Dream celebrity couple

This is too cute. Seriously. So adorable. Both of them.

Please start dating already.

You look really familiar. No really, that's not a pickup line.

Amy came to visit the other weekend, and after watching BRING IT ON: THE MUSICAL (which, before you start laughing and make fun of me, was actually really fantastic and awesome and so so cool with the crazy stunts and you should go see it too), we decided to hit up one of the local bars to catch up over drinks.

We grabbed our drinks, found some seats, and sat down. Where we promptly noticed that a guy in scrubs was sitting right next to us.

Remember, this is post-musical. So it's not like it was 5pm happy hour. It was roughly 11pm. And this guy was wearing hospital-issued scrubs in a bar.

And then he tried to pick up Amy, who stopped him before he even got past his opening line, by flat out asking him, "Are you wearing scrubs? Really?! No really, really??" To which he replied, "Well you know, I'm a doctor. I work really long hours."

To the guy's defense, that line probably works usually. Probably gets him some awww's and poor baby's and some phone numbers. And there was no way he could have known that he was talking to two residents. Except he was. And we kinda let him have it.

"Wow, you must work in a really hard specialty if you have to come straight to the bar in your scrubs." "Seriously, shouldn't you be sleeping if you're post-call?" "I worked all day today and then went to the airport to pick up my friend, and somehow managed to change clothes in between too...but that's just me, you know, good work ethic." "Work must have been really bad today that you had to go straight from the hospital right to the alcohol."

Really, he should not have been wearing baby blue scrubs in a bar at 11pm at night. Seriously. Change the pants at the very least! Or throw on a decent shirt over the scrubs! Even a regular t-shirt might have saved him. And who wants to bet that he's just a respiratory therapist? Or a lab tech?

But the night was just beginning.

After we moved to the bar, Amy and I saw an extremely drunk Indian guy in a suit lumber over towards us. On alert, we quickly turned our backs and started chatting with our neighbors at the bar. That didn't stop him. And he reached out his hand and essentially slapped Amy on the back.

"Hey!! Haaaaaaaaave you met Andy?"

Yes.

Yes. He used the line from How I Met Your Mother. It's almost as bad as going up to a girl, looking her up and down, and saying, "how you doin'?" a la Joey from Friends.

"No, I haven't met Andy and I don't want to."

Amy was cold, but what else can you do in that situation, right?

But then, something strange happened. Andy started asking us about which school we went to, if we used to live in Chicago, and if yes, did we happen to live in Streeterville, maybe in McClurg?

Thank goodness he got that last bit wrong, because otherwise I would have thought that he was stalking us.

It turns out that we did indeed know Andy. We had met him four years ago at a Northwestern APAMSA-APALSA mixer. And when Andy introduced us to his other friend in the group, well, it turned out that Amy knew that guy from high school.

Yes, really.

It's a small world after all.

I don't understand

Really?

How was this not some kind of joke set-up?

My patient was Korean, and she was brought in by her roommates -- a young Polish guy, a middle-aged overweight Italian man (complete with handlebar mustache), and her Nigerian landlady, who happened to be in a leg cast and crutches. All of them spoke minimal English. And all of them were trying to translate what the other was saying.

At one point, the Italian guy was trying to tell me what the Nigerian lady was saying and the Polish guy was explaining the entire scene to my Korean patient.

Seriously.

To this day, I still have no idea what they were trying to say. I hope they understood the whole 72 hour hold issue and that my advisement was indeed complete.

This is why I'm fat

Seriously, what is wrong with me.

Please don't be one of mine

Whenever I read a really horrible story on CNN local or the LA Times, about a terrible suicide or someone seriously psychologically disturbed who goes on a shooting rampage on the corner of Vine and Sunset, my heart races while I try to place the name. Did I know that person? Did I take care of him? Did I let him go too soon?

It hasn't happened yet, but I worry that one of these days, I'm going to recognize the name as one of my patients.

And that, my friends, is why I'm so conservative when it comes to discontinuing holds, why I'm so reluctant to discharge my patients too quickly, and probably why our psych ER is constantly full.

Reunion, part 2

And then we roadtripped to Atlanta to make the BFF trio complete.

JLM reunited.

And reunited at Richard Blais' FLIP burger, at that!

Yum!

Let's do it again soon.

Reunion, part 1

Reunion with the bestie!

BFFs for good reason. :)

Naughty or nice

Occupy LA is being forced to shut down tonight by the LAPD. Roads have been closed, and now there are six helicopters circling overhead, beaming red and green lights down onto the street.

Along with seemingly all my other neighbors, I went out onto my balcony to see what the commotion was all about...

