't find a job. But we still like (and love) each other after anniversary #4, and I think our three doggies still like and love us, too. As long as we keep the belly rubs and bacon treats coming, that is.

Anyone who hasn't seen me since Houston has probably not met our third furry baby Dallas. While Izzy was initially a little less than thrilled to have a new baby sister, they are now puppy BFFs and mope whenever separated. One thing I've been disappointed by is Dallas' hound-dog howl. I mean, her singing voice is downright pitiful. Speaking of singing voices, I wonder if Alan Jackson would be interested to know that Dallas is, in fact, in Tennessee.