In memorium

Well, today's post is a day late and will prove to be a dollar short, I'm afraid. Nashville saw its first white Christmas in almost two decades, but a peek through my patient's window was as close as I came. Apparently Santa doesn't grant MICU wishes.
He was young. So young. A pit in my stomach at 2 am and a sense of impending doom. A flurry of activity and barking orders. Knowing it's all in vain before we even start. So you wash your hands and move down the hall, pausing to remind each other how life should not be, should not end, that way.
Surely doesn't feel like Christmas. Kinda feels like just any other day, doesn't it? Except that this day has been set apart in rememberance that God Himself came in the form a man, born in a manger, that we might have life, and have it to the fullest. Emmanuel, God with us.
Lord, it is still well with my soul.

True colors

Hey, guess what? I'm back in the MICU, that's what. But just for the five days from now until Christmas. Here's a couple anecdotes from my first night back on call.

1) At Vandy, everybody's badge is color-coded so you can tell by lookin' what he/she is/does. And basically, the darker your badge, the more important you are. For instance, medical student badges are white. Resident badges are light green. Attending badges are dark green. So we often make comments based on badge color. Like when a situation gets sticky with a consulting service, and you just need the attendings to talk directly to each other. "This needs to be a dark green conversation." But that isn't the point. I work myself into a conniption fit when someone whose badge is darker than mine tries to boss me against my better judgment. Which of course happened today, but I can't do much about it other than aforementioned blood-boiling. I shall not air my grievances in wide open cyberspaces, but be it known in these wee small hours that I'm huffy about it.

2) This is my first night on call with my new intern. I went to the cafeteria for a tasty beverage earlier and offered to grab him something. He handed me his badge (because just like in college your ID = $$$) and requested a Sprite. When I went to pay, the cashier didn't understand I wanted to pay for the diet Dr. Pepper with my card and the Sprite with another card.
Her: "Uh, you don't want them on the same card?"
Me: "No. We're not that close yet, me and my intern."
Her: "Oh, I get it now."
Me: "Yep. Maybe by breakfast we'll be there, and I'll buy his coffee."
All the while, the nurse behind me in line is cracking up, which only serves to contribute to my illusion that I am in fact funny.

Night-night!

A lesson in irony

Nick and I are cleaning out the junk room in preparation for selling the house this spring. We unearthed this book Nick purchased shortly after he adopted Jonesy. Note the authentically dog-chewed corner.

And that's what Jonesy thinks about that.

Like water for chocolate

Remember how I made a cheesecake last week? And how it wasn't what I was expecting? Well, my taste buds are just having a tough time dealing with it. My cerebral cortex thinks, "cheesecake," and my gustatory complex expects a very particular combination of sensations. While my concoction is sweet and creamy, it just hasn't satisfied the cheesecake craving.
I also made a butternut squash and sweet potato au gratin last week. Twas cheesey and gooey and good, but again, just not what my brain was expecting. It looked up "au gratin" in its amygdalar (that's where you make/store memories) dictionary and expected plain potatoes. It's much too busy with other important things to rectify sweet potatoes with its previously identified expectation of gratin.
Which brings me to the following... Some things in life are absolutes. God. Death and taxes. The dogs winding up muddy even if it hasn't rained for weeks.
The corollary to this statement is that some things in life are absolutely contraindicated. (Sorry, I have a problem with using medical terms in casual conversation now. But I just can't think of a better word to finish that sentence. Moving on). Such as water in a can. Who invented that anyway? What a horrible idea! Water in a can! It totally confuses my brain! My eyes see a can coming towards my mouth, and my tongue gets all excited at the prospect of something sweet and bubbly. And then, it's just. Water. Plain, wet water. Lemonade in a can is almost as bad. I'm just sayin'. When your mouth wants water, or potatoes, or whatever, it wants what it wants and nothing else will do.
Alright, that's all for today. I'm headed to the kitchen to put an end to this cheesecake craving situation.

We've all got our reasons

In response to the maddening success of "Battle of the sexes," I'm starting a new series outlining the many reasons why Tennessee is not for me.

Reason #12: Tennesseans don't understand the difference between "friendly" and "helpful."

I'll now provide an illustrative story.

I went to the post office by campus today to purchase a money order. (The flaws and shortcomings of the post office are not Tennessee's fault; however, this story is not about apathy, which is the post office's defining characteristic.) With that said, let's move on.
I know that you can't buy a money order with a credit card, but I believe cash or check is acceptable. I therefore start writing a check after I tell the clerk the amount. The clerk watches me fill out my check, and offers "Postmaster" when I pause at the "pay to the order of" line. Friendly, no? Seemingly helpful even? I complete me check.
The clerk then says (I kid you not), "You know, you can't use a check to pay for a money order."
And there you have it. Friendly is not the same as helpful. There are no words. I simply stare.
"You need cash." Pause. "But we also take credit cards now!" Another pause. "But you can't use those to pay for a money order either."
Still no words. I continue to stare. I dig some bills from my purse, pay the clerk, and move on.

Am I smarter than a 5th grader?

Today's installment comes complete with illustrations for your viewing pleasure.

Bachlorettedom (bachlorette-hood? state of bachlorette-ism?) has reduced my high-falutin' culinary taste to pizza rolls and chocolate milk for dinner.

While I enjoy these simple pleasure as much as the next gal, I decided to try a cheesecake from my Williams Sonoma Desserts cookbook in an attempt to save myself from myself. I quickly skimmed the recipe to ensure I had all the key ingredients.

I started with the graham cracker-almond crust. Yum. Remove from oven and cool completely. Check. Next I mixed and scraped and mixed some more.

Then I checked the recipe to see for how long my deeelicious cheesecake should bake. Well, really cheesecake bars; I halved the recipe since it's just me, and who's ever heard of baking half a cheesecake in a springform pan? Incidentally, an 8"x8" square pan works nicely. Suddenly, much to my chagrin, I realized something, something very, very important.

.

.

.

This is a no-bake cheesecake. Hmm, I kinda wondered why there were no eggs.

.

.

.

And that, friends, is why your elementary school teachers always told you to read all the way through the directions before starting your assignment.

But fear not! My story does have a happy ending. After waiting a grueling 8 hours or overnight (yeah, that's cookbook humor), I discovered that despite lacking the signature cheesecake texture, my cheesecake bars are cool, creamy, and oh-so tasty in their own right.

I promise I'm more careful with procedures at work. Really. No, really.

Rain, sleet, snow, or shine

Yeesh. As I mentioned, we've had a wee bit o' snow yesterday. I thoroughly enjoyed holding my mug of hot chocolate and staring out the window at the whirly swirly flakes.

This morning, however, I was singing a different tune. I was singing the tune of "uh-oh, I have to drive to work somehow." It goes something like this...

You see, last year when this happened, Nick dug his way up our driveway so I could go to work. But remember how Nick is in Texas right now? Hmph. What a pickle. So I put on lots and lots of clothes (including two pairs of socks) and shoveled/hoed my way up the drive this morning. (Digression: Am I the only person in my neighborhood who still had to go to work today? There wasn't another soul out shovelling with me.) Anyhoo, this shovelling process took a long, long time. But not nearly as long, however, as actually driving to work. My usual twenty-minute commute took (any guesses? anyone?)... an hour and a half! And I counted 7 wrecked cars in the ditch between my house and the main road. Seven! And of course the highway was packed with backed-up big rigs. I finally rolled into work around 9:30 and was quite miffed that no one else was ready to be righteously indignant over my ordeal with me. So I had to be righteously indignant all by myself.

Jack Frost may think he's so clever, zinging me two years running. But I'll show him. I'm gonna move to Houston, where it's gonna be a temperate 70 degrees tomorow. Take that, Jack!

Dr. Jekyll and Mrs. Hyde

I live a double life. Wait, make that a triple life.

I am an unassuming medicine resident by day. And sometimes by night. (Sorry, but I have no pictures of me at work.)

A 1950's housewife on the weekends. Chocolate cherry brownie bars are the creation du jour. I even have a cherry-pattern apron. Yay.

And a glammed-out rock star once a year for the medicine resident Christmas party. We clean up pretty well, no? The phrase "fly like a G6" comes to mind.

No, there is no fourth person to the far right of the photo. For some reason the girl taking the picture just put us very off-center, giving the illusion that Fed has her arm around someone whom I dislike so much as to cut out of the photo. And let's take a moment to give a shout-out to Angela and Cassandra for teaching me the Cupid Shuffle at Roommate Reunion; that knowledge came in pretty handy last night.

PS Lots and lots and lots of snow today - pics coming soon!

Rabble rouser

Apparently I leave quite a wake. Believe it or not, the following conversation is actually factually true.

