Good idea at the time

One less lonely girl

I walked into the room to see how my 8 year old girl POD#1 s/p lap appy was doing.

There was music blaring, and my patient and her roommate - who had never met before coming to the hospital, but now BFFs for life, duhhhhh - were jumping up and down on their beds, singing and dancing their little hearts out.

ME

Whoa! You guys have a little dance party going on here! Awesome!

CUTE LITTLE GIRL #1

Are you a doctor?!?!

CUTE LITTLE GIRL #2

DUH! She has a steh-da-scope! Ask her ask her!

ME

I'm just a med student, but ask me what??

CUTE LITTLE GIRL #1

[feigning sickness]

I think I'm sick.

CUTE LITTLE GIRL #2

[also now looking listless]

Me too. Cough cough.

ME

What! What happened?? You guys were just dancing! And singing!

CUTE LITTLE GIRL #1 or #2

No we're sick!! Can you take our temperature??

ME

Let me feel your foreheads.

CUTE LITTLE GIRL #2

I have a fever right? Cough cough.

ME

[having no idea what she's actually in the hospital for, since she's not a surgery patient]

Um....

CUTE LITTLE GIRL #1

My turn, my turn! Feel my forehead!

ME

Why do you guys think you're sick?

CUTE LITTLE GIRL #2

'Cause the nurse said that we have Bieber fever!

ME

Oooooh. You know, the only solution to that is more cowbell.

CUTE LITTLE GIRLS

Huh? What's that?

ME

Never mind. Let's dance!

Oh, the places you'll go

I'm officially dating a neurosurgeon! Woot!!

Alone

My room is full of clutter. All the things that Martin was going to throw away somehow ended up in my apartment, largely thanks to his mother wanting to give me the last of his detergent, toilet paper, packing tape, coffee beans, and so forth and so on.

My apartment now looks as though it belongs to a hoarder. Yet, even though my apartment is busting at its seams with boxes and extra reflex hammers and other useless things, my apartment feels so empty.

Martin's gone.

And now I feel so alone and vulnerable. My support system is on a plane, flying halfway across the continent, crossing two different time zones, getting ready to start a notoriously busy year as an intern in East LA - home to gunshot wounds and stabbings and other such sequelae of gang violence.

As Martin and I did all of our "last" things today before his flight - one last stroll along the river, one last brunch, one last sunrise, one last Grey's Anatomy episode curled up next to each other, one last hug, and five last couple pictures - I started to feel a little mopey.

Because I couldn't help but worry. My friendships with J and Lisa have drifted this past year. J, because he refuses to pick up his phone when I call, isolating himself so that Lisa and I won't find out about his secret trips to see the ex-girlfriend he hasn't yet (and probably never will) gotten over. And well Lisa - even though she's only an hour or so away, she's busy trying to cultivate relationships with the people she's going to be spending the next 3 years of her life with - her coworkers. That, and she's busy trying to convince herself that she can be just friends with her ex as well.

And well, if my friendships that have lasted seven years have drifted, what's to say that my 2 year relationship with Martin won't drift a little as well?

Especially since people in Los Angeles are thin, tan, and ridiculously good-looking.

And thanks to not having seen the sun in over six months, I'm pasty white, and getting fatter by the M burger minute.

Yeah, I can't really compete with those reality starlets in Hollywood.

So in the midst of my quiet musings and worryings, Martin looked at me, pulling my face in close with his hands.

What's wrong? Are you sad because I'm leaving or are you worried about something?

A little bit of both, I replied, still quiet.

Well, I'm sad that we're going to be apart. And that I won't be able to see you everyday. That we won't have dinner together. And I'm sad that I'm going to have to watch TV all by myself with no one to laugh with me. But I'm not worried. I'm not worried about us because there's nothing to worry about. We're going to make this work. And we'll be back together before you know it. Okay?

I nodded.

It's okay to be sad. But you don't need to worry. Because I love you.

And now I'm sitting here in my cluttered, but empty apartment, six hours after the fact. Sad, but not worried. Just counting down the days until I get to cross those two time zones into his, so that we can stay up past our bedtimes and laugh at TV show punchlines together.

And I'm going to be eating salads and yogurt until then. Suck it, reality starlets. Bathroom scale, please be my friend.

