Disarray

My attending nudged me. Oh my, look at that complex tic. This might be the only time you'll see it - it's SO rare!

I stared at the classroom. Who was she referring to? Which child had Tourette's? There was one girl in the corner singing songs, or was she vocalizing? Her singing was pretty poor and pitchy, after all. There was another kid who kept thumping his chest. Another boy kept twirling his hair around his finger. And then there was another boy, sitting at the table drawing, but shuffling his feet back and forth, occasionally grasping his elbow during his awkward chair and table dance.

Today was my first day of child psych. And while I was completely lost on what I was expected to help out with, and answered questions completely incorrectly, the time flew by.

I'm keeping my fingers crossed that I love this upcoming month, because this is what I supposedly want to do for the rest of my life.

P.S. My personal statement is officially done and uploaded into ERAS. Praise the powers to be.

Diamonds are a girl's best friend

Martin got me a present for our 28th monthiversary.

And because he loves surprises, but knows I hate them, we compromised - he told me a hint each day that would lead me to the answer.

Hint 1: Like LPT not height or size/but in its lack of cornered sides

Hint 2: Twinkles lightly like a star/but closer to you than they are

Hint 3: It was first found amongst the rocks/ now you can add to your pink box

Hint 4: Almost time to end this game/it's coming from a sister's name

Hint 5: Just one last hint for your list/this present should go on your wrist

And then the next day I got a nondescript brown box from New Jersey. And inside was my gorgeous diamond charm bracelet from Tiffany's!

I love it.

For the record though, I was expecting a cinnamon sugar pretzel from Auntie Anne's.

The boy is mine

Martin visited for two weeks, and it was absolutely wonderful.

But then he left, and my stress ulcer grew back.

Boarded doors

While other teams complain about rocks, we keep getting bounce-backs. One in particular.

Mr. Parise is an alcoholic. He'll go out and drink a liter or two of vodka and then stumble into our ER, where he always complains of the same thing - pain in the epigastric region that extends around to the back. And he says the magic textbook words - "like a rubber band."

Then he gets admitted for pancreatitis.

And we give him fluids and pain medicine.

Even though he doesn't have any abdominal pain when distracted. Even though he can change positions easily, but then has severe pain if we so much as try to poke him. Even though his CT scan shows no evidence of chronic pancreatitis. And his lipase and amylase are all within normal limits. And he's starving, asking for 2 trays of food, while we all know that patients with pancreatitis normally don't even want to think about putting anything in their mouths.

But I get it. Pancreatitis can present in different ways, and this guy has the number 1 cause of pancreatitis in men - alcohol. So we have to treat the patient - not the imaging, and not the lab results.

Yet, inevitably on day 2, when we start to decrease the frequency he receives his pain meds, he freaks out, and demands that we go back to what it is, or he'll leave AMA (against medical advice). So then we have a huge long discussion with the patient, telling him that he doesn't require such high doses of meds, but it's important for him to remain NPO (nothing by mouth) to prevent further inflammation of his pancreas.

He then asks for an AMA waiver, signs it, and heads out.

Then, 3 hours later, or if we're lucky, 2 days later, we get a call from the ED saying that our patient is back, reeking of alcohol, and complaining of the exact same symptoms.

And I know this probably makes me look like a terrible doctor-to-be, but I gotta wonder when it stops. If someone signs out AMA and then comes back complaining of the same exact symptoms, I feel like there have to be some repercussions. Especially when we have an ED full of people, and no beds for any one.

Cheater cheater

The secret's out.

I've got your number

Dating's a harsh harsh game. Especially in our medical school bubble of a neighborhood.

The other day, a couple of friends and I were celebrating a golden weekend, so we hit up a local bar to just hang out. As we nursed a couple of beers, chatting up our most memorable (read: craziest) patients, a guy probably in his late 30s - balding and pot-bellied - came over to us.

He addressed my two guy friends first. "Hey guys - are you working this angle?" as he gestured at me. "No no! Not at all! We're just friends!" They sputtered, tripping over their words, as their denials couldn't come out fast enough.

Now, I'm not a bar regular. I don't know bar etiquette. Do I tell the guy upfront that I have a boyfriend? Is that presumptuous? I didn't quite know what to do, but luckily, I didn't have time to get a word in edgewise, as the guy kept going, full steam ahead.

He gestured at me, his hands straight out, as though I were assessing for asterixis. "Well then, I just wanted to tell you, that I love this outfit that you've got going on..."

I looked down at my ratty tank and jeans, as he did a little wax-on, wax-off move.

"But you know what? I have something for you that would make it even better," he said, as he did a poorly executed magic trick and pulled out a flower made from one of the bar napkins.

He held it out to me. I blinked at him.

My guy friends, watching this whole time, swallowing their guffaws, nudged me and stage-whispered, "TAKE IT!"