...and overheard my neighbor's five-year old son exclaim to his mom, "OH MY GOD. SANTA'S DOING A TEST RUN!! HOW COOL!!!!"

If only it were all that innocent.

Deck the halls indeed

Christmas trees make me happy.

Putting up Christmas trees and decorating them while you're sipping hot chocolate and Mariah Carey's singing in the background? That always puts a smile on my face. 

Always.

So after an especially bad week in the psych ER, Martin and I went and bought us a tree and all the trimmings.

Who cares if we put it up five days before Thanksgiving? If Starbucks can start handing out red holiday cups on November 1st, and KOST has been playing nonstop Christmas carols for the past week and a half, I say I can put up my Christmas tree. 

before...

...and AFTER!!

It makes me really happy. Super duper happy.

And it's awfully pretty.

I'm pretty positive I'm going to leave it up until March.

You never know, it might be in the DSM V

Sometimes there are bad days at work.

So bad that you start to wonder what if. What if I went to my second-choice program? What if I were in a completely different state? What if my program were more therapy-based instead of medication-heavy? What if I had gone to a non-county program? What if this and what if that and what if what if what if.

True story: yesterday night, I scoured the forums to see if Mt. Sinai still has their PGY-2 spot open.

I've had an entire string of bad days this whole week.

The patient load has been extraordinarily high and the work is unending, to the point that I don't stop writing, I don't stop moving from the moment I set down my purse 'til I finally leave the hospital, three hours after my shift is supposed to be over.

I'm just tired. So tired.

I've been so tired that the other day I diagnosed a new mother with postmortem depression, when I really meant to write down postpartum depression.

And it worries me that it's only going to get worse once January starts and I'm headed over to the other side to be a neuro/medicine/pediatrics intern. Lord, give me strength. And give me time to sleep.

And this is why we never have voluntary admissions

I couldn't breathe, my stomach was cramping, and my heart was pounding so quickly, there were no longer individual beats, but rather just one long systole-diastole hybrid. I was getting more exercise than I had for the past five months combined, and yet there I was. Still running. Still running as fast as I could.

See, I was running after my patient.

My patient, who had seemed so calm and cooperative, who had suddenly bolted from the exam room as I waited for a nurse to accompany him to the unit.

And now he was fleeing, running away, weaving through traffic and between businesses, and the nurse and I were the only people running after him.

Through the lovely streets of East LA.

As part of my psych ER rotation, I get to evaluate people who walk in to the outpatient psych clinic and ask to be seen without an appointment. Usually it's pretty easy, I just have to talk to them for a bit to see if they're suicidal, homicidal, or unable to take care of themselves. If they are, then I take them over to our unit, and if not - I set them up with some follow-up care and I can return to my other duties.

We usually let them wait, because they're pretty low priority. And it's pretty unlikely that a patient gets admitted.

Yesterday, it was especially busy in the ER, and so my patient ended up having to wait five hours for me to evaluate him.

I talked to him, determined that he was endorsing a lot of passive suicidal ideation, so I wrote up his 72 hour hold and got him ready for admission. He sat and waited in one of the exam rooms while I quickly assessed the two other patients who were waiting for me (who did not meet admission or hold criteria), and then we were ready to go.

Except, he suddenly stood up and asked to use the bathroom. As I directed him towards the on-unit bathroom, he twisted away from me and started running.

Shit.

Shit shit shit.

I started running too, all while yelling at the charge nurse -- "Call a code! Eloping patient on hold!! CODE GREEN!!!! DO IT! DO IT NOW!!!"

I had no time to tell if she understood me, because he was sprinting through the hallways, and I was on close pursuit. And then security came.

Or so I thought.

A security guard was returning to his post, opened the door, saw the patient running towards him, also saw me running after him, and what does he do?

He holds the door open for the patient.

Shoot me now.

So the patient got out of the clinic, and here we were, running down the streets of East LA, as I tried pleading with him from 20 meters behind, pleading with him to come back, to stop, to slow down, to just let me talk to him for a bit. Because I had just put him on a involuntary hold because he said he wanted to sleep and never wake up, that he wanted to accidentally get hit by a bus...and what was he doing? Running through the streets, where the possibility of getting hit by a car or bus - accidentally or not - is astronomically high.

Thankfully, just as my body was about to collapse, three sheriff cars came tearing through the streets, screeching to a halt in a U-formation, blocking my patient's escape route.

The good: they caught my patient.

The bad: they couldn't apprehend him unless I had the hold in my hand -- which of course I had thought to grab as I was chasing my patient in the hospital. Except I didn't. So what do the sheriffs make me do? Run back to the clinic, grab the hold, and then run back to their location so that they could finally escort him over to our unit.

And that, my friends, was my first day back at work after an especially fun and lovely week of vacation. I love my job.