All the right moves

If you think violin = orchestra nerd, you gotta watch this. Because it's violins + Lady Gaga + Ke$ha + Rihanna + Usher. And that equation adds up to possibly still nerdy, but FREAKING AMAZING video.



Seriously, SO cool. The guy's got talent.

Also randomly - not only does this guy sing well (which makes him swoonworthy, clearly), he's got those super nice beefed up violin arms with the veins that pop when he's using some serious vibrato. That slays me. Just ask any of my guy standpartners, whom I developed unhealthy crushes on. Popping arm veins = sexy to me. And when I'm just 12 inches away, I can't help but drool. Sorry Jason and David - I'm glad we're still friends. Kinda. From 50 feet away. Per the restraining order.

Just kidding. Maybe.

Thank goodness my boy also sings well and has swoonworthy arm veins that pop when he's holding a scalpel.

Stronger

Yes, I'm hating my surgical rotation, but I know at the end of this month, I will walk away with 2 things.

1. I will know everything there is possibly to know about thyroids and parathyroids and neck anatomy.
2. I will be as tough as nails. Sticks and stones might break my bones, but words truly will never ever hurt me again.

Sometimes I think it is my attending's goal in life to make me cry at least once a day. My new goal in life -- not to give in to the tears.

Sometimes her razor-sharp insults are deserved. I don't know the answer to her pimp question? Then yeah, sure. Go ahead and let your scorn rain down on me. I am the stupidest student in the whole wide world. I should have studied more. But guess what lady - I really don't care any more.

Sometimes, I feel like she's picking on me just for the purpose of having something - nay, someone - to criticize. Yesterday, I was in clinic with her, and she decided that she wanted me to interview every patient first. While she watched me.

It was nerve-wracking to say the least. Especially since she made a point to criticize something after every patient. At first, they were good constructive criticism about things I could improve on. Concrete things.

Patient #1: "You need to push harder when you palpate the thyroid. Don't be a weak little girl - you need to REALLY push. You're not going to hurt the patient okay?"

Patient #5: "You didn't elicit a very good history just now, did you? Really, you don't speak a word of Spanish?"

Patient #13: "Michelle, it's really disrespectful to the patient when you open the conversation with 'What brings you in today?' - It makes the patient think that you don't care enough about their problems to look at their chart beforehand."

Yes, I was criticized for not speaking Spanish, and for introducing myself the way I have for the past 3 years.

Whatever - I just let it roll off my back now.

But let's be honest, I'm not completely unfazed.

Today, in the OR, she asked me about more anatomy.

DR. MEANIE BIKINI

Michelle - what is this?

ME
Oh, I believe that is the ansa cervicalis!

DR. MEANIE BIKINI
When you look at structures, please don't block my light.

ME
I apologize, ma'am.

DR. MEANIE BIKINI
And what does it do?

ME
It innervates the neck muscles.

DR. MEANIE BIKINI
Scrub nurse! [true story, she doesn't refer to the assisting staff by name, but by their positions] Give Michelle a marking pen. Michelle - draw the ansa cervicalis and tell me what each specific branch innervates.

ME
I'm sorry, I'll have to get back to you on that.

DR. MEANIE BIKINI
Michelle, when I tell you that you need to know the operation, you need to know EVERY SINGLE THING that is in the neck, so you can answer these questions when we proceed with a different approach. What it does, where it comes from, where it goes. You've been with me for a week now. I told you yesterday that I want you to impress me in the coming weeks. [dramatic pause] Do you think you're impressing me?

I guess I was just happy she didn't throw me out of the OR again. But I no longer care what she says to me. I already know I'm going to get an average to below-average evaluation from her. Because there is no impressing her. There is no living up to the expectations that she sets. It's not possible, and I recognize that, so I'm not even going to bother.

Seriously, what does it say about a person, when her personal assistant and nurse each pull me aside and tell me that she's mean to everyone - including them - and that no one can live up to her expectations? It says something that no resident wants to work with her. It says something that the clerkship hasn't given her a student all year, until now - because so many of the regular attendings are on vacation.

My senior resident today asked me how I was doing with her, and I lied and said I was doing great. To which he replied - "just remember this when things get rough, because unless she's changed dramatically - and I highly doubt she has - she thinks everyone is below her."

