Open arms

I became a psych major in undergrad because I was fascinated by the stories. Fascinated by how the mind could create such elaborate illusions and perceptions. Fascinated that the individual could lose track of reality and become immersed in something that seemed all too unreal to me.

During the first two years of med school, my best units were the psych ones. The material was interesting, so I was willing to go above and beyond with the required and recommended readings. Some might also argue that the psych units were much easier than everything else. And I agree that the concepts certainly were much easier than memorizing every single muscle and nerve in the human body and all that preload/afterload physics crap for the heart.

So I was looking forward to starting my psych clerkship. This was where I was going to shine! Or so I thought.

My first day - my first hour! - on the psych consult team, we were sent to evaluate an agitated patient. He would yell out every ten seconds, all while flailing around in his bed. It got to the point that the nurses had to put him in restraints to protect him from hurting himself.

We could hear him as we approached his room - Mercy! Please! Mercy! Help me!- his cries falling on deaf ears as the nurses shook their heads. He had been yelling for the last two hours nonstop so they had resorted to just ignoring him, as inhumane as it might seem to the casual observer.

And now we were there, trying to talk to him. Mr. Schaffer - what's going on? How are you doing? How are you feeling? Why are you yelling? He stared at us icily. We were the bad guys, so he refused to talk to us.

We were all standing so far away from the patient. Then, remembering how my medicine team had commended me for my abilities to connect to patients and understand them, I walked closer and leaned over to reassuringly touch my patient on his arm. We only want to help you sir, I said soothingly. He became still, and I became hopeful that maybe what I was doing was working! And hey! Maybe I am meant to be in psychiatry. And then in the midst of my daydreams - out of nowhere - his fist, confined to mittens to prevent him from getting out of his restraints, whacked me across my arm and chest. F*ck you, he seethed at me.

I was fine - more shocked than bruised, but my resident quickly ushered me out of the room, while the attending tried to talk to him some more. She came out a couple minutes later, with no additional information.

She led us back to the team room, where she pulled out a handout on Personal Safety and gave us each a copy. I probably should have given this to you guys before we went to go visit Mr. Schaffer, she noted wryly, pointing to #9 - Stay an arm's length away from the patient during interviews, especially with aggressive and agitated patients. That qualifies even when they're in restraints, clearly.

I blushed.

The pager went off. Another patient. This one was convinced that he was an assassin. Could we evaluate?

Welcome to psychiatry, my resident smiled. Let's go!

Amazing love

I give thanks for:

my wonderful friends who were willing to crowd around a 4-person table for Thanksgiving Eve dinner,

Alton Brown's Good Eats Roast Turkey recipe (scientifically proven to work! and see above photo? It did!),

my boyfriend for learning how to carve a turkey from YouTube, 5 minutes before diving in with a knife,

my roommates - old and new,

all the delicious food that everyone brought,

all the laughter,

and

all the love.


I'm thankful to have met each and every one of you. You've helped turn Chicago into my home away from home. You are family to me.


Happy Thanksgiving, everyone.

Greatest story ever told

In case anyone feels like they want to see a romantic comedy, but don't have time to watch a full-length movie, here's Letters to Juliet. A three minute trailer that covers all the typical rom-com cliches and gives away the entire movie.



Seriously, what's in the movie that they didn't show in the trailer?

Just remember friends - the greatest love story ever told...is your own.

Marian, the librarian

So I'm studying at the law library - and I see people glaring at others talking on cell phones or eating lunch overly loudly. So when my phone goes off, I grab it and run out to the atrium, so that I can have a normal conversation and not disturb the peace and relative quiet.

I finish my phone call and when I turn to go back in, I realize - oh crap! I left my ID card at my desk. And now, I'm stuck at the turnstile. I turn to look at the librarian, who just saw me run out the doors three minutes ago, but is now feigning complete indifference, ignoring me.

ME
Um, excuse me?

[No response from the librarian.]

ME
[a little louder]
Sorry, excuse me? I left my Wildcard at my desk when I went to go answer my phone!

LIBRARIAN
Please don't speak so loudly! You're in a library!!

ME
Oh, I'm sorry. I can't get in, because I left my Wildcard at my desk!

LIBRARIAN
Are you a student here?

ME
Yes, my Wildcard's at my desk - I can bring it back to show you.

LIBRARIAN
Are you a law student?

ME
No, I'm a med student.

LIBRARIAN
I'm not allowed to let you in.

ME
I have access via my Wildcard - I just left it at my desk - I can go get it and bring it back to show it to you.

LIBRARIAN
I can't just let anyone claiming to be a Northwestern student into the library, you know.