May the odds be ever in your favor

I cannot wait for this movie.



Jennifer Lawrence is perfect. Absolutely perfect as Katniss.

I VOLUNTEER!!!

Such desperation. True story: I started tearing up just watching the trailer. I'm gonna be an absolute mess during the actual movie.

I'm glad our one win of the season was against them

So Nebraska joined the Big Ten this year.

And Nebraska made a big deal about how their abbreviation ought to be NU for Nebraska University.

Only one problem...Northwestern already is NU.

Nebraska wanted us to change ours to NWU or UNU or some other ridiculous abbreviation that made no sense whatsoever. Why? Because they're the better football team. Because they're the program with the national exposure. Because they're consistently ranked on ESPN. Because their games are actually shown on ESPN.

This weekend, we played Nebraska. Our terrible football team went up against the #10 program in the nation.

And guess what? We won.

So Nebraska, here's an ecard for you...

Suck it.

It does sound the same, especially with a Spanish accent

Today, a patient's family gave me the most adorable gift ever:  a cow made out of marshmallows. On a stick.

Then they told me why they got it for me. They thought my name was Dr. Moo.

---

CO-RESIDENT

Oh my goodness! Did your patient give that to you??

ME

Yeah! Isn't it adorable?? They said it's a cow for Dr. Moo!

CO-RESIDENT

Ummmmmmmmm, except it's a pig.

ME

What! No, it's a cow!

ATTENDING

Wow, Michelle...did you go to elementary school? Because you must have failed Farmhouse Animals 101....

ME 

Laugh all you want, I still think it's a cow!

You just can't argue with that kind of reasoning

ME

Sir, I really need you to keep your clothes on. There are ladies here! And I can see your man bits.

PATIENT

Adam and Eve didn't wear clothes. 

ME

Well, they wore leaves to cover their delicates, and since we don't have leaves, hospital gowns it'll have to be!

PATIENT

No! [gesturing to the other patients] Come! Join me! Throw off your cloaks of shame!

CO-RESIDENT

Oh man, now we're just gonna have a full on mutiny orgy in the psych ER. Look what you've done Michelle...look what you've done.

Say, do I know you from somewhere?

ME

Hello ma'am, I'm Dr. Wu. Can you tell me your name?

PATIENT

Can I tell you my name?? How do you not know who I am?!

ME

I'm sorry ma'am...even though you look like a frequent visitor to the psych ER, I can't say I remember your name...

PATIENT

How dare you! I am a Mayan princess! I have diamonds in the soles of my feet! Bow down before royalty!

Chicago has my heart

I don't know how to write this post.

There's so much nostalgia bursting through, all these memories competing for top dog honors, all these loves and friendships that I don't know how to convey on paper.

I love Chicago. I love Northwestern. And most of all, I love my friends.

Really had quite the amazing reunion weekend. Pictures and posts to come.

No place like it

Chicago, I'm coming home.

Long distance friendships

Best friends don't last forever.

It's just hard to maintain that level of closeness, especially when you're separated by 2000 miles and multiple time zones and strange night float schedules and engagements and new babies. So, it's hard. And the best-ness in the friendship starts to feel a little less "be fri" and a little more like you're marching slowly but inevitably towards the "st. end."

So best friends don't last forever, because they just can't.

After two and a half years, I finally saw J again.

Two and a half years is a long time. A long time trying to sustain a friendship on just random text messages and occasional happy birthday facebook wall posts. And we both knew that if it weren't for interviews, there was no way he'd be out here in Los Angeles visiting me.

I think he knew it was awkward too. He didn't ask to stay with me, but booked a hotel instead, opting instead to spend $300/night out of his measly resident salary to avoid awkward silences and lack of personal space.

So when we finally met up the day after his interview, it felt a bit strange. It felt a bit awkward. I mean, where do you start off a real-life actual conversation that you haven't had in two years? I pulled up to his hotel, and got out of my car to give him a big hug.

Instead his giant chin punched me in the forehead.

And right away, we started laughing, and the awkwardness melted away, as he pulled out his phone to show off pictures of his brand new baby, and then took my phone to create some new shortcut to fix my GPS so that I can actually find my way home now from anywhere in the United States. (Yes, I might be more excited about that than seeing J for the first time in a two years.)

So sure, best friends don't last forever. But at some point, best friends become dear friends. And that's when you know you'll be friends for a long time, even if you don't talk on a weekly basis. Because you know each other well enough that you can just pick up where you left off, even if you're both ten pounds heavier and now dealing with more stressful life issues like mortgages and diapers instead of midterms and final papers.

