On the road again, and again, and again

Sorry about the retrograde posting, but I just haven't had time to sit down at the computer for a while.

I am on vacation! But there will be no rest for this weary soul. I am hitting the road, soon to be southbound 35 (actually 65, but who's counting?). I've got three fellowship interviews over the next two weeks. So now with aforementioned awesome interview suit in tow, I affix my "professional" smile and hold my breath. Meeting with nine people for 30 minutes each sounds more like a gauntlet than an itinerary. I mean, I can talk to a brick wall, but I'm afraid even I'll run out of things to say. My solace lies in the fact that rheumatologists tend to be nice people, which should make the going easier. I pity the fool who has to meet with nine surgeons in a day!
I will also be heading to Houston and WF to see my long-lost friends and mom. Nick will be staying home with the dogs, but no need to cry for him. He knows this trip would be more work than play for him in the end. Could you imagine listening to me for 38 hours (yes, that's actually how long this will take in total) in the car? Especially as I'm agonizing over my interview days and the $64,000 question of whether to stay or go? Nick is a good husband and all, but there is only so much any reasonable man can take.
Speaking of which, as the jury is still out on my rank list (my end and theirs), I am censoring any and all comments regarding my specific interview days for now.

Winter wonderland

Well, Jack Frost finally decided to pay Nashville a visit; my fair city currently lies under six inches of snow. Flakes graced us with their falling presence all day Friday and most of Saturday, too. The highlight of my frozen tundra weekend was taking the dogs outside Saturday morning. They'd seen a dusting of snow last year and weren't really impressed; this time around, however, we got the desired reaction. Dallas dug her way through the yard and snapped at the snow with every step. Izzy flew across the yard leaving a trail of snow dust behind. Poor Jonesy high-stepped around to avoid touching the weird white stuff. Nick pegged everyone (including me) with snowballs and even made me a snow angel in our driveway.
While we were outside (I kid you not), some random neighborhood lady shuffled past our backyard in skis, cross-country style. You can't make this stuff up. I don't know where she was going; the park area spans about three blocks before dead-ending against a chain-link fence overgrown with forestry. Maybe she was on her way to the grocery store.
My snow-filled weekend is almost over. Nick had quite a time ice-picking his way up our driveway to get the car out for me to go to work tomorrow. But that's OK. Only two more days, and then I wake up to two glorious weeks of vacation! And interviews. I better get packing!

Let it snow, let it snow, let it snow!

Well, the weather outside IS frightful. But I have no fire, no popcorn, not even a marshmallow. I am sitting at the Va Spa (nickname for the not-so-beloved Nashville VA hospital) watching snow swirl and fall in fat, delicious flakes. All week the weather people have been predicting and end-all, be-all blizzard for today, but given their track record (the last "blizzard" was totally a non-event) we were all skeptical. But now I am a believer.
And to top it all off, my clinic this afternoon is cancelled! That's right, folks! Come 1:00pm I am a free woman. Can I get an "Amen?" I am very much looking forward to spending my precious weekend off snowed in with my hubby and my puppies. I am already planning chicken noodle soup and homemade bread for dinner. Yummy. We were supposed to go over to Jeff and Jeanetta's house for dinner to see their place all spiffed up to go on the market, but Small Frye (my personal nickname for their unborn child) decided to make his grand entrance into the world today. At least they made it to the hospital before the snow started falling.
If the snow melts and re-freezes over the weekend, I might need Santa and his reindeer to pull me up the big hill getting out of my neighborhood. Speaking of which, I should sign off and peace out; gotta drive home before this stuff gets too thick.

Part II

As promised, here are my remaining words of wisdom:

3) Own what you know. This and #4 are products of my own experience. After following rules #1-2, you are self-equipped to make your own decisions. Frightening, yes, but true. Trusting your own judgment is tough stuff. Don't assume someone who disagrees with you knows better just because he/she is older or has reportedly been in this situation before. You will regret making an error based on someone else's judgment or knowledge so much more than if you'd trusted yourself but been wrong. Getting punished in the morning (as in after your night on call) for someone else's mistake is an unpleasant scenario indeed. Don't get high and mighty, but for the sake of many tears and restless nights, please, oh please, stand up for what you think is the right thing to do. I wish I had last February, but that's a story for another day.