ME
I promise I'm a student here. I've been studying here since 10am! I just went to answer a phone call, no more than two minutes ago. Um, if you want, you can escort me to my desk, where I promise, my Wildcard is sitting.

LIBRARIAN
[scoffs]
Yeah, because I have time for that?

ME
[speechless]
I'm sorry. I - I don't know what to do.

LIBRARIAN
[huge sigh]
I need you to leave something here as collateral, and then I'll give it back when you bring me your Wildcard.

ME
Uh. I'm not wearing any jewelry...

LIBRARIAN
[loud sigh, again]
YOUR PHONE!

ME
Oh right! Sorry.

So I hand over my phone. She heaves another great sigh, and then clicks the turnstile so that I can enter. I thank her and then hurry over to go get my Wildcard, which was a mere 25 meters away. I come back with the proof that I'm a Northwestern student, and she gives me the third degree yet again, lecturing the whole time about how I have to have identification on me at all times (because according to her, it's a felony apparently if you don't). She makes me fill out some random paperwork and makes me feel like an absolute criminal at the same time. I pause before the signature, trying to figure out what exactly I was signing, and she barks at me, "print and SIGN your name!" Yes ma'am. Right away ma'am.

As I'm doing all this, another student comes to the turnstile.

STUDENT
Excuse me, miss! I forgot my Wildcard at home.

LIBRARIAN
Are you a law student?

STUDENT
Yes.

LIBRARIAN
[clicks the turnstile open]
Happy studying!

Seriously, what the hell dude. She didn't even ask for his name or anything! Clearly, the moral of the story is this: forget about being honest - just lie. I should have known; I was studying with soon-to-be lawyers, after all.

Ugh, I'm so annoyed by her power trip. Totally unnecessary.

Cup of coffee

It was going to be another long day at the clinic. My preceptor had asked me to come an hour early and informed me that I'd probably end up staying until 10pm that night, since he had double-booked almost every time slot. Fabulous. Just fabulous. Mind you, this was the day before my shelf exam.

I figured I probably ought to get some coffee. And while I was at Starbucks, I saw a man that looked vaguely familiar.

I stared at him. Was he an old patient? Maybe one of my hospital patients? The thing is, I have a pretty good memory of everyone I took care of...and his diagnosis/condition wasn't jumping to mind. Where had I seen him before? I knew it was in a medical setting, but I just couldn't figure it out.

By that point, he had seen me staring.

He gestured at my white coat. Northwestern?

Oh, um yes, sir.

I'm a standardized patient.

Oh! Thanks! I knew you looked familiar!

He had gotten his coffee by this time, so nodding a goodbye to me, he walked out.

And that's when I realized that I knew exactly which standardized patient he was. I knew him from my first-year physical exam class. You see, he had taught us the male GU exam.

Seriously, so many of my classmates never see patients or pseudo-patients outside of the hospital. Why does it always happen to me??

Time for miracles

After a whole month of reminding patients daily how important it is to eat right and exercise on a consistent basis, I started to feel awfully hypocritical with my hospital cafeteria burgers and couch potato ways. Oh, TV how I love thee.

It also probably didn't help that we just had a nutrition lecture that basically told me to stop eating lard. And I can't walk up a flight of stairs without getting short of breath.

So last weekend, I threw out my Sunkist (okay, not really, they're just tucked away in the pantry for special occasions), and bought myself some rabbit food and something that promised me the "best body of [my] life."

Ladies and gentlemen, I bought Jillian Michaels' 30 Day Shred.

And it came in the mail yesterday.

So today, after a DASH-friendly lunch of salmon and roasted asparagus (thanks Grand Lux!), I came home after my more-brutal-than-expected clerkship test, puttered around for a little bit, and then figured I had wasted enough time putting it off.

I put on some comfy clothes, popped in the DVD, and psyched myself up to have Jillian Michaels yell and bring me down, as she does to all the Biggest Loser contestants. And we were off.

And holy cow, were we off. We were switching between windmills and pushups and jump ropes with only 3 seconds in between. Everything was coming so fast, I sweated through my clothes in just five minutes. I had to pause the DVD.

"And that's the end of the warm-up! Let's get ready for strength!" barked Jillian. (Except, she's actually quite nice and encouraging on the DVD and very different from her Biggest Loser persona. So there was no barking, per se, but it makes me feel better to think that I was so tired because she had beat me down.)

Yes friends, I had to pause the DVD at the end of the warm-up. I hadn't even gotten to the actual workout-workout!

It's still on pause. Maybe tomorrow I'll do the warm up + the strength exercises. And then the day after that I'll do the warm up + strength exercises + cardio.

