Me and my Snugglebunny

Nick hates when I call him that, which is the main reason why I continue to do so. But that isn't the point. The point is that today is our fifth wedding anniversary! Now that's legit, huh? Surely five years is enough to shush the nay-sayers. And if marriage is a marathon, I think we've hit our stride. I'll spare you a repeat gushing about all the ways in which Nick is wonderful and just say that in my humble opinion we are good for each other; Nick keeps my non-hospital life glued together, and I do something (much less tangible, possibly related to a paycheck) that seems to make him happy, too.

My VA rotation has left little time for romantic weekend getaways, so we had our honorary fancy-pants dinner date last weekend at F. Scott's. I do enjoy getting dressed up. Unfortunately I'd left my camera in my desk drawer at work (for photographing odd rashes and such on call), so we have no pictures. Zilch. Sorry. We look mostly like we did five years ago except a few worry wrinkles on me.

I'd suspected that my Friday afternoon clinic and aforementioned VA duties would keep me at work late today, our actual anniversary, so we'd made no particular plans. But miracle of miracles.. I left work at 5:00! After much debate over the phone on my drive, standing in the closet, and even carried into the car pulling out of the driveway, we just couldn't settle on a dinner destination. Solution... frozen pizza and cupcakes on our couch, watching a DVD (Pirates of the Caribbean). Now that's real love, right? After five years, I can't imagine anywhere I'd rather be after a long day's work than curled up on the couch with my snugglebunny oops I mean manly man husband. Happy sigh.

Maybe we've found our anniversary tradition.

My green thumb

Remember Sisyphus, the guy who for various and sundry reasons was sentenced to roll a rock up a hill every day for all eternity only to have it roll back down just before the crest? Well, I certainly feel his pain. My rock is just metaphorical rather than literal.

First, a residency vocabulary lesson:
rock: a patient with no endpoint of hospitalization on the horizon, usually due to placement and/or disposition issues (eg patient refuses nursing home placement but daughter refuses to take him home again); implies medical stability

wreck: a patient with no endpoint of hospitalization on the horizon, usually due to a plethora of acute and/or chronic medical problems (eg infected diabetic foot wounds, heart failure, kidney failure, and cancer); often used as part of the phrase "train wreck"

VA six pack: coronary heart disease, diabetes, chronic kidney insufficiency, emphysema, cancer (any type), chronic low back pain

rock garden: phenomenon occurring when multiple rocks accumulate on a service

I am growing quite a rock garden, my friends, which I feed and water with TLC. Day after day we round on them, say our hellos, crack a joke about the food, and wave our good-byes. Poor guys, the situations aren't generally their fault, but whew! They weigh my service down. Just when I think I have a disposition lined up, something bad happens. A fever. Rejected insurance. Or the infamous "hey, doc, I haven't been able to move my legs for two days." Why yes, that has really happened to me. You can't make this stuff up.
But my end is finally in sight. Only 6 more days. Then elective. Which will involve a dash of ortho clinic, a sprinkle of musculoskeletal radiology and a healthy dose of roommate reunion part II. Sounds like Eden to me.

I spy with my little eye

Nick and I had date night yesterday, dinner and a movie to be exact. Against all odds, I made it out of the hospital at 2:15, 45 minutes before I'd predicted to Nick that I'd actually leave. The next two hours involved showering (gotta wash out the eau de Va), trying on 6 different outfits (finally settled on uber cute strapless purple and white cotton sundress) and the never-ending debate about where to eat. There's lots of restaurants in Nashville I want to try before we move (in a mere 339 days), but sometimes I just can't resist a craving for an oldie-but-goodie; we finally agreed on the Cheesecake Factory. The place was packed, but the food was good, as usual. Chicken madeira and a shared banana cream cheesecake slice later, we moseyed on over to the Green Hills movie theater.
We found ourselves among the masses headed to a Saturday evening show; the place was jam packed. I'm picking my way through the crowd, when what to my wondering eyes should appear... No, it couldn't be, could it? No, no, not eight tiny reindeer. Nicole Kidman! Yes, friendly cyber-citizens, a good hard stare confirmed that the famed Aussie was indeed before me. (She lives in a ginormous house in Nashville with hubbie Keith Urban.) Nick was directly facing her with nothing but a foot of air in between them. I tried to play it cool and only stare from the corner of my eye. Once we got inside and were no longer directly beside her, Nick looked at me. I said, "Yes, that was her." Blank stare. "Yes, it really was." More blankness. "Nicole Kidman. You were staring right at her."
"WHAT?! WHERE?! NICOLE KIDMAN?!" Now I don't know if I should brag that even when face-to-face with Nicole Kidman, my husband only has eyes for me or if I should be disturbed at his complete lack of awareness of his surroundings. What if bad guys came and carried me away? Would he even notice? But that's not the point. The point is that Nick made me poke around the movie theater lobby until we could see her face again. Satisfied with the reality that he was in the same room with Nicole, he turned and wondered aloud, "What movie do you think she's going to? Who do you think she's with? ... Why do I even care?"
And that's all, folks. We're not new BFFs. I don't even know into which theater she went. But that is officially my first Nashville celebrity sighting. The end.

The cuckoo's nest

Momma said there'd be days like this, but she never said there would be so many in a row. Being a resident in July is somewhat akin to being a momma bird: lots of mouths to feed (interns, subI, med students), all squawking (yes, that's spelled right, I just looked it up) for your attention at the same time because no one has quite figured out how to walk on two gangly legs yet. And getting your feathers all ruffled up, making lots of noise yourself, if an outsider dares to threaten your young. I've lost count of how many times I've heard the acquiescing fear in my intern's voice with the receiver to his/her ear. "Tell him if he doesn't like it he can talk to me." And that's that. Nobody messes with my baby birds.
This momma hen business is exhausting but also rewarding. I confess that it's crossed my mind to kick them from the nest once or twice; however, I can't help but beam with pride when one gets a snippet of praise or a pat on the back for a job well done from the attending. At this point, everything they know they learned from me, so surely I can take a weensy bit of credit. And there's nothing like the "eureka" moments in their eyes when they do something for the first time. I did that. I did.
So even though it's just halfway through the month and I am draaaaaggin', I know even the hard parts are worth it. Worth every minute.