The cast:
Me: Well, me
R2: other resident
Dr. A: other resident's VA (veteran's i.e. government hospital) clinic attending
mVA: unidentified VA staff, presumable in the MICU (incidentally, MVA is also the standard abbreviation for motor vehicle accident, most often seen on the surgery wards)

R2: Hey, Beth, were you just in the VA MICU?
Me: Yeah, why?
R2: Well, Dr. A came to clinic after a meeting today and told me this story. And I just knew it had to be about you.
Me: Uh-oooohhhh...
R2: No, you're gonna get a kick out of it.
Me: Uuuuhhh, guess we'll see.
R2: Dr. A said there was some VA person at the meeting complaining about something.
(And he quoth...)
mVA: I was in the MICU the other day, and I saw this tall, blond girl walking around in heels. And I just don't think that's appropriate. She can't do her job wearing high heels. What if she had to run to a code or something? She wouldn't be able to!
Dr. A: Well, I don't wear high heels myself, but I don't think it's my place to tell someone else they can't do their job wearing them.
Dr. A: (later, to R2) I just think that was so dumb.
R2: Um, was it a resident she was talking about?
Dr. A: Yes, it was.
R2: Ha! I totally know who that is! There's not many tall blonds in our program, and I can only think of one who would wear heels in the MICU!
(back to the present)
R2: So, you were pre-call** that day, right?
Me: Yes, and I was also doing a med student lecture, so I had to look nice! And who does she think she is, saying I can't wear heels! She's just jealous because I dress nicer than her! (And on, and on, and on)
R2: Yeah, I know.
Me: Hmph!

The best part? Another resident approached me later in the day and told me the exact same story! Apparently word gets around. But you know what? I'm proud to be a revolutionary in the war for equal rights for fashionable doctors.

**"pre-call" in the MICU means the day before you are on call; duties on this day's shift are limited to pushing the COW (computer on wheels) on rounds, typing orders, and making phone calls. Not exactly high risk for blood and body fluid exposure. And by the way, I can totally run in heels to codes. I've done so many a time.

Sweet little lies

Intern year is hard, no matter who you are or what your specialty.* All year, well-meaning people above you on the totem pole** will ask you how you are, if you're doing alright, if you're coping. And there is one correct answer, as evidenced by the following conversation between an intern (not me) and an attending.

Attending: So, Intern, how are you doing this year? Everything going ok?
Intern: Well, Dr. Attending, it's actually pretty hard. Carrying 10 patients every day is a lot of work and can be kinda overwhelming.
Attending: (with panic in his eyes) Oh, poo. No one's ever said that before. What do I do what do I do what do I do?!?!
Intern: Oh, I wasn't supposed to say that. He's getting all panicky now.
Intern: But I'm doing great. (pasting smile back on)
Attending: Oh, ok. Good. Let's move on.

So when I ask my interns how they're faring, I tell thim it's ok to say, "Not good." In fact, I tell them I won't believe them if they say they're loving staying up all night and spending more time with me than their spouses. And I think that simple acknowledgment that all is not in fact right with the world of residency can sooth a poor little PGY1*** soul. It's ok not to want to work this hard and feel this beat down forever. It really is. What a revelation. This is a means to an end but not the end. Worth it? I dunno yet. I'll keep you posted.

*Pathology is the exception that proves the rule. Talk about a cake walk. They only see like 3 live patients the whole year. They spend the rest of their time with tiny, very quiet pieces of patients prettily mounted on slides.
**Group of people constituted of, well, basically everybody except the med students. And even the med students feel sorry for you.
***post-graduate year 1, ie first year of residency

Home alone

Greetings from the other side of the MICU! It's been just lovely NOT being on call these last 5 days, and I have 3 more weeks of no-call fun still to come before my MICU Christmas tour. But back to the present. Nick packed up his car, took Dallas, and left me earlier this week. No, no, not forever. He's just at Mom's (that's Mom Z to him) for a few weeks to renovate another bathroom.
On the upside, it's been nice in a novel way to have the house to myself for a few days. I go all day without turning on the TV. I try new recipes I know Nick would hate (basically anything with vegetables). And I just spent an hour trying on dresses for the department Christmas party, and no one fussed at me for obsessing and trying multiple shoes on with each dress for a party that isn't even until next weekend!
On the downside, my bed is very cold. I have to go traipsing past the super prickly bush to get to the plug when the Christmas lights go on the fritz. I have no one to whom I can phrase my rhetorical questions, like "What should we have for dinner?" when I already know what I want to make. I have no one to hug, no offense to Jonesy and Izzy.
All said and done, I find myself a bit on the lonely side tonight. Guess I'll just have to take my mind off it, starting with a girl movie marathon. PJs and popcorn, anyone?

Battle of the sexes cleans house

Do you like the new look? I found a great website for blog designs, Hot Bliggity Blog. I thought a new look would be apropos in celebration because this is my 100th post! Congrats to me. And now back to our regularly scheduled programming.

I present for your reading pleasure the latest installment of the ongoing saga of Beth vs. Nick. No, no, I mean Beth AND Nick. Well, maybe versus. This particular issue is even funnier after we discovered at a recent trip to our friends' house that they have the exact same drama in their household. You see, Nick and I are both clean people, but we have different approaches, as outlined below.

Nick: What are you doing?
Me: Cleaning up.
Nick: Why are you doing that? I was gonna clean tomorrow.
Me: So? I'm off today, so I have time.
Nick: First of all, you shouldn't spend your day off cleaning.
Me: It's fine. The mess was starting to bug me.
Nick: I knew I shoulda cleaned up. I know how mess starts to bother you if you're the house for a whole day, and then you go crazy.
Me: I'm not going crazy; I'm just tidying up.
Nick: No, you're throwing stuff away.
Me: Yes, because it's junk.
Nick: How do you know that's junk?
Me: Because it's been wadded up sitting on the dresser for weeks.
Nick: It's been there for weeks because I was saving it.
Me: Then why don't you put it away?
Nick: (frustrated sigh)

The usual subsequent chain of events goes something like this. I move said wadded paper from sitting on dresser to posted on fridge and catch sight of other clutter on the kitchen table. I start to dispose of this newly discovered clutter in the proper receptacle, be that cabinet or drawer or wastebasket. While putting away a magazine in the magazine bin in the living room, I spot yet more clutter. I again get distracted and launch an assault on the new newly discovered pile o' clutter. And so on and so forth. Eventually I make my distracted way back to where I started, and all the clutter is annihilated. I feel better and sit down.
Nick's version of cleaning has much more to do with scrubbing and much less to do with tidiness. Every tile, mirror, and faucet in our house sparkles (complete with little twinkle of light and "ping" sparkly clean noise), I'll give him that. But you know how there's sex-linked inheritance of color blindness that's fairly common in men? My husband suffers from a lesser known deficiency, "clutter blindness." Good thing he has me.
We shall not talk about my desk. Anyone who's ever seen my desk - back in WF, my dorm, apartments, and even this house - knows it is my Achilles heel of clutteriness. And it will stay that way. If I were too perfect no one would like me, right?

Insult to injury

In response to the wild praise for my last entry (by which I mean that I found myself really funny), here's a second installment. This conversation actually occurred only minutes after the last one, but they've been divided to maximize comedic value.

Me: Joe, it makes me sad that you'll be on call on Thanksgiving and then be all alone post-call. You should come eat with Nick and me since we're doing our big dinner on Friday.
Joe: Can you even imagine what a third wheel I'd be? I can just see you, dressed kinda like that*, and Nick in a red sweater vest...
Me: Um, Nick doesn't own a red sweater vest. He might leave me if I bought him one.
Joe: But I can just picture him in a red sweater vest, carving your turkey. And you're both sitting on opposite ends of a really long table, with candles in the middle.
Me: Well, we could always get a sippy cup and little squatty silverware for you.
Joe: But I don't own a sweater vest.
Maggie: Ha! And Beth wearing pearls. And can't you just see her Stepford hairdo?
Joe: (raucous laughter)
Me: Hmm, I was thinking about re-wearing this sweater for dinner, but now I'll have to reconsider.

I told Nick about this, and he's sent this warning to Joe. The next time they meet, he's gonna teach Joe a lesson for accusing him of owning a sweater vest.

*patent cream heels, khaki pencil skirt and belted blue ribbon-front cardigan. You know, the usual.

An OCD Christmas

The following transpired verbatim in the MICU earlier this week. Joe and Maggie are the other two upper-level residents with me this month, and in a former life (ie, last year), they were both my interns.

Joe: What did you do on your day off yesterday, Beth?

Me: Not much. But I did go to Hobby Lobby to get new ornaments for the Christmas tree this year.

Maggie: You love Hobby Lobby, don't ya?

Me: Yes, yes I do. And this year Nick is letting me have a color coordinated tree - all red and gold.

Maggie: As opposed to the hodge podge trailer trash type of tree like I have?

Joe: Sounds like an OCD Christmas tree.

Maggie: Ha! Yeah, that sounds about right.

I don't get no respect. But it is lovely, no?

Rip off

Ugh. So tired. Didn't sleep last night. At all. Not a minute. So crazy you'd think I was making it up. Actually lost count of how many people I admitted and/or shocked and/or coded. Too sleepy to be witty about it right now. Can't even write my own post. Instead re-direct you to a post by someone I don't even know. Long but funny, especially if you have doggies.

