Pursuit of happiness (nightmare)

I ran around this morning like a chicken with its head cut off.

I had gotten to the hospital early - it was my first hospital day with a new attending, and she wanted me to round on all seven of her postpartum patients. I had just finished visiting all the patients, and was sitting down to write all of their notes, when I realized that I had lost my pager.

Lots of colorful words tricked out in asterisks flew through my head. $%$#!@! $%#^ $#@$! My pager is my lifeline. It tells me about my patients, tells me where I'm supposed to be, and I had paged myself reminding me what my pin number to get scrubs were. So without my pager, I would have no idea when my attending arrived, where she wanted to meet me, and I wouldn't even be dressed to go into the OR.

So I freaked out. Naturally.

I ran back to see all of my patients, thinking that my pager must have fallen off my pants when I was checking incisions or assessing for swollen legs, but I came up empty. I retraced all my steps, thinking that perhaps as I was running through the halls, maybe my pager got jostled out of my pockets. Nothing. I went back to my locker, hoping that maybe I just never took it out of my bag. It wasn't there.

By that time, I was ten minutes late for morning report. I walked in the door to find out that my clerkship director - the person who basically decides my grade - was on service. They had already discussed my patients, so my getting there at 5am to round now seemed ridiculous.

Rounds finished, and I emailed my attending to let her know that I was a terrible and irresponsible student who had lost her pager, and if she could please call my cell phone instead, it'd be very much appreciated? She texted me back immediately, being very nice and understanding, saying that stuff happens, and that she would meet me in the OR at 9am, and gave me her own pin number so that I could get scrubs. Crisis averted.

Then, I figured I ought to page my own pager with my cell phone number, so that just in case a Good Samaritan happened to come across it, they could call me and I could get it back.

I hit the 'send' button, and then one of the five pagers on my clerkship director's belt starting buzzing. She glanced down to read it.

"THIS ISN'T MY PAGER. WHO'S MICHELLE?!" she bellowed. Oh crap - she was my Good Samaritan?? Given all that I'd heard about her, if I had known she was the one who found my pager (inadvertently or not), I probably would have cut my losses and paid $120 to just pay for a new one.

"Oh, that must be my pager...I dropped it earlier...." I replied back meekly.

"SPEAK UP!" she said. "THIS IS YOURS?"

"Yes, ma'am," I replied, trying to speak up, but still quivering in fear.

"KEEP A BETTER EYE ON YOUR BELONGINGS!" She threw it down on the table, yelled at me some more about things that weren't even related to me (or my pager), and then stormed out of the room presumably to go take care of some patients. I scurried over and put my pager back in my pocket, hoping that the earth would open up and swallow me whole.

It's amazing how some attendings can be so super nice, and others can make you feel like you're stupider than mud.

Imma be

I don't know what I'm going to do with the rest of my life.

We're in the midst of planning our fourth year schedules, but inherent in those decisions is knowing what you want to be when you grow up. Want to go into surgery? Gotta start applying for audition rotations. Want to do family medicine? Maybe you should do an elective in rural Montana. Want to do something competitive? Take your Step 2 early.

So now I'm completely lost.

Coming into med school, I was convinced I was going to be a pediatrician. What can I say? I love the kiddies. They're cute and more resilient, and far more likely to get better than say, an 85 year old slightly demented grandma who thus forgets to take her medicine. I was a camp counselor, coordinated the peds interest group, played my violin at the children's hospital, etc. - everything I did was pediatric minded.

Then I did my pediatric rotation.

Maybe it was just (bad) luck of the draw, but I found that I didn't love it as much as I thought I would. The kids in the hospital were super sick, but it seemed like all we were doing was giving them oxygen and physical therapy. It probably didn't help that I did my inpatient rotation during January, in the midst of RSV season. I saw 35 RSV-positive bronchiolitics, 16 RSV-negative bronchiolitics, and 10 asthma kids. And for each and every one of them, the protocol was the same. Start them on oxygen via nasal canula, increase as necessary, and albuterol treatments every 4 hours. By day 3, I was itching for something a little more exciting. But I only got more bronchiolitics and the occasional ear infection.