I'm going back to Chicago next weekend for my undergrad reunion. Here's hoping that this whole best-friends-equals-dear-friends-who-aren't-awkward-around-each-other theory holds up and I can show off my new non-awkward, non-klutzy self.

I don't have high hopes.

Too soon?

No hope, no cash, no jobs - but at least there's bacon.
And if you play the game right, you're never more than seven degrees away from it.

And then I ran up some stairs like Rocky

I never want to be known as the stupid psych resident.

I know the stereotype is out there. That the psych resident only knows how to sedate patients, and that if a patient were to present with chest pain, we'd call it factitious disorder first before thinking of getting an EKG.

I like to think that there's absolutely no way that would ever ever happen, but I gotta admit, I'm only five months out from medical school, and because I've been in my very happy bubble of psychiatry and psychiatry only, I've forgotten a lot of stuff.

It's hard to remember all that medicine we learned in school, especially when I'm not using it every day. True story, last week I treated a patient's athlete's foot with a vaginal antifungal cream. Thankfully, it was indicated for both. I'm also very thankful that I didn't switch it up the other way around and give a foot cream for someone's vagina. That probably would not be very good. Or pleasant.

I know. I'm not doing much to dispel the stupid psych resident stereotype.

But today! Today I saw a patient in the med ER, and after I assessed her and put her on a hold for suicidal ideation, I let the resident know that we'd take over as the primary service as soon as they could give me some recommendations to teat her pelvic inflammatory disease, and as long as it wasn't via intravenous delivery, we could totally take care of it. The ER resident stared at me, "she doesn't have PID." "Oh, well she's endorsing some symptoms that sound like it might be PID?" I stuttered, unsure of myself, unsure if I actually remembered the symptoms correctly. The ER resident smiled at me patronizingly, and said that he would check it out again, but he was sure the patient was fine and could be transported immediately to our ward. I smiled passive aggressively back at him, and thanked him for this very interesting consult.

The patient finally came to our psych ER eight hours later. After she had been diagnosed with PID secondary to trichomonas infection.

Booyah.

Reason #278 for why we should have electronic charting

ME

So this guy can probably go. He came in with suicidal ideation, but is now saying he's fine and he was contracted for safety.

ATTENDING

Whoa, whoa, whoa, hold up. Start at the beginning. Give me an actual presentation on him.

ME

Oh. You want the whole spiel, not just the dispo plan.

ATTENDING

Yes.

ME

[flipping through the chart to find the patient's H&P which was written by my co-intern]

Umm.

ATTENDING

Does he have a job?

ME

Um, no, I think I read that he was unemployed.

ATTENDING

Does he do drugs?

ME

No, I asked the patient, and he denies any alcohol or illicit drug use.

ATTENDING

What does the chart say?

ME

[still flipping]

No, no drug use. Utox on admission was negative.

ATTENDING

So why was he laid off from his job?

ME

[finally finding the H&P amidst all the other paper documentation]

Okay, here we go. Here's the ID -- this is a 55 year old Hispanic male with no prior psych history, presenting with suicidal ideation and prolonged depression after a MVI five years ago.

ATTENDING

So he doesn't do drugs, but he took a multivitamin five years ago. Why the hell do I care about that?

ME

Oh. I mean motor vehicle accident (MVA). I couldn't read the handwriting. Sorry.

Very happy unbirthday

Well, I'm officially dreading turning twenty-seven.

Which might be why I'm dead set on watching everything on my DVR instead of going to bed.

I know. I'm so rebellious.

My reward for my awesome parallel parking job

I've gotten pretty good at driving recently. I can back into spots, maneuver around sharp turns, squeeze in between buses, drive over 70mph, and -- drumroll please -- I can even parallel park now.

I know. Shock. Gasp. Awe.

I'm an Asian girl...who can parallel park? But that's impossible, right?

But I can. And I did. Today, on my way to have coffee with an old friend (and I mean old as in we've been friends since middle school, not old as in my mother telling me I need to have children old), right across from the cafe we were going to, I saw a woman pull out of her parking spot.

Super excited to have such a prime spot, I parallel parked my way in, and paid my dollar an hour in quarters for the meter.

I had a grand ol' time catching up and complaining about intern year with my friend, and then, when we came out, there it was.

A parking ticket.

Are you kidding me? I couldn't believe it. I had checked my watch, so I knew exactly when the meter was going to run out. We were well within my time limit!

Then I saw the same thing on all the other cars parked around me.

So I let myself hope for a good thirty seconds. Oh, maybe it's just a flyer. An advertisement that someone came by and put on all the cars!

But nope.

Here it was.

A real life parking ticket.

I mean, I kinda knew I was due for a ticket. Driving three months, speeding away and running late to things? Yeah, I knew my karmic chances were just about up.