Dogs Don't Understand Basic Concepts Like Moving

More from yours truly next time.

Up all night

I'm not as young as I once was. I never was one for pulling all-nighters, but being awake all night agrees with me even less as my MICU month drags on. But the good news about my perpetual punch-drunk state is that it makes for great entertainment.

Sometime around 3am earlier this month, I decided that my intern and I should make a game of picking a Bon Jovi song to match each patient. Hi-lar-i-ous! For example, "You Give Love a Bad Name" (Shock to the heart, and you're to blame...) was just perfect for the guy in the corner who'd required DCCV (you know, paddles and yelling "clear!" and all that jazz) not once not twice but three times that day. Or how about this one? "Blaze of Glory" for a guy who was exsanguinating and had received 24 units of blood transfusions in the last 24 hours. (For all you math nerds out there, that's your entire blood volume three times over.) And when we couldn't think of anything more specific, "Livin' on a Prayer" worked for anyone.

When that got boring, I decided to play "Let's Annoy the Intern." If you don't watch Scrubs, let me explain. There is one episode where all the residents get a med student, and Elliot's is a lazy, spoiled, little rich boy. In one scene, he does a little song and dance to annoy her. It goes something like this. So while my intern was trying to write his notes, I sat beside him and "Wa-wah, wa-wa-wah"-ed until he laughed and started singing, too.
This game totally backfired on me, by the way, when my intern started dancing behind my attending on rounds, causing me to crack up and completely lose it during my patient presentation. Lucky for me my attending thought it was funny.

At least there's nothing wrong with me that 61 hours of extra sleep won't cure.

Sob story

Today I tell you a tale of sorrow, woe, and angst, the story of my post-call trip to the grocery store. I've mentioned before how sleep deprivation predisposes me to enjoying a leisurely shuffle through the aisles daydreaming of tasty things to eat, and today was no exception. I got home early, before lunch even, so I planned my weekend menu over my bowl of cereal. I was particularly excited today because of the Thanksgiving sales. Here I come, half-price butter!
However, I came to a halting realization as the squeaky clean doors slid open, welcoming me to all things food. I. Forgot. My. List. Noooo!!!! I rummaged through my purse a bit more, muttering to myself like a crazy lady, but alas, the list was not to be found. Forgetting my list is an unfortunately common occurrence, but it's so much worse post-call. My brain really wants to conserve energy, so it cuts production to essential tasks only, which do not include remembering things I wrote down! Ugh.
Now I'm left to wander, like a stranger in a foreign land. No joke, I circled the produce section four times, looking to and fro, trying to remember that I needed butternut squash. The produce stocker guy was starting to stare. Oh, did I forget to mention that I still had on my fleece, scrub pants, crazy non-blow-dried hair, and about half of yesterday's make-up? I'm sure I was quite a sight. I decided on the strategy of just going up and down every aisle, thinking that maybe visualization would trigger memories of items on my long-lost list. This kind of worked; I only forgot three items altogether. But yeesh, in addition to aforementioned produce rambling, I went back and forth in the dairy section three times before I remembered the butter which had only half an hour prior excited me so. Not to mention that I realized there was no sugar in my cart once I was in line but was just too lazy to go back for it. And then someone had the audacity to park a maroon mini-van across from my maroon Pathfinder, which was initially quite confusing to my new-baby-giraffe, no-sunlight-since-yesterday eyes. Whew. I'm finally home. But now I don't know if I can get up from my desk to cook anything. Maybe I'll just take a quick nap in this comfy chair first.
Moral of the story: Not all who wander are lost. Sometimes we've just lost our lists.

It's a mad, mad, mad, mad world

Whew! Call Friday was insane-o, one of the busiest I can recall from my residency. I mean, when you admit new people before the bed is even cold from the last guy (transferred out, not died! come on, that's morbid), that's a mad crazy busy night. But I was in control the whole time, just like Sandra and Keanu were in control of that bus in Speed. Ha.
Remember how I just told you that the worst think that could happen in the unit is everybody coding and dying? Well, my second best accomplishment of the day (#1 - three joint taps yielding septic arthritis, woohoo!) was that I ran a successful code. By this I mean 1) we got his pulse back, which almost never happens and 2) I didn't hyperventilate. I did, however, accidentally call Nick when I was trying to reach my fellow in the midst of the action to update him. Poor Nick picked up his phone, and I just lambasted him. "Hey, just wanted to let you know Mr. X is coding. I've given 2 rounds of epi already and shocked him twice and..." It was a solid 30 seconds before he managed to interrupt me and say, "Beth, I can't help you." It actually took me a few seconds to realize whose voice it was. "Oh my gosh thought you were my fellow gotta go" (click). I hung up on him and called the correct person. My intern thought the whole thing was hilarious, and Nick is never gonna let me hear the end of it.
Tell you what. Makes me appreciate a lazy Sunday afternoon.

You can't always get what you want

Ick. Last night's call was by far the worst of the month. We only took 3 admissions, which isn't bad; however, some not-so friendly debate arose regarding the validity of various purported VA "policies." Read between the lines: Nursing staff told me I couldn't and they wouldn't do certain things, which led to a long and painful night for me (not to mention my poor intern). Next time you find yourself thinking that maybe the government should be in charge of health care, ask me for more details about life at the VA. The irritations and inefficiencies, including having my skinny cinnamon dolce latte with which Maggie so kindly surprised me this morning taken away because I was standing too far away from the "hydration station." No, I'm not making that up. (Hey, OSHA? Guess what? Doctors get thirsty, too? You let the patients have drinks!) But I need to move on or else I'll get worked up all over again. Let's have a good laugh instead, shall we? Alright, let's do.
Let's pretend you're a primary care doctor in Anywheresville, America, in Friday afternoon clinic. Your patient has just a few questions for you. Pick something from column A and something from column B. They don't necessary have to correlate; in fact, it's more awesomely bad if they don't.

Column A (But doc, my___ is so well-controlled!)
hypertension
diabetes
pain
weight
heart failure
cholesterol

Column B (Can't I just ____?)
stop taking my blood pressure pills?
stop taking my insulin?
have some extra pills, just in case?
quit exercising?
quit my fluid restriction?
eat french fries every day?

You: Riiiiiiiigghhht. Umm, you see, the reason your Column A is so well-controlled is because you don't Column B.
Patient: So, doc, you're saying I can't Column B for the rest of my life?!
You: Pretty muccchhhhhh, yeah.
Patient: So why have I been takin' all these bleepity-bleep pills!
You: Well, to control your Column A.
Patient: But if I'd known I'd never be able to Column B...
You: Hmm, yes. (Rise slowly from chair and back away towards the door.) Don't you need your tetanus shot updated? (Hand turns the doorknob slowly, surreptitiously.) I'll just have the nurse (Your body is halfway out the door.) comeinhereandgiveitthenyou'refreetogobyehaveagoodweekend.

And you're out!

Bookworm

Reading was pretty much my job during med school, which meant I pretty much did anything but when given the choice. My childhood love of reading went by the wayside for far too long, but I have rediscovered books and reading for fun in the last several months. So demand is up, which leaves the issue of supply. I trotted down to the local public library like a good citizen only to find my local branch a little, well, atrophic if you will. The first floor of my house is larger than the whole building. And don't tell me to go to the main branch. Too much investment in Google maps, gas, time, etc. And I lament the lack of Half-Price Bookstores in Tennessee, but we'll soon remedy that with the move back to H-town.
I've been trying a nice blend of classics, modern best-sellers, book club lists, and guilty-pleasure chick lit. I had a noble goal of reading six books while on vacation last month, but I only made it through four. (There was just too much other fun to be had.) The Guernsey Literary and Potato Peel Pie Society is currently on deck. Here are my most recent reads.

Books I loved and think you should read, too, if you haven't already:
The Poisonwood Bible
The Count of Monte Cristo
I Know This Much is True (caveat - hard to get into at first, but an impressively realistic portrayal of mental illness and its impact on family and society)
The Help
Patron Saint of Liars

Books I liked and wouldn't be embarrassed if you told someone I recommended to you:
Home
The Nanny Diaries
A Wrinkle in Time
One Day
Gilead
Life of Pi
The Memory Keeper's Daughter

Eh, ok. Read if someone gives it to you for free:
Water for Elephants
House of Sand and Fog
Bel Canto

Books I didn't like, so consider yourself forewarned:
March
The Girls' Guide to Hunting and Fishing
The Girl with the Dragon Tattoo
The Time Traveler's Wife
The Dirty Girls Social Club
The Red Tent
The Fifth Mountain
The Alchemist

Book I couldn't bring myself to finish:
The Elegance of the Hedgehog

Any suggestions from your shelves? I'm open, with the exception of the following.