She's all about doling out the criticism. Maybe she should take a good hard look and dole some of it out for herself.

Agony

Welcome to More Misadventures in Surgery-land, Part 93479.

This is a completely true, unembellished word-for-word conversation that I had today with my attending while we were scrubbing into our first case.

ME
[avoiding eye contact, scrubbing furiously, completely silent]

DR. MEANIE BIKINI
So were you on call this weekend?

ME
Oh no, it was my golden weekend! I got to catch up on sleep and studying. And be outside in the sunshine! It was won--

DR. MEANIE BIKINI
[cutting me off]
How often are you guys on call?

ME
Oh, well, they're pretty nice to us - we only have weekend call.

DR. MEANIE BIKINI
That's not being nice to you, that's more like - there's too many of you guys, they don't know what to do with you. Sigh, they've changed this clerkship so much this year. You know, the only real way you learn how to manage surgical emergencies is by being on call. The clerkship is doing a real disservice to you by only having you be on call for two weekends. You don't get to learn anything. When I was a med student, we were at the hospital every other night. But I guess things have changed - I just hope your education doesn't suffer. Sigh. You should really try to take extra call if the opportunity presents itself. Not being on call isn't a "golden weekend" - it's a weekend where you don't learn. I'm serious. Call is very educational.

ME
Well, I would be more than willing to take call when you're on, especially since that would make the most sense, seeing how I round on your patients and all.

DR. MEANIE BIKINI
Oh, I don't take call.

ME
Oh. Um, hm. I'll try to find something else then.

---
A little bit of me wonders how much of that is like the stories our parents tell. You know, the "when I was your age, I used to walk to school in the snow, barefoot, uphills both ways" kind of stories. I definitely believe that she was a super hardcore med student who probably didn't sleep and didn't need to eat, because she is Intense City. But I also have to believe that she's human, and understands that it's not surgery on the brain, all the time. I wish she would recognize that not everyone needs to learn the way she learned. And that not everyone is programmed to function that way. Change is good. Progress is good. Sleep is good.

Mamma mia

(from postsecret)

Luckily for me, my mom makes the best, most delicious meals, so I never have to force anything down. My dad's food, on the other hand...

Happy mother's day, mommy. I love you.

Highway to hell

Surgery is not going well.

No, it's not going well at all.

We had a midterm on Friday that's worth 15% of our grade. And I've been stressing out about it, because instead of studying during my outpatient month, I went out to dinners and dates nights with Martin. So I ended up with only 2 weeks to cram as much general surgery knowledge into my overworked, sleep-deprived brain. I come home at 7pm (at the earliest!), eat my 3 meals of the day in one giant sitting, then try to study for an hour or so, before my body gives up and I pass out. In a chair, at my desk, in bed - it doesn't matter. The moment the clock strikes nine, my body poops out and refuses to function.

And I can't drink coffee to keep me going, because I haven't had coffee for the past two months, out of fear that my caffeine-aided anxiety will cause my hands to shake uncontrollably during crucial parts of retracting or suturing.

So yes. The studying, and subsequently the midterm, did not go so well.

But if it were just the studying and the tests that weren't going well, it'd be okay. After all, that's what happened with ob/gyn, and I still loved it.

No, it's the studying, and the tests, and the not having a good relationship with my attending.

Now, I originally thought my general surgery rotation was going to be awesome. My attendings for my first week were these old men, who just like to joke around in the OR with the nurses, but were are also awesome teachers, because they know I'm there for a reason - and want to reward me for my impeccable retracting job.

But then my real attending came back from vacation. It's a female surgeon. And when I first met her, I thought I had hit the jackpot. She was nice, relatively young, and really knew her stuff. I was upfront about my lack of endocrine knowledge, and she reassured me, saying that I'd be able to recite all of it by the end of the month. She promised I would know it inside-out, upside-down, topsy-turvy, and right ways up. It seemed like it was going to be a great learning experience.

I was so wrong.

This week has been absolute torture.