But a parking ticket?

How lame is that? A ticket for not anything sexy, like speeding to get to the hospital or running a red light to catch a flight. Nope. I got a violation for parking.

Now, before you guys think it's cause I parked in two spaces, had boxed someone in, or was twenty-five inches from the curb -- no, none of that applies. My parking job was flawless. A nice six inches from the curb, and smack dab in between the lines. It was beautiful, and it was perfect.

No, my parking violation was for street cleaning.

STREET FREAKING CLEANING.

Sigh. Sixty-eight freaking dollars. Talk about the most expensive parking spot ever.

Whodunit?

Here we are at our psych residency retreat! Where we all played a real-life Clue! Aren't we cute?

Can you spot the murderer? I swear it isn't me. Swear.

This is why I should listen to more country music

On my way home today, I heard sirens. In the distance sure, but lots of them, seemingly coming from all around me. I looked in my rearview mirror and didn't see anything, but I pulled over to the side like a good driver.

I slowed to a stop, and waited for the ambulances/fire trucks/police cars to pass me.

Instead, I got some crazy loud honking and cursing from all the cars now backed up behind me.

See, those sirens? Just part of the song that was playing on 97.1 FM. Thanks to Carson Daly and over-synthesized pop music, I fulfilled my stereotyped role as bad female Asian driver today.

In other news: my car has surround sound! Who knew?

Kentucky fried

ME

So sir, can you tell me where you're from?

PATIENT

Greenville, Kentucky, ma'am.

ME

And why are you in Los Angeles?

PATIENT

I'm on my way to Bakersfield to meet the movie stars. Because I'm starting acting too.

ME

Bakersfield?

PATIENT

Yeah. My third cousin, MacGyver, lives there.

ME

Is that so?

PATIENT

Yeah, so if you could help me get to Bakersfield so that I can start my acting career, I'd really appreciate it, ma'am.

ME
And do you know where you are right now?

PATIENT
Yes ma'am. Los Angeles.

ME

Have you been in movies or television before?

PATIENT

No ma'am. I usually hunt vampires. That's my real job. But don't tell the Count.

ME

The Count?

PATIENT

Yeah. Dracula. You know.

Thanks for giving me your seat sir, but that's just my food baby

My bathroom scale is usually under my bed. Out of sight, out of mind. And as long as my clothes fit, I don't really care about the number.

Except my clothes have started pinching and showing off things that really should stay hidden.

So I pulled out my bathroom scale, put in some fresh batteries, and voila! I've gained fifteen pounds since starting intern year. Fifteen pounds! In two months! Egads!

Now, I know that everyone jokes about the freshman fifteen, and how that terrible event in our college lives rears its terrible head all over again during intern year of residency, but seriously. This is ridiculous! Fifteen pounds! Are you kidding me?

Lord help me.

For those of you who don't believe me, maybe you'll believe my crazy psychotic patients. Sure, they might be delusional, but they're also disinhibited and have no sense of social aptitude and are thus extremely truthful. Harshly truthful.

Case in point: today, my patient looked at me and remarked, "I didn't know you were pregnant!"

I"m never eating again.

Back from vacation...

And it hurts so much.

Man, it was rough waking up this morning. Rough making that drive to the inpatient psych hospital. And sandpaper rough having to go from peace and quiet and calm and beautiful scenic drives to crazy psychotic patients who yell and curse at you constantly.

I'm already looking forward to my next break.

Chicago! October 25th cannot come quick enough.

Ten years later

We remember. 9/11/01

You rock my whirl

My co-residents are so punny. I'm a big fan.

Since you spent $60000 on your car, maybe you can afford $50 on a driving lesson

After three months of driving research, I've come to this completely biased study conclusion:

• People who drive Audis are giantly huge dickheads.

Doesn't matter if it's a sports car, a sedan, or a mini-SUV. They all drive like they think they're the shit, when really, they just drive like shit.

They make my blood boil and my road rages rage. Ugh, hate!

I guess as long as the death threats and marriage proposals even out somehow...

Neurosurgery sucks.

Hours are long, work is hard, and there's a lot of stress and responsibility that comes with the job.

So I don't envy Martin for what he does. At all.

Well, I do get a little jealous on just one thing. His patients adore him. They love him and they're appreciative of everything he does for them.

My patients, on the other hand, hate me. 

Every day that they see me, they ask me when I'm gonna let them go home. Ninety-nine percent of the time, I have to say, "Nope, not today!" which causes them to go into hysterics, curse the parents that borne me into this world, and inevitably, will explicitly tell me how much they hate me. It doesn't matter how many times I try to explain to them that we're doing things to help them. They feel like they're being jailed, and I'm the jailer holding the keys. 