Books I will never, ever read:
Harry Potter series
Twilight series

News flash

Heeellllloooo, world! As of this moment, I am 2 down and 8 to go for MICU calls, and last night was great. OK, maybe not great, but very good. Team B&E managed to score only 1 transfer from the floor and NO new admissions. Woohoo! You know what that means? Well, I'll tell ya. Eight hours of sleep, that's what! This is especially sweet because the other residents gave us a hard time on their way out the door yesterday about us getting the extra hour of call for "fall back." Well, the joke's on you, guys, because we scored an extra hour of sleep while on call. Take that. But that's not even the really good news.
The really good news is that I realized about halfway through the night that I'm not scared of the MICU anymore. Once you realize that 1) All you can do is all you can do AND 2) The worst thing that could happen is everyone coding and dying, it's much easier. What I mean by that is the realization that I can't save them all (and honestly, that decision is ultimately and infinitely above my pay grade), and as long as I do everything I know the best I can, that's all there is to it. No one can ask anymore or expect any less from me. That's been a long time coming, huh? Too bad I couldn't have had this epiphany months ago. Don't take me wrong here; I'm still firmly in the low-adrenaline rheumatology camp. I just thought I'd share my moment of clarity. Let's hope it sticks with me when everyone actually does start coding next time I'm on call.

Bonus points

Everyone's always asking for funny hospital stories, and I can never come up with anything good on the spot. So I've decided to tell you this one while it's fresh in a two-for-one posting special today.
I'm on ID (infectious disease) consults right now, and we were recently called to assist with the evaluation of a man with nausea, vomiting, diarrhea, and abdominal pain. Yes, all of those things at the same time. He was understandably feeling poorly and a bit grumpy, and when I entered his room to see him, he asked me to go away and come back when he felt better. Well, isn't that the point of being here and me coming to see you? What good will it do if I wait until you're feeling well? And what makes you think you'll get well without us doing something about it? He was not entertained when I told him that (politely but firmly, of course). Even better, he asked me not to touch his belly because it hurts. Um, yes. But again, isn't that why you're here? How can I figure out why your belly hurts if I can't examine it? You wouldn't ask your accountant to do your taxes without letting him see your W-4, would ya?
One other little tidbit. I saw a personal record for UOP (urine output) today: 11 liters in 24 hours. Now that's a lot of pee!

The day the music died

Well, folks, it's that time again. Time for me to write a self-indulgent, whining post about heading back to the MICU (aka "the unit"). That's right, I said MICU. A whole month of intubations, central lines, pressors, and more bodily fluids than you can shake a stick at. Waaah-waaaaahs and frowney faces all around. I've been more than just a bit spoiled by this cush consult rotation (in fact I'm sitting at my desk writing this), so I guess the powers that be decided I should join the Polar Bear Club and dive right into the icy cold unit. I'll do my bestest to keep you posted on the trials and tribulations of critical care medicine, but please promise still to love me even if posting gets sparse and I fail to return your phone calls or e-mails. Odds are, I'm still alive.
The only person who deserves more of your pity than me is my intern, whose birthday is tomorrow on our first call. Time permitting, I plan to bake him something tonight, poor thing. As for me, I have volunteered Nick to take me for my last supper at Midtown Cafe. After that I see another month of Luna bars and yogurt in my future.
So when 3am rolls around and the unit's hoppin' with action, I'll just look around and remind myself of what I don't see. Rheumatology fellows. They're all at home asleep, and that will soon enough be me, too. Honestly, the dreading is (almost) always worse than the actual doing when it comes to the unit. So let's paste on our fake smiles, shall we? That, along with a healthy serving of rules #1-2, should carry me at least until Thanksgiving, and by then it will be old hat all over again.

Speaking of change in the wind...
1) Even at the risk of offending my future employer, I'm siding with my alma mater. What up, UT? Here's to breaking the 15-year losing streak. Sic 'em, Bears!
2) I voted today. Did you? Sic 'em, GOP!

Capacity

ca-pac-i-ty [ku-pas-i-tee]: noun, in a medical legal sense refers to ability of a person to understand risks and benefits and make independent decisions based on those risks and benefits

Some days I have capacity. The other day I did a Pap smear for an annual well-woman clinic visit. The procedure went smoothly as always, so I removed the speculum and told my patient to push back and sit up. Still business as usual. I stepped to the other side of the curtain and gave my spiel about results within a week or so, blah, blah. Second nature. Then I notice something out of the ordinary about my ponytail holder. You detail-oriented people out there may remember that I religiously keep 2 ponytail holders on my left wrist for pulling my hair back whenever wherever. Two because one isn't strong enough since I like the metal-free no-pull do-hickies. But getting to the point... I notice I now have but one lonely ponytail holder on my wrist. What has happened to the other? Well, faithful readers, as I absent-mindedly pulled my left glove off inside-out with my right thumb, I caught the unsuspecting band and trapped it inside the glove, touching the side involved in aforementioned Pap smear. Gross! I had a decision to make. I could salvage the ponytail holder, wash it off, and walk around all day with phantom speculum lube in my hair, or I could cut my losses and realize that while I'm not rich I darn sure have enough money to buy a new ponytail holder. In fact, I already have a whole pack of them at home. I unceremoniously dropped the whole wad in the trash and moved on. Like I said, some days I have capacity.
Some days I don't. Like today, when I decided to go on an adventure in rutabaga. I found a recipe for a veggie soup involving parsnips, turnips, potatoes, and rutabaga. I saved the rutabaga for last on my cutting board, working up the courage to stare it down. Megan had even just warned me that she had to google how to chop a rutabaga, and she's at least as good as (probably a better) cook than I am. But I braved it on my own. All my fingers are intact, but that is one unevenly chopped rutabaga. And I'm about to reap the consequences of eating two pieces of candy and licking the maple-pecan (cup)cake spatula immediately before doing cardio. I'll be regretting that one in about 15 minutes, eh?
So how are you doing today, cyber friends? Is it a capacity day or no?

Happy trails

I almost forgot to tell you about our trip to the park over my vacation. Nashville has many a park and lake for hiking, biking, etc. Now I am no mountain woman, but it would be such a shame not to experience the great outdoors of Tennessee at least a weensy bit before we move. Hence, I scoured the Nashville Parks Department webpage a la Goldilocks for a trail not too hard, not too easy, not too long, not too short. I settled on the blue trail at Percy Warner Park, which purports itself as 2.5 miles of moderate walking/hiking. We wanted to make it a family affair but in the end decided we should only take Izzy. Dallas and Jonesy can have their turns next time; we needed a well-behaved doggie for the first run.

Despite my professed disdain for the outdoors, I actually enjoyed myself. The trail was exactly what it claimed - moderate. The uphill wasn't too bad, with just enough incline to make myself feel simultaneously ashamed and proud of the burn in my legs. Downhill was a little more treacherous though.

In the end I let Izzy stay a few paces ahead of me since she was better at picking her way through the rocky parts. And I figured if we did start an avalanche, it would be better to let her slide down the hill and hurt herself because she would be way easier to carry back to the car than me. She didn't mind at all; in fact, she had a grand ol' time sniffing and stalking chipmunks and squirrels and birdies, oh my. At the end we were all pooped and very ready to be back in the air-conditioned car.

I think Izzy lorded her trip over the other two a bit, but hopefully we'll find time to take each of them (not all together - we're not that crazy of dog people) before we move.

Road Trippin'

Nick and I actually went on vacation during my vacation last weekend. We spent a day in Washington, DC, and a day in Charlottesville, Virginia. Yes, I know that is a lot of driving. But we had a good time and only argued once or twice the whole time about directions; this represents significant progess in our marriage.

But that isn't the point. We had a really good time in DC. I'd never been, and I felt quite patriotic strolling through the National Mall. My favorite was the Washington Monument. I knew it was tall, but my, oh my! It was an impressive sight to say the least. We also went to the Smithsonian Air and Space museum. Oddly, there were no helicopters there; I only mention this because it precluded Nick from his usual commentary about how all helicopters are good for is crashing. Eh, no matter. He used the lack of helicopters as a segue for the afore-mentioned heckling.

We drove to Charlottesville to see our friends Jeff and Jeanetta, who recently moved there from Nashville for her GI fellowship. We had a blast just hangin' out like old times; the only downer is that it kinda made me wish they'd move back. Their little baby Garrett is growing like a weed and now big enough to grab my hair and scootchie-crawl away with surprising speed.

The best part of any Scholz road trip, however, is the mandatory Dairy Queen pit stop along the way. I got a mint Oreo Blizzard as opposed to my usual plain Oreo Blizzard, and I was quite pleased with my selection. Maybe I'll do a mint brownie for our next vacation - in April.

Me and Clint Eastwood

Today I bring you three short stories about food.

I. The good
I have made a few delicious things lately. My reputation preceded me to my first day of ID consults. I walked into the work room this morning, bananas foster bread in hand, and the fellow exclaimed, "Oh yeah! You bake a bunch!" At least I'm known for something. Cherry tortoni was a big hit at home. Nick is pretty selective with culinary praise, and this fluffy concoction measured off the Richter scale. I actually got, "Wow. This is really good. Really good. I really like it." Strawberry almond cream tart was pretty good, too. Next time I'll use a regular graham cracker crust instead of the Cooking Light version (needs more butter!), but it was company worthy.