4) Never ask a patient a question to which you don't already know the answer. (AKA: Trust no one.) You are taught in med school to always believe what the patient tells you, but patients lie. All of them. Some mean to, some don't. Because I think it's discriminatory to choose how much I believe of what you say based on appearances or first impressions, I employ a blanket policy to trust no one. To keep myself from operating on false information, I verify to the extent possible the data I seek through objective means (old op reports, clinic notes, etc). Then, akin to a lie detector test, I ask a few non-important questions to see if the patient's answers line up. Drug screens are my favorite; urine doesn't lie (you can quote me on that). This then determines how much I trust your other answers. Next time you end up in the Vandy ER, consider yourself warned; there will be a pop quiz.

Words to live by

I know it's been a few weeks since I posted, but this one's worth the wait!

Every med student who rotates on service with me learns to live by my four pillars of medicine, which also apply quite well to life in general. Today, you lucky, chosen souls, I share them with you...

1) Fake it 'til you make it. I can't entirely take credit for this one. I owe this motivating pearl to my high school band director. People often misinterpret this one; I don't intend for you to lie or attempt procedures for which you are not qualified. I simply mean to say that if you act confident, people will have confidence in you, which in my opinion dramatically impacts what you actually are able to do.

2) Never guess, look it up. I have Mom to thank for this one, who passed it to me from her elementary school spelling club. (I know, my mom is cooler than your mom.) You won't regret going back to double-check a dose or side effect before you order a med, but I bet we can all think of a time that made us regret not doing so. You also significantly decrease the risk of making yourself look like a horse's hiney when you verify the op note (record of procedure) or MRA (medication administration record) before yelling at the surgery resident or nurse. Frequent employment of this principle also obviates the need for Pillar #1.

That's enough wisdom for today. Tune in next time for the life rules #3-4.

Is there a doctor in the house?

My Friday night went a little something like this... I was minding my own business, sitting on a plane headed to Tucson, where I would spend the weekend shopping for wedding dresses with my sister. Then with a crackle and hiss of the overhead speaker, a quavering voice cries, "Are there any medical personnel on board the aircraft?"
Oh no. My heart starts tachin' away (medical slang for beating uber fast); I am medical personnel. What could it be? Fatal exsanguination? A woman in labor? Sudden cardiac death? An older gentleman leaps up and bounds toward the back of the plane. Maybe I can just stay where I am; that other guy got up. But what if he's just an enthusiastic radiology tech or retired pathologist? About 10 seconds have elapsed at this point as I stand up and head for the guy laying down in the back row. The flight attendant says, "Oh, do you need to use the bathroom?" After offering my assistance, she explains that a man felt queasy in his seat and then felt as if he were going to pass out on his way to the bathroom. Really? That's it? Mind you, he hadn't actually puked or actually passed out. I head back to my seat; the other guy is obviously more impressed than I am.
A few minutes later the flight attendant approaches my seat and asks 1) if I am a nurse (really?!) and 2) if I will examine his heart as the other guy (neurologist it turns out) can't hear anything. Neither do I, but as his blood pressure and heart rate are fine and he feels better, I don't entirely care.
Feeling very much like I'm dealing with the ER, I sit the guy up and take off the oxygen (running through one of those little plastic yellow emergency masks). He is not in the mood to go the ER upon landing. I inform him that we can't make him do anything. The other MD and me keep checking on him, and there is no further adieu.
Do you think the CEO of Southwest will send me a handwritten letter of his personal gratitude for my heroic services?

Oooohhhh, halfway there

January 1st marked the halfway point of my residency. I thought I had a fair idea of what to expect when I started that fateful July 1, but I could never have predicted and still can't quite describe my life over the last 18 months. The glass half-full way of putting it is to say that my experiences have made the first season of Scrubs a lot funnier. There's lots of glass half-empty days, too, when I can't remember the last good day or why I got myself into this in the first place. I wish I could tell you I have enough special, satisfying moments with my patients to keep me going, but that's just not true. If you require gratitude of patients or success against disease and dying to keep you trucking, I am fairly confident my line of work would beat you down and then kick you in the head for good measure.
But I believe God put me here and that He gave me the rest of my life to keep me where He put me. My sweet Nick, for example, regularly cuts me off from checking patient charts at home and meets me with hot chocolate at the end of a long day. And who can stay angry with the world when three waggily tails greet me at the door every evening?
We recently had an ethics lecture in which a silver-haired doctor told us stories to illustrate how being a compassionate doctor makes you a better spouse, parent, etc. I frankly disagree. Maintaining my non-work relationships allows me to be a doctor (hopefully a good one) without completely losing my mind and my cool, not the other way around.
But that's enough of my heavy heart for one day. Until next time, I'll be oooohhhh, livin' on a prayer.