She's reprimanded me for wearing clothes that are too low-cut. Now, if you know me and the dresses that I wear, I think you'd agree that I'm dressed pretty professionally. Everything is at least knee-length, and they're professional work dresses from professional work clothing stores like Banana Republic or J. Crew or Ann Taylor. I'm not wearing slutty Forever 21 miniskirts, mind you. But one day, she asked me if I had a cover-up for my dress. I was already wearing an undershirt because my dress is a v-cut. But she wanted to know if I had a cardigan, to essentially cover up my neck. And she tsk, tsk'd when I said that I only had my white coat.

Then, another day, she told me to stop saying "um" and "like" telling me that it was completely unprofessional. Now, I'm sorry, but I can't help but say "um" during my oral presentations, so I eventually said it again (probably while I was searching for lab values). And once I said it, she cut off the rest of my presentation, saying I could try again with the next patient.

The day after that, she had an add-on surgery that I didn't know about, and thus, wasn't able to prepare for it. And even though I was able to guess 50% of the anatomy questions that she asked me, once we got down into the nitty gritty, I was at a loss. So no, I couldn't answer "what vein is this? Which lymph node is this? What is this structure?" because I honestly had no clue.

She then put down her scalpel and retractor (bad sign!) and looked at me, her headlight blinding me, saying "Michelle - I expect you to act as a mini-attending. Now, if I were doing your parathyroidectomy, wouldn't you want me to know the anatomy?" I was silent, eyes averted, letting the shame wash over me. But it wasn't a rhetorical question. "Answer me! Wouldn't you?" "Yes," I replied, quickly, quietly. "Scrub out. You're done. Go learn the anatomy." Near tears, I asked if I should return with the answers. She sighed, disappointed with me, "No, you're done. Don't let this happen again. Next time, I won't even let you into the OR."

I thought I had grown a thicker skin with each passing week of third year, but I'm still a sensitive crybaby. So I left and went to the library, where I proceeded to learn everything I possibly could about the neck through my blurry tear-filled vision.

And now, I dread waking up in the morning. Every time I see my attending, I have a mini panic attack. Thank goodness for scrubs, because I sweat like a pig under her rapid-fire questioning brigade. I'm exhausted and burnt out and I'm not sure I'm going to survive this surgery hell.

Six more weeks. I just gotta get through another six weeks.

Long walk home

Even if I'm completely miserable in the OR every day, at least Martin's taking cartoon me around Spain to see the sights.




Trust me, I wish I were there too. Really, I wish I were anywhere but here.

All we ever do is say goodbye

Everything reminded me of my grandfather today.

I was in clinic this morning, where a girl about my age accompanied her grandfather to his appointment so that she could learn more about the parathyroidectomy we'd be doing in a couple of weeks. He was nervous about it, and while I'm sure she was too, she hid it well, asking how soon after the surgery he'd be able to eat (the next day!), and promising him the best sushi dinner of his life.

One of the fondest memories I have of my grandfather is going to this swanky sushi place in Taiwan when I was merely 8 or 9. It was a hipster place, and I'm sure we looked completely out of place, but my 8-or-9-year old self just thought it was so cool and so fancy, and I was so excited. My grandfather had never been there before, but heard that it had the best sushi in the city, and grandfathers always want to get the best for their granddaughters, so we went to this hip restaurant that was completely packed. I was hungry, so my grandfather decided to splurge, and we sat at the uber expensive but empty sushi bar. I felt like such a grown-up, getting to order directly from the chef, instead of having to choose a kid's combo meal. And he let me order whatever I wanted! Salmon, tuna, red snapper, uni, anything I wanted to point to. It was the best meal of my life.

This afternoon, I also scrubbed into a hemicolectomy. The patient had stage III colon cancer, and as I told my resident the correct answer to survival curves and what should be used for adjuvant chemo, I couldn't help but feel defeated that my grandfather fell into the unfortunate 30% population that didn't beat the odds.

The 2-year anniversary of my grandfather's death is fast approaching. And while I have to admit that there are days when I don't even think of him, there are days - like today - when it hits me like a ton of bricks.

And that's when I wish I had done more, said more, held his hand more, and took him to eat sushi more.

But most of all, I wish he were still here.

Beau comme le soleil

Moi aussi. Vous n'êtes pas seul.

The good stuff

Donuts are worth living for. No sarcasm.



And there are times when you just need to eat half a dozen donuts in one sitting to make it through the day.