II. The bad
I am saddened to announce the abandonment of Project Cupcake. There were just too many duds. I could blame the first, and even maybe the second, flop on me. But after four busts (peanut butter, chocolate sour cream, butter cake, and I don't remember anymore), I decided to abort mission and divert my culinary energy toward a different target. (See above, "The good.")

III. The ugly
While in Seattle, my sister and I walked past this establishment:
As opposed to the unsanitary public market, perhaps? Or do they have something to prove? I feel like you wouldn't bother to emphasize the sanitary nature of your market unless it was not, in fact, sanitary. I'll stick to Kroger until I find my way home to HEB.

And that is all.

Battle of the sexes hits the road

Today we venture into a new realm of Scholz life, that of Going Somewhere New. (Sorry, I've been reading Jane Austen and just couldn't resist the urge to use odd but fitting capital letters.) We aren't a nagging, bickering couple, but travel all too often results in temper tantrums (on both sides). Even the acquisition of a GPS didn't solve this. The following is a mish-mash compilation of what you'd hear if you were a fly on the wall. Or windshield, rather.

Me: Were you gonna turn there?
Nick: Why would I turn there?
Me: That was our turn, but too late now.
Nick: That wasn't our turn.
Me: Yes, it was. There was a sign.
Nick: I didn't see it.
Me: That doesn't mean it wasn't there. I saw it.
Nick: It woulda been helpful if you'd mentioned it before we were past the exit.
Me: Well, you changed lanes. I thought you were doing that so you could take the exit.
Nick: But I didn't see the sign, so how would I have known to take that exit?
Me: Well how did I know you didn't see the sign? Why do you never see the signs?
Nick: Because I'm busy driving, watching out so other cars don't run into us.
Me: But they put the signs on the road so you can see them while you're driving.
Nick: Do you wanna drive?
Me: No, you just make fun of me when I drive.
Nick: No, I don't.
Me: Yes, you do. You grab the handle and the dashboard and yell like I'm gonna wreck.
Nick: Sometimes you're scary, flinging the car all over the road.
Me: See?! You do make fun of me.
Nick: It isn't making fun if it's real.
Me: Not funny. We're gonna be late.
Nick: No, we aren't. You made us leave 20 minutes extra early.
Me: Only because I knew it would take us forever to get there. Are you gonna miss the turn again?
Nick: No, this isn't it yet.
Me: But the GPS says...
Nick: No, it's not.
Me: Yes, it is.
Nick: No, it's not.
Me: Yes, it is.
Nick: No, it's not. See, we're past that light and it isn't telling us to turn yet.
Me: Oh.
Nick: Are you gonna be nice to me?
Me: I am being nice to you.
Nick: No, you're angry.
Me: I'm not angry.
Nick: No, you're definitely angry. I can tell.
Me: I am not. I'm just frustrated that we're gonna be late... And you're angry, too.
Nick: No, I'm not angry. I'm trying to cooommmuunnicaaatttee. And we're not late. That clock is fast.
Me: I know, but still. Are we there yet?
Nick: Yes.
Me: I love you, even if you are a booger sometimes.
Nick: I love you, too.

Bon appetit

I am pleased to announce my return to the Volunteer State yesterday evening. My second week of vacation promises the luxury of trying lots of new recipes. My first culinary foray this week is beef tenderloin. Sadly, tonight's herb-encrusted main dish was tasty but overall not blog-worthy. Why am I blogging it about it then, huh?
I told you that story to tell you this one, which involves three waggily tails. I saved the meat trimmings and cooked them up unseasoned for the dogs. They thought it better than Christmas when three plates of beefy goodness descended from Heaven onto the kitchen floor. We strategically spaced them out to avoid bickering about whose share was bigger, etc. Dallas and Jonesy pretty much inhaled theirs and then licked the plates clean. Izzy, however, was a bit more hesitant. At first she just stared at me, like this must be a trick. Remember, she is the rule-follower of our little pack, and I think she couldn't get over eating off a plate when she knows she isn't supposed to take food off plates. This was a moral dilemma that never even occurred to Dallas or Jonesy, but Izzy was torn. I coaxed her a bit, and she finally laid down (she always eats laying on the floor) and took a bite, staring at me the whole time. She then proceeded to transfer each piece to the floor before chewing (actually chewing) each morsel. I've never seen a dog savor anything like that before. I wish I had pictures, but my hands were ocupado holding the other two back; they really wanted to help Izzy with her dinner because they knew there would be no dessert until she finished.
Dessert, you say? Why yes, doggie dessert. There exists in this world a phenomenon called Frosty Paws, which is ice cream for canines. We splurged on a box once and bust it out for special occasions. My vacation, Nick's new job, and cheap tenderloin qualify as a special occasion. I divided the last of the Frosty Paws as evenly as I could and handed each pup his lot. It's so funny to watch them; they lick and lick and lick, try and chew but it's too cold, lick, lick, lick, chew some more. And on and on, the whole time watching the other two to see how they're progressing. By the way, Izzy has no qualms about eating her Frosty Paws. Then there is much licking of the floor. And wagging of tails. And that's my story.

Back in the habit

I was telling my intern last week about my planned trip to Seattle and how I knew I would get to go shopping with my mom. I asked her if she thought I was too old to let my mom buy me stuff. She replied, "You're never too old to let your mom buy you stuff." And with that indisputable observation, I was persuaded.
After 48 hours in Seattle, I have acquired a foofy flower bracelet, a ruffly shirt, skinny jeans, a shift dress, another ruffly shirt, and a bridesmaid dress. And a chunky pink beaded ribbon necklace, but I have to wait until Christmas for that one. (For as long as I can remember, Mom justifies buying me more stuff by holding some of it hostage until Christmas.)
And do you know what happens after a long day of shopping? You get very, very hungry. How to solve this dilemma, you ask? A swift trip to the nearest Cheesecake Factory, of course. Yum! Old habits are hard to break, so despite toying with the idea of a fling, I decided to remain faithful to my first love Chicken Madeira. But when dessert time rolled around, the waiter tempted me with peanut butter cup chocolate cake cheesecake. Banana cream pie cheesecake and I have had a good, long run over the years, but I decided to take the plunge, live on the edge, go for broke... I tried the Reese's concoction. And my oh my... it was goooooood! Totally worth all the heartburn induced by the stress of breaking my norm.
But I think that is quite enough craziness for one week. Time to get back in my nice, comfy rut, starting with my post-Cheesecake Factory elastic-waist PJs.
Good-night, all.

The break-up

I'm visiting my sister in Seattle this week. I've only been here one day, and I can already tell things just aren't gonna work out between us. Me and Seattle, that is.

Top 10 Reasons Seattle and I Should Break Up:
1) It's way too hard to get a tan this far north.
2) I have a serious aversion to puffy vests.
3) I'm too prissy for all the flannel-wearing tree-huggers out here.
4) I don't hike, bike, or climb rocks, trails, or anything else.
5) I can't wear high heels on your hilly streets.
6) I'm a Republican.
7) I think organic food is over-rated.
8) Have I mentioned how prissy I am?
9) I don't drink coffee.
10) I'm in love with somewhere else. His name is Texas.

So you see, Seattle? It isn't you; it's me. We're just better off not together. So if you don't mind, I'll be hopping a plane back to Tennessee in short order. I know he's not Texas, but if you can't be with the one you love, you gotta love the one you're with. Adieu, Seattle. We never had a chance.

Scrappy-Doo

I got the urge to scrapbook last weekend, so the kitchen table is a hodge-podge wreck of paper, ribbon, and the removable backing of those little photo sticky thingies. I made a serious attempt to let go of my inherent type A-ness and focus on a new strategy: It doesn't match, it goes.
I can do this with outfits. Why not scrapbook pages? This was my first page.
Still pretty matchy, but you may notice that the only orange on the page is the dots on the bottom flower chipboard piece. Hey, no judging. Baby steps.
This was next. I don't think I get much credit for this one, either, because these non-matching-but-still-going papers were nicely shelved side by side, already compiled for me.
I'm hoping to do more pages next week on vacation, and I have a few piles of deliberately paired non-matching paper ready and waiting. And some new ribbon. And a whole pile of various and sundry buttons. See you on the other side of Morgan!