And since we're on a locked unit, and I really am the one holding the keys.

Martin sees patients in clinic every Tuesday. Every time he sees someone he operated on before, they are profuse with their praise and admiration for his skills.

When I see repeat patients, it's because they went off their meds and they're crazy psychotic again and the police had to bring them in for trying to exorcise demons from strangers or for wandering into their neighbors' houses butt naked, or something along those crazy delusional lines. So when I see repeat patients, it's really to start the entire mundane process of titrating medicines, and listen to them curse me out for locking them up, all over again.

I know it's silly. Me, being jealous of a neurosurgeon. But I guess I would really appreciate it if I could have one patient give me some affirmation for doing what I do. Some tangible proof to point to and say, "See -- THIS is why I went into psychiatry."

As it is, I can't wait for vacation. Less than five days to go!

I really need to learn how to speak Mandarin

They told me he was out of control.

I didn't listen.

They told me that he needed an intramuscular cocktail.

I didn't listen.

They told me that they had tried redirecting him, asking him to take a time-out in the seclusion room, all to no avail.

I didn't listen.

Instead, I was convinced I could talk him down. So I went over to him in the day room, where he was raging against some hallucination, and he pointed at me. "YOU!"

"Yes?" I asked him.

"You my friend!" he replied, and held out his hand, gesturing that he wanted to show me something.

He doesn't speak English, so I figured miming our way through conversation would be better than taking him into a small interview room where we could get a translator on speakerphone. So I gave him my hand. And he immediately grabbed my wrist, pulled me towards him, and out of nowhere, slapped me.

"YOU BAD GIRLFRIEND!"

As soon as he grabbed me, all of the male nurses sprung into action, and took him down quite forcefully. So forcefully he was down on the ground within seconds, arms and legs splayed out straight, his voice muffled as he continued to curse profusely in Mandarin. "Now do you want to restrain him, doctor?" the charge nurse asked. "Yeah, we should probably do that," I admitted, chagrined that I thought I had magical mediator powers that could someone convince this crazy person that everything was going to be okay. Moral of the story: listen to the nurses.

Also, it turns out that my generic Asian face apparently resembles his ex-girlfriend's, who just recently dumped him. And so, seeing me there apparently caused him to go into an even deeper psychotic rage and consequently, started all the slapping. His family tells me that she was quite pretty, even if she did make him crazy.

Definitely gives a whole new meaning to receiving a "backhanded" compliment, that's for sure.

Road rage regret

I've been driving for three months now, and I have never used my horn.

In fact, there have been a couple of horn-deserving moments when cars have cut me off and I almost crashed into a wall, and I would have used my horn if I knew where it was. The first time, I sat there punching the middle of my steering wheel for a good thirty seconds, before I realized that the horn button was off-center, but by that time, the offending driver had cut off three other drivers and had driven off into the smoggy sunset. Long story short, it wasn't worth it.

Today, I used my horn.

I left a good ten minutes late for work, and I was feeling guilty since I'm the one who's supposed to relieve night float, and I knew I was going to be very late. So as I sat in the RIGHT TURN ONLY lane at a red light waiting for the car in front of me to go, I finally did it.

There were no pedestrians, no oncoming traffic, and yet, this car just kept sitting there. Sitting there, while I had places to get to, and night floaters to send home. Either he turn right, or move over so that people who wanted to, could.

So I laid on the horn.

That's when the driver rolled down his window, pointed to the giant "NO TURN ON RED" sign, and then flicked me off.

Oops.

Can I get your number? And an STD screen?

ALEX

Michelle, I hate psych residents.

ME

Take it back! You love me!

ALEX

Haha, you're the exception. But, okay, fine, I just hate the psych ER in general.

ME

Rough patients?

ALEX

Yeah, this 23 year old girl flipped out on me today.

ME

Oh.

ALEX

Actually, saying that out loud -- that basically sums up my life!

ME

Haha, so really, it was just another day in the life of Dr. Alex.

ALEX

Exactly, except this girl was a crack addict and had herpes and chlamydia...oh wait, still no difference.

ME

So this wasn't a patient at all, was it? Alex, you really ought to screen your dates better.

Why I need to read Perez Hilton at work

Confession: I reference pop culture all the time when I'm talking to my patients.

The one I use most often is Lindsay Lohan and her alcohol addiction.

The second-most common one is Britney Spears, especially when I need to talk about conservatorship. "You remember when Britney Spears shaved her head?" "Oh yeah, she was a trainwreck!" "And have you heard about her in the news recently?" "No, well, yeah -- they're doing some MTV tribute to her...they were talking about it on that talk show--" "I mean, have you heard anything negative about her recently?" "Hm, no, I guess not." "Well, that's because she's conserved. And that's what we want to do for you..."