It also didn't help that my senior resident was not the nicest or cuddliest of residents. She held her arms across her chest, gave me constant stink-eye whenever I gave an oral presentation, and would heave these huge dramatic sighs whenever I gave the wrong answer to one of her "what am I thinking" pimp questions. And it was apparent that she didn't get along with the other residents on the team, which made for a very passive aggressive environment for 2 weeks. It made no sense to me, given that I had thought that niceness and compassion were prerequisites for becoming a pediatrician.

Needless to say, it wasn't a very good experience.

So then I was back at the drawing board. Psych perhaps? I was a psych major in undergrad, and my grandfather - the role model for my life - was a psychiatrist. But while I loved the material because it was so interesting and there was so much patient interaction, I don't know if I could do consult psychiatry for 3 years of residency. Can I really endure 3 years of assessing capacity and delirium so that I can do what I find truly interesting - child psychiatry?

And then, this past week I started my Obstetrics and Gynecology rotation. Now, I deliberately set my schedule so that ob-gyn and surgery were dead last, because I knew I didn't want to do surgery. I can't stand blood, I fainted when I saw a c-section 2 years ago, and given my stage fright, there's no way my trembling hands wouldn't nick an artery or something and cause some massive damage.

Except, I'm one week into ob-gyn, and I'm loving the procedures. My hands are actually quite steady, and I've seen some major bleeding, and haven't freaked out or gotten woozy. I love that it fulfills my love for immediate gratification, because there's really nothing as gratifying as watching a couple turn into a family all within the timespan of 30 minutes, and knowing that you were a part of that. And the patients are all so happy - I don't think I'll ever stop feeling warm and fuzzy inside when I see the expecting parents light up and beam when they hear the fetal heartbeat.

Yes, it's only been one week and from other students' accounts, I've lucked out with the residents I've worked with. I'm sure if you check back in three weeks, I'll be hating ob-gyn and my sleep-deprived days on night float.

All I do know is that my 4th year schedule is due in five days, and I no longer know what I'm supposed to do with the rest of my life. And it's scary. This is where the rest of my life begins, but I don't even know which path I'm supposed to take.

First time

Today was my first day in the OR.

I scrubbed in for the very first time in my life.

And then I scrubbed in again, when I ultimately did something wrong and touched something non-sterile.

I put in my very first foley catheter.

I held the retractor as my attending cut open the amniotic sac, and didn't freak out when blood and fluid squirted out all over my gloved hands, spilling over the table and onto the floor, soaking my booties.

I watched as my attending and the surgical assistant used brute force to open the uterus and force the baby's head through the seemingly too-small incision. And I held back happy tears when I saw that baby boy's head pop out and heard him start squealing.

I cut sutures. I retracted. I wiped away blood. I pulled out blood clots. I stapled.

And the whole time, I smiled. Today was a good day.

Suzy Snowflake

How to build a snowman:

1. Find a park with lots and lots of snow. It helps if there was a giant blizzard the last two days. It also helps if the park is right next to your apartment so that you can run back in whenever you need to get hot chocolate and extra socks.
2. Pick a good spot and start scooping snow to build a snowman base. Don't get discouraged when it starts to resemble a pyramid instead of a sphere. Also don't get discouraged if the snow is super powder-y and won't pack well. Just keep scooping.
3. Have the boyfriend start on the snowman's head and torso. Be prepared to smile indulgently when he ultimately gets super excited and starts comparing his snowball to his head. Or foot.
4. Ignore him when he starts doing inappropriate things with his snowballs.

5. Give up on the misshapen base and go find the boyfriend to help him roll snowballs in the ground, in an attempt to make them grow.

And after 1.5 hours, even if the ball is still no larger than your head, take a break and drink some hot cocoa. And then get back out there and start rolling again. Continue to taunt the boyfriend about how your snowball is larger. Ignore him when he notes that his snowball is actually a sphere, whereas yours is a strange lumpy asteroid shape.

6. Put the snowman together. Realize that the torso ball is still too small. Pack some more snow in until it is the appropriate size, or until you realize you can't feel your toes anymore and you really need to go back into the heated apartment. Whichever comes first.
7. Then decorate! And take lots and lots of pictures.
8. 6 hours later - try to wipe off that giant smile on your face when you see little kids taking pictures with your pretty princess snowgirl-snowman.