A time for everything (all at once)

Aaah! Busy day. I was planning on having today off, but that went by the wayside yesterday. (Long, uninteresting story.) So I am now cramming everything I had planned into the afternoon. At least I left work early.
Digression: I almost won the game today, which means discharging all your patients. However, psych balked at a transfer to the pysch hospital. They say he's delirious (a medical problem); I say he's psychotic (a psychiatric problem). You say tomato, I say tomahto. Let's call the whole thing off. Which they did, most unfortunatlely for me.
Back in the game: I have already rounded, written notes, discharged my lady, signed out, and finished morning report.
Digression #2: Tomorrow is my LAST Vanderbilt morning report EVER!! Morning report is where one resident presents a case, another resident tries to work through it out loud, and then the first resident gives the answer and does a little presentation thingie on the topic. I've been saving this one for a long, long time. Since this is the last one, it's high time to open the vault and dust it off. DRESS syndrome! Get excited, people!
Back in the game again: I currently have cinnamon roll dough in the bread maker (to make my last morning report even more enticing) and a pumpkin cake in the oven. So that means two batches of icing (cream cheese and buttermilk) as well as dinner: ribeye steaks with baked potatoes and roasted carrots. Yum, right? And all that before book club, for which the pumpkin cake is destined.
Digression #3 (last one, I promise): I am so excited for book club. It feels like something normal people do. Woohoo!
Back in the game: I've got lots to tell you all about, from scrapbook pages to puppy stories to Nick stuff, but I don't think I can cram anything else into this post. More soon!

Things that go beep in the night

My pager scares me when it goes off. And not just because it's loud. It's more that the beeeep beeeep beeeep immediately provokes anxiety over the million bad things said page could bring. Another admission. A crisis on the floor. An intern stuck in the elevator. A wrong number.
The only thing that scares me more than my pager going off is when it doesn't go off. Why, you ask? Let me tell ya. While on general medicine, I take over triaging admissions at 11pm. So a silent pager overnight just makes me wonder what's going on down there. (The ER is in the basement.) Are they calling the wrong person? Is my pager working? Did I accidentally silence it?
This paranoia takes me so far that I can't sleep with my back to the pager. I set it on the nightstand in the call room and then actually sleep facing it even though I am usually an avid start-on-the-right-end-up-on-the-left sleeper. I know it's irrational, that it's so loud you can probably hear it in your bed wherever you are all the way from Tennessee. But I just feel better with it in front of me. Sometimes to reconcile my anxiety with my desire to lay on the other side, I put it in the bed by my face. This just results in anxiety that I will knock it out of the bed or inadvertently shove it under the pillow (as if that could actually keep me from hearing it - you could hear this thing at a rock concert), so I put it back on the nightstand and start over. I'm just a hamster in a wheel with that thing.
Don't tell me to think of it like my alarm clock, which wakes me up no matter in what position I'm sleeping. You can't reason with paranoia. However, speaking of alarm clocks, I need to set mine and hit the sack. Hasta luegoa, amigos mios.

All Greek to me

Attention, class. Let's get started. Today will be a lesson in residency vocabulary.

OTD: Out the door. Discharged and (presumably) leaving the premises.

A la casa: Similar to OTD but employed mostly south of the Red River (ie, in Texas)

NMP: Not my problem. Someone else's problem.

HMP: Originally pediatrics, high maintenance parents. Adapted to adult medicine, high maintenance patient.

pimp: to ask series of questions to be answered verbally on the spot, especially on rounds, to those below you on the totem pole with the intent of either education and/or public humiliation.

GORK: God only really knows. As in, none of us have a clue what's going on. Often used in past participle form. Eg "He's totally gorked."

zonked: state of sedation or altered mental status, either due to medication administration or disease process Eg, "I tried to get more history, but she's totally zonked after that Phenergan."

rose: patient who is doing well, can refer to original state upon admission or progress made during hospital course. Eg "She looks like a rose. I don't know why she even got admitted." OR "She was crumping on me last night, but she looks like a rose this morning."

peach: difficult or challenging patient, usually referring to psychosocial needs rather than physical maladies. Eg, "Did you see Mrs. X is back on my service? Yeah, she's a real peach. I was up all night trying to find her a strawberry Ensure because she doesn't like the chocolate ones."

white cloud: State of good fortune, usually referring to low census (how many people are on your service) or quiet pace of call nights. Can also refer to the person who has this state of good fortune. Eg "I love being on service with Susan. She has a such a white cloud." OR "Don't worry, call will be fine. I'm a white cloud."

black cloud: State of unfortunate fortune (aka plain ol' bad luck). The opposite of a white cloud. (Incidentally, I don't believe in clouds. You make your own white cloud. But if you really pressured me, I'd say my cloud is white all the way.)

And PS, these are all in fun. Residency is tough, and we've gotta laugh so we don't cry. That doesn't mean we won't still take very good care of you, even if you are an HMP.

The silent treatment

Today was a long one. Eventful and long. Oh, if only I could tell you everything! Tales involving patients, attendings, and other residents involved in comical mishaps and heart-wrenching tragedy. OK, so that may be exaggerating a bit, but honestly, I've been on the verge of tears (both angry and sad) at least three times today.
But most unfortunately, in the interest of my long-term career viability, I dare not repeat that which I have seen, heard, and spoken. I know, what a let-down. The motto of the day is "polite but firm." I will go so far as to allude to the fact that I can't fix crazy, also known as "there is no reasoning with the unreasonable." If I tell you demonstrable, objective, reproducible medical facts, and you call me a liar, I just don't what there is left to do. I really don't. Especially if you cross your arms, roll your eyes, and refuse to talk to me when you are 38 YEARS OLD! I guess we're done here then. The best I can offer is to repeat myself over and over again (firmly and politely every time) until I'm blue in the face or one of us gives in. And I'll warn you now, I don't give in.
OK boys and girls, it's almost my bedtime. Gotta get my beauty rest so I can get up and do it all over again tomorrow. Good night and good luck.

No turning back now

I had two very exciting rashes last week. Well, not me personally, but my patients. I sat in the medicine resident work area, showing off pictures of some really wicked mouth ulcers, and thought out loud.
Me: Maybe I should have been a dermatologist. I love rashes.
Other resident: Yeah, maybe.
Me: And sleep. And money.
Other resident: Well, those are the three pillars of dermatology. Rashes, sleep, and money.
Me: Yuh-huh. Lots of money.
Maybe in my next life.

Insane in the membrane

I have a confession to make. If I were totally honest,the kind of honest you can only be when you're sleep-deprived punch-drunk and not looking anyone in the eye, I'd confess that I like Morgan (the general medicine service). People whine and complain about the work and how it's a dumping ground for the hospital's refuse, but I just can't help myself. I like general internal medicine. Did you hear that, world?
I LIKE GENERAL INTERNAL MEDICINE! I like finding heart murmurs. And googling "MAGIC syndrome"** in the middle of the night. And ordering pizza with my intern. And teaching my medical students to tie sutures.
That being said, I sure am tired today after call last night. Those two (count 'em, two!) admissions at 3am sure were brutal. Rheumatology still sounds like a mighty fine plan to me. I just needed to get this off my chest... I may be crazy, and you can judge me if you want; but, there are actually days when I like my job. And today is one of them.

**mucosal and genital ulcerations with inflamed cartilage - No, he didn't have it after all.

If I'm lyin', I'm dyin'

You can't make this stuff up.
I admitted a gentleman with a rectally-oriented problem. He believed the problem had resolved overnight, which he indicated via gesturing to his rectum on rounds. And by gesturing I mean touching.
Then I fell prey to one of the classic blunders, the most famous of which is, "Never get involved in a land war in Asia." Only slightly less well-known is this... When a man who has just touched his poopy-hole area offers you a handshake, never, ever accept. But I was living-dead tired and just straight up forgot until my hand was half-way to his. Then it was too late; I was committed. Shudder. My attending closed the conversation, and I bolted from the room with my arm extended high in the air.
"I'm contaminated!"
This drew the attention of several ER nurses and residents.
"He just touched his poopy-hole and then shook my hand."
A collective "Oooooohhh."
I found a sink and decontaminated myself. And life goes on.

Wake up call

I was supposed to be at work by 7:30am today. The alarm rang at 5:45am. I snoozed. I caught it at 5:49am and reset it for 6:00am but decided to get out of bed at 5:52am. Shower, breakfast, make-up, hair. I put on a dress and my jewelry. Then I vacillated, wondering if a different shirt would better complement my new Cole Haans. But I decided to just leave and arrive early. I pulled out at 6:43am.
Leaving my neighborhood, I saw a van on the side of the road with smoke rising from the hood that was wrapped around a tree. A young man was in the driver seat, trying to speak to 911 on his cell phone, clearly very disoriented. I approached, offering help, and stretched to reach inside for his phone. I spoke to the 911 operator, giving various details... street name, no I didn't witness it, just one victim. I couldn't examine his injuries since trees pinned the driver's door closed, but he did give me some pertinent medical information. He lost consciousness moments before the ambulance pulled up. After briefing the EMT on the brief history and survey I'd accomplished, I handed his cell phone to the cop and drove shakily into work.
Vandy is the only trauma center in the city, so I scanned the ER roster after rounds and found the trauma bay attending who'd seen him. Turns out he has a bit of internal bleeding and non-operative fractures but nothing too serious. He's gonna be fine. Whew. I even got to introduce myself to his very grateful parents.
Timing is everything, huh? If I'd changed my outfit, I might have arrived after he'd passed out. If I'd not hit snooze, I might have passed the scene before he wrecked. Moral of the story: God is in the details every second of the day.