I had a patient who agreed that her life was kinda spiraling out of control - Britney Spears style - and she probably needed someone to keep an extra eye on her. So we went to court to get her conserved and set up with a public guardian.

But there's a lot of waiting involved with court. We had to sit through current conservatorships that were getting renewed, asking the court for specific resources (bicycles, tennis shoes, shopping carts, etc), and then we had to sit through conservatorship terminations.

---

LAWYER

We would like to end this conservatorship because the conservatee is no longer with us.

JUDGE

What happened?

LAWYER

She died, Your Honor. The conservatee was placed at a nursing home two weeks after conservatorship was started --

JUDGE

Oh, I remember her. She had a diagnosis of Stage IV skin cancer. Is that why she passed?

LAWYER

Unfortunately, she choked on her dinner and was unable to be revived.
---

Over in the audience gallery, my patient turned to me and looked at me in absolute horror.

PATIENT

Dr. Wu! I don't want to be under conservatorship! I don't want to die!!

ME

Don't worry, you won't die. We'll make sure you go to a good facility. But to be on the safe side, just make sure you chew your food carefully.

My adventures on night float, night 7

I wasn't prepared for an emergency. I mean, during my entire week of night float, the craziest thing I had to do was disimpact a pregnant lady and ward off the gays who then all claimed that they too had abdominal pain and hadn't pooed in days. (Insert obligatory "full of shit" joke here.)

So on my last night, I was sitting in the resident library, waiting for sign out, and embarrassingly reading about the Kim Kardashian wedding. And then, one of my fellow residents walked in, "Hey, um, do you think you can come help with this patient? There's something wrong."

I jumped up and went with him to the unit, where pandemonium was everywhere. Nurses were furiously clicking on computers, someone was tasked with calling 911 but kept getting the sheriff's office, people who should have been watching their suicidal patients were milling about the nurses' station instead, and no one could tell me where the patient was. After finally getting the proper room number, I walked over, and saw five different doctors and nurses simultaneously assessing the patient all at the same time.

I honestly didn't know what my place was. There was an attending, but she seemed overwhelmed, the charge nurse was trying to put the patient into restraints, and my fellow resident was checking pulses but couldn't find any. And all the time, the patient just laid there, completely unresponsive. I don't know what came over me, but my Northwestern training clicked into place, and I started barking out orders.

Someone call 911 for immediate transfer to a medical center.
Someone tell me his one-liner. What's his name, age, diagnosis?
Take those restraints off.
Did someone do vitals? You, go get me the vitals machine.
Unless you're directly involved with this patient's care, please leave the room and wait outside.
Someone tell me what meds he had today, and if there were any recent changes.
Call phlebotomy; I want a stat blood draw.
Charge nurse, what was he doing prior to this happening?
How long has he been like this?

And all the time, I was going through the head to toe physical exam checklist. Thank you Northwestern for tediously testing our physical exam skills five times a year. I can now do this in my sleep. Sternal rub. Checking for posturing. Checking pupils. Checking his mouth. Checking his pulses. Checking his heart. Checking his lungs. Checking for urinary and bowel incontinence. Checking reflexes. So on and so forth.

I was surprised at how outwardly calm and cool I seemed. Especially since I knew my mind was racing, my heart was pounding, and I was thinking a colorful rainbow of curses, as I tried to figure out how to best take care of this patient with my rather limited County resources.

Before I knew it, the paramedics were there, and as we rolled the patient towards the hospital exit, I told them all that I knew, and my best guess diagnosis (seizure). And halfway towards the ambulance, the patient started coming out of it.

And just as I was finishing the transfer note, my pager went off. Five new admissions would be hitting the floor in about 30 minutes. Fabulous. Just enough time to eat dinner.

My adventures on night float, night 6

Our call room is musky and malodorous.

Even though housekeeping cleans it every day, vacuums the floors, wipes down all the surfaces, and provides us with new sheets and blankets, something about the room just makes it feel dirty. All the time. You start itching if you spend more than thirty seconds in there, I swear.

It smells like body odor mixed with essence of skunk meets teenage boy basketball shorts. In summary, it smells. It smells absolutely nasty.

Since the dawn of time, none of the residents have ever slept in that call room. Besides, the call room doesn't have a computer, doesn't have a TV, doesn't even have a pillow. So we sleep in the residents' library instead. Because there's a giant comfy couch in there, computers galore, a TV and DVD player, and Season Three of The O.C. It really doesn't get much better than Misha Barton and Adam Brody. I mean, how can it, right? Look at them! And their snarky commentary about their overly dramatic teenage lives!