Innocence

ME
[pulling out stickers to bribe the patient into letting me listen to her heart]
Hi Annabelle! I'm Michelle, and I'm going to start your checkup today. Is that okay with you?

ANNABELLE
[choosing a Finding Nemo sticker]
Um, okay!

ME
[looking at chart]
Oh my goodness, was it your birthday yesterday?

ANNABELLE
YUP!!!!

ME
And how old did you turn?

ANNABELLE
FIVE!!!

ME
Ooh, how exciting! What did you do to celebrate?

ANNABELLE
I saw Tooth Fairy!

ME
You saw the tooth fairy!?

ANNABELLE
Not the real one, silly. The movie.

ME
Ooooh. Haha. How was it? The Rock is in that, right?

ANNABELLE
Yeah. Eh, it was okay. He wasn't really believable.

ME
Oh really? Was his acting bad?

ANNABELLE
Nah - pink just doesn't look good on him.

I knew I loved you

This was the best Superbowl ad.



Hands down. The best.

Ah, Google - you have my heart.

Paperweight

The boy leaves me fun post-it messages from time to time, but I think this most recent one is my favorite.



...although I did have some trouble trying to decipher that second image for a while. I blame fatigue, not his drawing skills.

Hot n cold

Ghetto superstar

I fail at life.

Even when I'm trying really really hard to be a *SUPA STAR!*

I'm currently on outpatient peds with a pretty well-known Chicago pediatrician. I'm gonna call him Dr. T here, because he is just as intimidating and awesome as the real Mr. T. Anyways, I've been busting my chops trying to impress him these past couple of days, mainly so I can get a glowing letter of recommendation from him. Yesterday, Dr. T asked me to come in for Saturday morning clinic, since I would be missing half of next week for tests and other fun exam-like things. Clinic started earlier at 8am, but also finished by noon at the latest, he promised.

Now, even though we typically get weekends off during the outpatient weeks, I was more than willing to come in. After all, Dr. T promised that I'd see lots of really cool patients - from a trisomy 18 mosaic to a girl with Rett's syndrome. And that recommendation letter was hanging over me - I really needed a good one, saying that I was a great student willing to go the extra mile, willing to come in on the weekends.

First of all, I just want to say that I am normally not a super star. In fact, I'm probably the farthest thing from a star, let alone a super one. Even when I want to be a star student, I just can't manage to get to work more than 5 minutes early. And I definitely don't have the smarts to be one of those super intelligent students who knows the answers to every single bizarre and out-there pimp question. Heck, I don't even know the answers to questions that are glaringly obvious to others. So me? Yeah, my starlight doesn't shine so star bright.

I normally would have said something about having to study for my upcoming tests, and if it would be okay if I didn't come in this Saturday. But I didn't. Because I wanted to be a star for just once in my life. Because it feels nice to feel all bright and shiny, and like you're actually a somebody in this tank of sharks.

So I went in on Saturday. Made the hour-long commute to work. Saw some kiddos, listened to some lungs, gave out some stickers, and held down some arms while the nurse gave out pointy kisses.

Then I made the hour-long commute back to my apartment.

I was going to have to work tomorrow as well, since I was scheduled to go in for day call at the hospital. For the past five weeks, my co-teammate and I had been complaining about having to work on Superbowl Sunday. So, on a whim, I decided to check the schedule to see when I would get off and if I could possibly still make it back in time for the halftime show ads.

And then I saw it.

Michelle - Saturday February 6th - Urgent Care (day).

Holy crap. I was supposed to be at the hospital. I don't know why I thought I was working on Sunday, or why I had talked about Superbowl Sunday all this time, when in reality, I was supposed to be at the hospital. Right then and there.

I freaked out, naturally. I hadn't changed out of my clinic clothing yet, so I ran downstairs, hailed a cab, and high-tailed it to the hospital.

It ended up working out okay. Sorta. I mean, pediatricians have a reputation for being nice after all. And after just a mildly severe scolding that brought me to tears only once, the attending took me in and showed me the ropes and letting me see some patients on my own. And I finished out the rest of that shift, promising to come in and make up the rest of the time next weekend.

Moral of the story? I cannot be a super star for the life of me. I should just keep doing what I normally do - staying in the middle of the pack, trying hard not to be noticed. Because when I do try to be special, I just end up being a delinquent.

Sigh. Med student fail.