Miscellaneous, etc, and so forth

I really should know better by now than to blog post-call. But I think the sleep deprivation disinhibits my creativity, and the words just flow more better. So please pardon the poor grammar. And typos. And the rambling. Especially the rambling.

Call last night was icky. First a geography lesson. Round Wing:Vanderbilt Hospital :: Puerto Rico:USA. If you chose b) far, far away but still technically all in the family, you are correct! I spent all night running back and forth to and from the Round Wing babysitting a sick, sick dude who just kept getting sicker no matter what I did. I made a valiant effort for 17 hours, but I finally had to cave and send him to the MICU after post-call rounds. Bleh. The good news is that no one else I talked to had any idea what was going on with him either, which is also the bad news. Guess we'll see how things shake out (or shook out? see, I really need to get more sleep) tomorrow morning.

Speaking of nothing in particular, I have the world's tallest intern. No, for real. At 6'9", Will most literally towers over me. Last year, I thought my first ever intern Joe (6'1") was really tall. Then Scott the intern was taller. Then Eric the intern was taller than that. Then Brad the intern was taller still. But I can't imagine anyone beating Will. If I find such an intern, I'm submitting him to Ripley's Believe it or Not.

Moving on. After my bleh night, I wanted to bake something. I've been jonesing for cupcakes lately. Not to be confused with Jonesy, see exhibit A:

So anyway, I made super tasty apple almond streusel cupcakes for my first day with the new team last week. And I decided to give white mountain cupcakes a whirl today. Bet you can't guess the etiology (there I go using medical words in normal conversation - why don't I just go to sleep?!) of the name. See exhibit B:

The 7-minute merengue-ish frosting is a nice contrast to the chocolate. And Nick approves, too. I've decided I'm going to bake my way through Elinor Klivans Cupcakes! cookbook. A la Julie and Julia, minus the snooty French words. Sticky fig cupcakes may be next. Yum, huh?

Speaking of yum, Nick tried his hand at hickory-smoked spare ribs today. Ohhhh myyyyy gooooodnessss. Sooooo goooood!!! Wish we had smell-o-vision because it was mouth-watering.

OK. I admit defeat. Must sleep. Buenas noches, mis amigos.

For he's a jolly good fellow

Last Saturday was Nick Appreciation Day. For you to, well, appreciate it, let me start with the backstory. I think I may have mentioned once or twice how much I love my husband. He's just the best. I think I may also have mentioned how tough intern year was for me. One day during that bleak November, Nick announced "Beth Appreciation Day." I don't remember exactly what we did, but I'm pretty sure it involved shopping, him cooking me dinner, him rubbing my feet, and us watching a movie of my choosing (probably 13 Going on 30). In all seriousness, the fact that he made such an effort to make me feel special when work was beating me down so, so badly really did lift my spirits immensely. And because, as Nick likes to say, our marriage is a competition, I couldn't let him be the only one making sacrifices for the other's happiness. Hence was borne the tradition of Nick vs. Beth Appreciation Days.
We started with lunch at Pei Wei, where we shared Nick's favorites, chicken lettuce wraps and sweet and sour chicken. Then we walked around the mall to kill some time before our movie started. This is where Nick let me sneak some Beth activity; I got a pretty ribbon-embellished blue cardigan from Banana Republic. And Nick got a couple T-shirts, too. (Yes, I do take responsibility for his addiction to BR cotton.)
Then we saw the much anticipated Scott Pilgrim vs. the World. For those of you like me who don't follow the gaming and/or comic industry closely or even at all, let me give some more backstory. This movie is apparently based on a comic book. It has gotten great reviews but overall flopped at the box office because it lacks a target audience; there just aren't enough comic and gaming nerds to compete with the teenage girl buying power backing Zac Effron. But that is neither here nor there. Nick was excited to see this movie. For me, it was... interesting. Very different, very visually engaging with the comic-book style overlays (Wam, Pow, floating hearts, etc) and the Matrix-meets-Nintendo fight scenes. But the novelty wore off to me about halfway through. Nick liked it quite a bit, though. So if you're a closet gamer and/or comic junkie, go eat your heart out.
So there you have it. Three cheers for Nick, and a halfway-enthusiastic thumb up for the first hour of Scott Pilgrim. I'll be cashing in my next Beth Appreciation Day soon since I'm heading to a general medicine ward service later this week (eek!). Hasta.

Decisions, decisions

Today is my last day of freedom, for a little while at least. No more weekends off next month, so I have to squeeze every last drop of weekendiness from today. Here's the plan.
1) Go to church. Check.
2) Catch up on emails. Check.
3) Eat dessert. Check and check again. Banana cupcakes with cream cheese icing AND ice cream with homemade hot fudge sauce. (Come over sometime and eat my hot fudge sauce; you will never buy the jarred stuff again. Moving on.)
4) Shop. Check as of yesterday. Banana Republic had a few great finds on the clearance rack, and Nick let me have a short interlude during Nick Appreciation Day (more on that later this week).
5) Cook. Check. Carrot soup, which I made today to eat Tuesday because everyone knows soup is better if you let it sit overnight so the flavors can meld, but I'm going out for dinner tomorrow so will be unable to eat or cook said soup tomorrow evening. Therefore, I cooked soup tonight to eat Tuesday.
6) Work out. Half a check. I walked Izzy this morning but am trying to find my motivation for some Pilates tonight. Maybe if I do Pilates, I can reward myself with more hot fudge sauce. That's how it works, right?
7) Read. Check, like three times over just this afternoon. Bible (I finally finished Job, woohoo!). How to Talk to a Liberal if you Must (Ann Coulter). One Day (David Nicholls).
8) Blog. Almost check. This is the part where I announce the winner of the Shoe War from last week. In a stunning eleventh-hour upset, these lovely cream Cole Haan pumps won out thanks to a fab deal on ebay.
More than you wanted to know about my day, huh? Coming blog attractions this week: Fed's bridal shower, Nick Appreciation Day, and new recipes.

Fountain of youth

For hundreds of years, mankind has dedicated too much energy and brainpower toward discovering the secret of eternal youth. That's way too hard. Instead, let me give you a personal, hard-earned lesson on a quick and easy method to feel really, really old.
1) Start by sleeping in so that you have to rush through your morning routine. This will guarantee kinda smudgey eyeliner and not-quite-perfectly straightened hair, which will highlight the forming wrinkles over your forehead and by your eyes. Wow. You're old.
2) Wear fabulously cute but impractical shoes. This will ensure your tootsies feel each and every step of the 10,000 you'll walk up and down the halls at work, which will in turn remind you how your feet didn't hurt when you wore those shoes a gagillion years ago when you bought them. Wow. You're old.
3) Spend all day at work. Start yawning at 3pm. This will remind you how you used to stay up until 3am and still be ready for more. Wow. You're old.
4) This next step is key... Spend two hours doing college athlete physicals. Seeing spry young whipper-snappers who are physically capable of doing things you can't even dream (like run 30 miles just because) will bring to mind how thin and fit and tan you used to be. Emphasis on past tense. For good measure, inadvertently use slang that was cool when you were their age (a decade ago!!) but is now obsolete, like "clutch." Fight back the urge to tell them to enjoy it (meaning their youth) while they can. Wow, you're like ancient.
5) And the clutch move is going to bed before 10pm. I know this may sound difficult at first, but think about the trying day you just finished and the equally trying day ahead! You'll be yawning in no time, and off to dreamland you go at 9:43pm on the dot. This seals your entry into the class of the prematurely elderly.
Yeah, I'm old, and yeah, I know it. No shame. Well it's almost my bedtime. Good-night, all.

Persuedsive

I am in love. And I'm not talking about a man, wonderful as Nick is. I'm talking about shoes. I try to be practical, but I just can't get suede out of my head. I know, Houston is a rainy place, and suede reacts to puddles just like the Wicked Witch of the West. But I can't help it. Like I said, I'm in love, and there's no stopping me.
First there's the cognac Anne Klein knee-high boots.
Or maybe the grey Sofft knee-high boots.
Or compromise with a suede-accent purple Cole Haan heel.

Please, please click the links. I couldn't figure out how to get the pictures on the blog without getting myself hunted down by intellectual property lawyers. And oh, you will swoon. I'd bet a dollar I'll own one of these by the end of the week. What's the point of moonlighting if I don't get to be a little impractical every now and then? I mean, I have ten whole months left in Nashville. I promise I'll wear them every day, Nick, really! I guess we shall see...

Battle of the sexes, part deux

Remember a long, long time ago when I took you on a little journey into the his vs. hers approach to getting dressed? Well, here's a little jaunt even deeper into the Scholz psyche - choosing what we will eat for dinner. (Insert dramatic music here.) This conversation usually occurs when I'm driving home from work in the evenings.

Beth: Hi. I'm on my way home. Work was gross. What do you want to eat for dinner?

Nick: I dunno. Food.