I took it, awkwardly. "Um. Thanks!"

He blushed brightly, and I instantly felt bad for him. I wanted to tell him that I appreciated it, but I had a boyfriend. But before I could get out two words, he stopped me. "Just so you know, there's a special treat inside." He paused dramatically. "...my phone number."

My friends lost it. And they started cracking up, all while kicking each other under the bar, hoping that the pain would make them stop laughing.

I again, awkwardly thanked him. He smiled at me and then went back to his friends, sitting at the other end of the bar.

I put the flower back down on the bar, without opening it, as I could see him and his friends periodically glancing over to see how I would respond. My guys continued laughing, wiping tears from their eyes.

At that moment, Judy arrived at the bar. "Hey guys!" She called out to us brightly, making her way over to us. Then she saw the guy, and she stopped and smiled. "Oh hi! Dr. Lang!"

Dr. Lang?

We made our way over to Judy, as she engaged in a little bit of small talk.

Dr. Lang looked at us. And then gestured at Judy. "Are you all friends?" We nodded. He hesitated. "Are you all med students?" We nodded again. "Fourth years," we told him. At that point, Dr. Lang's posse of friends started laughing.

Judy smiled brightly, unaware of everything that had gone down in the past thirty minutes, and said, "Oh did you already meet? Dr. Lang was my RIC attending!"

He smiled awkwardly back. "So, are you all rotating through RIC this year?" "Next month, actually!" one of my guy friends said.

"You too?" he gestured at me, sounding a little bit aghast.

"No, I'll see you in March!" I told him.

"Ah. Looking forward to it...nice meeting you guys," he replied, but he could not sound any less enthused.

We walked back over to our post at the bar, where we promptly dissolved into fits of giggles, as Judy kept asking what exactly was so funny.

My friends suggested that I keep the flower and wear it in my white coat for my rotation. I found out the next day that one of the guys actually took it. Just in case he needed it for blackmail. Even though grades no longer matter.

Love the way you lie

I haven't talked to J in more than 4 weeks.

But today I had a really stressful day, so I called him up. And even though he normally lets all of his calls go to voicemail, today, he surprisingly picked up right away. It's like he knew.

And the moment he said, hey, what's up?, I started bawling as I poured out everything that has gone wrong these past couple of days. All my self-esteem issues that are ridiculously amplified by the whole application process.

And instead of making fun of me and my hiccup-ridden conversation as he normally would have, he just reassured me. Told me that I would match. And that I would get great training no matter where I ended up - even if it was in Sarah Palin's Alaska.

Because even though I probably have had this exact same conversation more times than I can count, I just want to be reassured. Because there are times when the self-doubt and the what-if's overwhelm, and I drown in my worries. And that's when I need someone like J to pull me out of my pool of negativism, with a reassuring line or two.

Sigh. I miss my J&L dinners.

Three coins in the fountain

ME

Oh my goodness, this is the cutest coin bank I've ever seen.

MARTIN

It's for a child.

ME

It's so cute.

MARTIN

And really, who's going to put in one coin at a time? Who has the patience to wait for each coin to be taken??

ME

[replaying video for 4th time since starting this conversation]

I would.

Make you feel my love

When I was in high school, I was on the journalism team. I loved writing. Whether it was a profile on the school's first girl football player or an expose on pyramid schemes, it never took me more than thirty minutes to knock an article out. And people enjoyed what I wrote. It got to the point where I was given my own column - michillaneous musings - and a monthly stipend. Sure, it was only $10, but it made paying for museum tickets and coffees more accessible.

I became the youngest person to oversee a newspaper section on my own, and was named the "Best Journalist of the Year" two years in a row.

Now, our newspaper wasn't all too shabby. We would go to competitions and sweep everything. We would have awards in every category, except for one thing.

My category.

I was always entered into the feature/human interest race. And I always lost.

Maybe it's because writing under pressure never appealed to me. The things I wrote about were fun, fluffy. There were never any consequences to my articles, except during competitions. Then, it was WRITE or DIE.

And so those articles were terrible. I would sit there for fifteen of my allotted 45 minutes, just writing and rewriting the first paragraph, because I knew how important it was that my sentences grab the reader and drag them into a world I would then create. A world that never completely materialized. A world that never won the prize.

Fast forward 10 years, and I'm still writing. Fluff pieces on my blog about patients and my life in medical school. Things just for fun. Things of no significance.

But now I have to write my personal statement. Something that DOES matter. Something that residencies will look at to determine if I'm a good fit for their school.

I've been trying to write the same thing for the last month, and every time I read it, I know it's not right. It doesn't have the right gravitas, the right tone, the right amount of yearning without turning sappy. It's not award-winning.

Bottom line? I have writer's block. But I must finish this personal statement today. I'm just worried because I know it's not going to be any good. And that stresses me out.