The Golden Rule

Reciprocity. What goes around comes around. Karma. You reap what you sow. I don't care how you phrase it; it's true.
I emphasize to my med students and interns that I am available to help with whatever, whenever, however I can. How you treat underlings (yeah, I have underlings now) is even more important than how you treat authority figures, so I make a point to teach them, keep them involved, and overall just plain treat them like I wanted to be treated as a med student and/or intern.
This occasionally results in extra work because someone will eventually take you up on your offer and actually ask for your help. Like Friday, when I spent an hour helping someone else's intern with a paracentesis.* I had four new admissions of my own, but I couldn't rescind my offer.
And man, is payback a cupcake.
Saturday night said intern was on call, and he spent a couple of hours making a (ahem) difficult discharge happen for my team.
Since one good turn deserves another (and because he really went over and above the call of cross-cover** duty), I am making cinnamon rolls tonight for him and his whole team to have for breakfast tomorrow. Sure tastes like a winning strategy to me.



*Paracentesis is the procedure by which fluid that has accumulated in the belly for various and sundry reasons (aka ascites) is removed. This involves a very, very long needle and a lot of awkward chit-chat with the non-sedated patient while the fluid drains via said long needle into large bottles that unfortunately end up resembling apple cider. "So, you live around here?"

**Cross-cover entails dealing with acute (and sometimes subacute) issues that arise on other teams' patients overnight when you as the on-call team are the only ones in the hospital. This can range from ordering cough syrup or a late dinner tray to transferring a crumping patient to the ICU. I've got a great story about just such a crumping patient, but we'll save that for another day.

Big girls don't cry

Here I am, back to my old ways, retrograde posting because work keeps me so busy. Friday was especially bad. I'll spare you the details. I finally limped (figuratively of course - I can walk all day in my Cole Haans!) out of the hospital Friday night around 9pm (rules say we are supposed to be gone by 8pm); I found myself walking alongside another one of the gen med ward upper level residents.

Brian: Make sure you leave the hospital by 8pm, right?
Me: Yeah, long day. This place is enough to make a grown man cry.
Brian: Yup.
Me: Good thing I'm not a grown man.
Brian: I never thought you were, Beth.

Very good.

Pi(e) squared, or On Life and Pi(e)s

Two things.

1) I love making pie crusts. Quiche, fruit pie, cream pie, whatever. Homemade pie crusts are quickly becoming a lost art in America, land of the frozen pie shell. My Midwest farmer genes simply won't tolerate pre-made crust, and I'll just go ahead and say right now that if you are a frozen crust lover, I do judge you just a little bit. I mean, who doesn't love a good turn now and again with your rolling pin? But that isn't the point. The point is that my friend Laura and her husband Nick invited us to dinner at their new house, which incidentally looks like a page out of a Pottery Barn catalog. I made dessert, which was a peach and blueberry pie using peaches from the local farmers' market. They were fragrant and just-right ripe, and my lattice crust was (almost) perfect. Laura's homemade vanilla ice cream was the perfect partner in dessert crime.

2) I just finished reading the book Life of Pi. Now I didn't love this Pi as much as my pie, but I quite thoroughly enjoyed it. The best word to describe the story is creative. I am pretty sure I can honestly say I never, ever, ever (nunca, nunca, nunca, jamas) would have come up with that concept for a book on my own, which is one of the plethora of reasons why I am a doctor and not an author. The beginning was a bit slow, but this may have been because I am impatient and just wanted to get to the part about the tiger in a lifeboat. His descriptions of the animals seemed realistic, and I felt the writing style was quite convincing as arising from the mind of a 16 year-old boy, albeit a slightly precocious one. Pi's practicing of multiple religions kinda annoyed me until I realized the character's ideas really led to me think about what I believe specifically and why I believe it, which I find refreshing and necessary as a life-long Christian. Bottom line, I would recommend it to a friend (that's you).

That's all, folks.

Letter to the editor

Dear Neighbors,
I write to you today regarding your indiscretionary use of fireworks. It's all fun and games until someone loses an eye. Then you'll race to the Vandy ER, telling your family members and the ambulance driver things like, "I want the best." Well, has this occurred to you? The selfsame fireworks and festivities that lead to your second-degree burns, missing eyes, and potato-salad enteritis deprive your friendly local resident physicians of restorative slumber when we are already sleep-starved. Just saying. You're only hurting yourself here.
And me. Please, no more fireworks. I'm trying to sleep.
Regards,
Needing a Nap in Nashville

It's a jungle out there

Today was the beginning of the end. My last July 1. And what a day it was. Someone in administration forgot to turn in some important form, so none of the new interns have passwords. Delightful, no? People scurried around all day, occasionally popping into our team room or shooting off a text page... "Try now." Hopes were raised only to be dashed again. "This is not a valid user name or password." Over and over and over again. No big deal, right?
Except that my interns and I were on call for their first day. Ever. They were troopers, writing notes for which I would get credit since I saved everything to the chart under my name. Yeesh. But we made it. 7 admissions, 1 MICU transfer, and 24 hours later, we were all still alive and kicking.
So B-rod and MC, here's a big congrats from Momma Hen. You done good. Welcome to the jungle.