Beth: I was thinking maybe I could make that pear and prosciutto pizza I've been wanting to try for a while.

Nick: Uhh... OK.

Beth: Or we could defrost the lasagna from the freezer. And we have that loaf of bread, so I could do garlic bread. And I could stop and pick up broccoli from the store.

Nick: Or there's always Red Robin.

Beth: Nooooo, we always go to Red Robin.

Nick: We don't always go to Red Robin.

Beth: We went there last month.

Nick: That was a month ago.

Beth: Well, what do you want for dinner?

Nick: (Frustrated sigh.) I just told you, but you don't want that. So you pick.

Beth: But I want to have something you want. Or I could do -

Nick: There you go with your options again. Always gotta have more options.

Beth: (Frustrated sigh). We could just do sandwiches and cereal.**

Nick: Why don't you like sandwiches?

Beth: I do like sandwiches, just not your kind of sandwiches. I like hot sandwiches, not boring turkey sandwiches.

Nick: Well, if you put mayo on your sandwich it wouldn't be so dry, and it would taste better.

Beth: But I don't like mayo.

Nick: Well, whose fault is that?

Beth: How come all you ever eat is turkey sandwiches?

Nick: I eat cereal for breakfast. I don't want cereal.

Beth: Well, I like cereal like you like turkey sandwiches.

Nick: Just make your dumb pizza. I know that's what you want to do.

Beth: Yes, but I want you to want it, too.

Nick: If I don't like it I'll just eat a sandwich.

Beth: OK. I'll be home soon. Love you.

Nick: Love you, too.

The end.

**When the cupboards are bare, Nick defaults to a turkey sandwich. Beth does not like boring turkey sandwiches. Beth defaults to cereal. Nick only likes cereal for breakfast. It is startling how often we have this exact conversation. Like every week.

Trading places

Sigh. Mike and Kristen are gone. But we crammed a lot into their short visit. We started with a short scenic tour of Nashville, ending with dinner at Bread & Co, which is the new love of Kristen's life.
Tuesday morning Mike accompanied me on my morning commute through primo "rush hour." The quotation marks here indicate sarcasm; if you've seen both Houston and Nashville traffic you'd understand. (The whole reason for them to come was for Mike to have a second look day, kinda like a follow-up interview, with the neonatology department to help him decide where to do his fellowship. ) We spent that afternoon completing our driving tour of the city and then tried a new restaurant called Burger Up. Mmm, it was yuhm-my. The regular, turkey, quinoa, and salmon burgers all got two enthusiastic thumbs up from our entourage, but the highlight of the experience was (yes, folks, this really exists) the Krispy Kreme doughnut bread pudding. We then funnelled our sugar high energy into a rousing game of Apples to Apples that really came down to a battle of the sexes in which {Mike and Nick} and {Kristen and I} tried to figure out and pick each others' cards just so they wouldn't win.
Wednesday was a full work day for me, so the others ate breakfast at the Loveless Cafe without me. Nick doesn't know it, but we're in a fight because he didn't bring me any biscuits. And the sky literally rained on my parade, so we didn't go to the lighted Chihuly glass exhibit at Cheekwood Garden like I'd planned. And dinner was not quite the glorious success for which I'd hoped, either. In summary, homemade sweet potato gnocchi are OK but not good enough to justify the hours of prep time. And how did I not know about Mike's white food rule?!** But I think he found the chocolate mint ice cream pie tasty enough to compensate for the spinach dip and ricotta-filled zucchini.
Sadly, Mike and Kristen are now back in Houston, but probably not for long. How sad will it be if/when our moving trucks pass each other on I-40, going opposite directions between Houston and Nashville! Now we just have to start convincing them to buy our house.





**He won't eat white foods. At all. White sauce, cream cheese, sour cream, ricotta, etc. Can you imagine life without cream cheese?!

Weekend warrior

Whew! Was I ever glad to get back to work today, where I can rest up from my weekend! But seriously, I did actually exert more energy on my days off than I did in clinic this morning. Doing what, you ask? Well, I hope you've got a tasty beverage because here we go.
First off, I worked out Friday morning for the first time in a couple weeks, which means that my workout Sunday was extra painful. And no, I don't have a good medical explanation for why the second workout hurts more than the first. However, I think Sunday's pain was more secondary to my silly decision to take both Izzy and Dallas for a walk all by my lonesome. Overall, they do so well, but they fall into a vicious positive feedback cycle of worked-uppedness when they see another dog that is exponentially worse than when they're separate.
After said walk and workout, Sunday was a mad, mad whirlwind of cleaning because... Mike and Kristen come today! Two days prior to company, Nick and I always repeat the same ritual of whipping our house into shape, and much to my delight, I have fooled most of you into thinking my house looks like that all the time! My biggest accomplishment this go-round was sifting through a hundred or so medical journals and clipping only the one article from each I am most likely to read during a spell of motivation. I then promptly filled that hard-earned space on the bookshelves with the stacks of books that had previously been piled next to the bookshelves. I didn't make it to my desk, which has always been and always will be my Achilles heel of cleanliness. Like Scarlet O'Hara, I will just think about it tomorrow.
I might have made it to the desk this time, were it not for an overwhelming desire to scrapbook after seeing Angela's albums last week. I completely strained my right brain, but I managed to finish a couple pages. If you promise not to laugh, I'll share one.

Well, that's about it for today, folks. Maybe I'll tackle the desk in the next 20 minutes before the Stewarts arrive. Or maybe not.

An elephant never forgets

I think I promised photos of roommate reunion. Let's see if the photo uploader is behaving today. There was the dance party, which consisted of Angela dancing, Cass twisting, and me spinning in circles. Also lots of cooking and lounging. It felt good to laugh that much. I can't hardly wait for next year, ladies!

Smoke gets in my eyes

My darling husband turns 32 years old today. Whew, that is a LOT of birthday candles. I think he's had a good birthday. I mean, he did get a fabulous present from yours truly. I think I've already told the following story to everyone who ever reads this blog, but humor me here.

I had the amazingly, wonderfully, brilliantly brilliant idea to get Nick a meat smoker for his birthday. I mean, the boys loves his grill like Izzy loves a squeaky ball; they just can't get enough. So what would be better than a meat smoker? Perfect. So I did my research and picked out a reasonably priced yet sufficiently high-quality model, which was scheduled to arrive August 11. I know, I lack the foresight I possessed prior to residency. Sue me. No, wait, please don't sue me. My malpractice can't handle it. Anyhoo...

I talked to Nick last Saturday morning when I was in Dallas rollin' with my girls. He said, "I don't know if I should tell you this but I will." (Me, silent) "I think my birthday present came yesterday because there was a big box on the front porch." (Me, still silent) "And it wasn't inside another box." Bummer! "But I like it a lot and I'm really excited to use it." Slightly less of a bummer. But still, I wanted to see his reaction

Nick hammered and screwed and finagled last night (picture cartoon cloud of dust with just arms and legs sticking out) and got it assembled. Then he went through all the trouble of seasoning it way too early this morning so he could cook something in it for his birthday dinner tonight. Please don't judge me for letting my husband cook his own birthday dinner. He wanted to. Mesquite smoked pulled pork. Mmm, mmm, good. With homemade barbecue sauce. Double mmm, mmm, good. I made mac 'n' cheese along with grilled bacon-wrapped asparagus. Could it get any better? Why yes, it could. Chocolate cake with 32 sparkler candles on top.

Happy birthday, honey. I love you!

Now and then

Oh boys and girls. I'm fresh off the plane back from Texas, and I already can't wait for RR3. The whole thing was just what I needed. We can go a year without seeing each other or even talking, but as soon as we're together it's just like old times. Even though our current everyday lives share basically no commonalities, we still get along as well as back in the day at our green-carpeted apartment in Waco.

Angela lives in Waco and works as a fully licensed CPA (woohoo!). She has a blog, too, which is mostly about scrapbooking but partly about her life in general. She just gave me a shout out for her favorite post of mine; since one good turn deserves another, here is my favorite page of hers.

Cassandra lives in McKinney (north side of Dallas) and has just temporarily retired from teaching 5th grade to stay at home with her still-gestating baby. She does not have a blog, but she recently joined the 21st century by signing up for Facebook, which she assures us will result in posting pictures of afore-mentioned still-gestating infant after his birth.

So that's the cast and crew. Now the story.

The weekend essentially consisted of an incessant stream of hyperverbosity punctuated by pauses just long enough to chew and swallow the massive amounts of food we cooked, including pizza rolls just for old times' sake. And time spent poring over wedding pictures. (Nick's exact words upon hearing about this particular point: "Praise the Lord I'm not going to be there!") And gushing at baby Mason's room, ready and waiting for him. There may also have been an impromptu dance party. Cassandra's husband went so far as to pull a double-header at the movie theater so we could have the house to ourselves all day Saturday, but he did make sure we gave her very pregnant self a nice long nap that afternoon. The photo uploader is being stupid right now, but more pics will follow soon. I hope.