Sigh. I am obese inside. But damn it, I'm going to be a lean fighting machine at the end of the next 30 days. Or the next 90. Just watch, it's gonna happen. I'm gonna make it happen.

Sunny day, sweeping the clouds away

To the street that always led me in the right direction, happy 40th birthday!

Can you tell me how to get - how to get to Sesame Street?

Watcha say

ME
Patient presents with a 6 month history of increasing depressive symptoms. He notes apathy, weight gain, and chronic fatigue even with 8 hours of sleep each night. He mentioned that he doesn't know what he wants to do with his life and feels somewhat lost.

PRECEPTOR
How old is he?

ME
Twenty-one, sir.

PRECEPTOR
How's his sex drive?

ME
No decrease in libido.

PRECEPTOR
Well then, it sounds to me like he's just lost his mojo - you know that reference right? Austin Powers?

---
Later that day, with a different patient:

PATIENT
[talking very very quickly]
I'm just super anxious and stressed out all the time. And little things will freak me out. I'm SO stressed out, I can't handle it. Like I was supposed to receive a package the other day, and they delivered it to the wrong apartment! And even though I got it, I was so frustrated, I broke down and started crying. Over a package! And then my boyfriend - even though I'm pretty sure I love him - I'll yell at him over stupid things, like him leaving the toilet seat up! Agh, just thinking about it is stressing me out!

PRECEPTOR
Would these things have bothered you two years ago?

PATIENT
I don't think so?

PRECEPTOR
Well, no offense, but I think you need a chill pill. Literally. Let's write you a prescription.

That's how country boys roll

Well, it's officially starting. My friends are giving up the single life for eternal coupledom.

One of our close friends got married this past weekend in Houston and it was absolutely beautiful. As were they.

Thanks for showing all of us such a fabulous time in Houston. For giving us an exclusive backstage pass to your culture and religion. For involving us in wedding games and traditions that had us covered in silly string, confetti, and so-called baby powder. For taking us to the best Tex-Mex in the world. For giving me a spoon when you realized I had trouble eating with my hands. For Shipley donuts, Jack in the Box 3am drive thru walk thrus, never-ending card games, never-ending wedding food, and a weekend full of sunshine, laughter, and friends.

It was really quite a wonderful weekend. And the cherry on top of this epic weekend was Northwestern's win over Iowa. Gooooooo Cats! And a big happy congratulations to Ameer and Insiyah.

Face drop

I'm on primary care this month and I got placed into an HIV niche clinic. So, as stereotypical as it may sound, I've seen a fair share of really gorgeous, fit, and well-dressed gay men in the last two weeks. For every patient, my preceptor sends me in first to get a quick history of why they're coming in. There's a lot of flu symptoms, various GI problems, and occasional back pain. My attending makes me give an oral presentation, lets me watch him try to find nonexistent physical exam findings, and then typically sends me on to see the next patient while he finishes up with prescriptions and last-minute concerns.

Last week, I noticed that quite a few of his patients had last minute concerns. I would be waiting to present the next case to him, and I would see him duck into the office lab and come out with a cup of liquid nitrogen.

Yup. Our patients had some genital warts that they didn't want to tell me about. Three patients, in fact. In one day. No joke. And no, not a single one of them mentioned it to me when I was taking down their problem list. Way to make me look like a terrible med student, patients. Thanks. Thanks a lot.

Later on that day, as my preceptor and I were sitting in his office writing up our progress notes, I summoned up my courage to ask him about the liquid nitrogen.

ME
So the office has liquid nitrogen on tap?

PRECEPTOR
Yeah. We see a lot of genital warts and it's just easier for me to do it. Since I've known most of them for quite a long time, I think they're more comfortable talking to me about it. Don't beat yourself up about it.

ME
Oh, okay. Thanks. [long pause] I actually had a favor to ask you...and of course, please feel free to say no, since I know it's kinda awkward and all that.

PRECEPTOR
Hm?

ME
Well, I know it's weird to treat a student, especially off the record, so again, please feel free to decline, but I've got a wart [pointing to right index finger], and it gets irritated a lot from just daily activity, and so I was wondering if you could burn it off for me...

PRECEPTOR
Whoa, what!? You want me to do what?!

Turns out, he wasn't looking when I was embarrassingly trying to ask him to burn off my finger wart. And given that he's used to burning off genital warts...well, it's easy to see how he got the wrong idea.

ME
[blushing like crazy]
On my finger! I have a wart on my finger!

PRECEPTOR
[sigh of relief]
Oh sure. Haha! That's fine. Just remind me tomorrow.

I never did ask him again about it. I figured my mid-clerkship grade was due soon, and the less conversation about warts - genital or digital - the better.