Granted, some of us don't sleep in the call room because some of us don't know where the call room actually is. [Side story: I was trying to get into my call room for a good fifteen minutes, wondering why my key wouldn't work, before my attending finally opened the door and asked me if I was at HIS call room because there was a patient to staff. Luckily there was, otherwise I would have had to pretend that I'm a sleepwalker or something. Seriously, so embarrassing.]

Anyhow, normally we sleep on this giant red couch in the library. But on the first night of night float, I came in, and on my would-be bed, there was a note instead:

So after trying to sleep on the table, or in a cubicle, I finally fashioned a bed out of chairs, and this is what I slept on for a good three days:

It wasn't the most comfortable, and I definitely fell on my butt one night when the chair rolled away and my body kerplunked onto the floor, but on night float, you start to take what you can get. And well, if five chairs was the only way I'd be able to sleep without waking up to bug bites all over, five chairs it would be.

My adventures on night float, night 5

I love food.

Big fan.

In fact, that's a major reason why I ended up choosing USC. We have a fabulous meal plan. Ten dollars a meal, three meals a day. And the cafeteria food isn't bad. It's not bad at all.

And so, my attending wanted to make sure I was getting fed while I was on night float and he brought me a little sack dinner, prepared just for me by the executive chef at our hospital.

This is what was inside:

Apple juice, a pear, and mystery fruit submerged in orange jello as my main entree. So appetizing, no?

(The answer is no.)

My adventures on night float, night 4

My attending told me to call him if I had any problems.

Problem: he gave me my own call room number to call.

My adventures on night float, night 3

I have a patient who legally changed her name to Tupac Shakur.

Seriously.

Except she's nothing at all like Tupac. She's teeny tiny, doesn't know anything about rapping, and she's definitely not from the hood. And her voice sounds like a five year old child's. As mean as it may be, she seriously sounds like Little Orphan Annie when she speaks.

TUPAC

Doctor! I have chest pain!

ME

That's not good. Where does it hurt?

TUPAC

In my leg!!

ME

Does it hurt in your chest?

TUPAC

No! Just my leg!

ME

Errr, so do you have chest pain??

TUPAC

Yeah! And the only thing that can make me feel better is some juice and a cigarette!

ME

Well, I can't give you a cigarette, but I can get you some juice.

[thirty seconds after finishing the juice]

TUPAC

Thanks doctor! My chest pain is all gone now!

It's the newest regimen for chest pain, my friends. Forget the morphine, oxygen, nitro, aspirin. All you really need is a good juice box. What can I say? I'm a miracle worker.

My adventures on night float, night 2

My patient pointed to his feet. "See? I told you! Behold the miracle!"

He thinks he's Jesus Christ. And so he told the nurses he was going to take a shower, but flooded the hallways instead.

Just so he could prove that he could walk on 2mm of water.

---
*Note: this patient is not to be confused with my other Jesus patient. Yes, this is a completely different patient. In fact, I actually have three different patients who believe they are Jesus. I wonder what would happen if I put them all in the same room. Would they form the Holy Trinity?

My adventures on night float, night 1

Getting paged in no big deal in psychiatry. Our patients aren't acutely sick and well, minus the occasional psychotic person lashing out and needing a few IM medications to calm them down, there's really not much to do. So typically when my pager goes off, it's to reassure the nurse that having a systolic blood pressure of 125 is okay and the patient is most likely not stroking out, or that yes, the patient is allowed to eat food that friends and family might have brought in for them, or of course, I'll be right there to sign the order to renew restraints that  won't expire for another three hours.

But yesterday, I got the strangest page in the world. Usually, the charge nurse will give me a brief heads up or a quick cliff notes version of events so that I know what I'm walking into, which is always a good idea if you don't want psychotic or manic patients charging at you for not believing that they're Jesus Christ. But this time around, the nurse just frantically asked me to come - come quickly - to her unit.

I ran.

Turns out a female patient, manic and hyper-sexual, had gone to the nurse to ask for one of her as-needed medications to calm her anxiety. The nurse was surprised; this was one patient who never wanted meds, but went to go get the Ativan. When the nurse came back, the patient was nowhere to be found. She looked in the group therapy room. Looked in her roommate's room. Looked in the dining room. Nothing.

Then they heard loud moans coming from the male dormitory side.

Yes.

Really.

It's just what you think.

The female patient had taken that short amount of time to sneak over to the guys side, find one willing participant, and give him a blow job. While he, in return, massaged her breasts.

Seriously.

And now they were sitting there, caught red-handed as thieves, waiting for me to dole out their punishment.

My first night on night float. And this is what I get paged to do. And besides the standard police report (just to make sure no one was taking advantage of anyone else), and the typical STD screen, I didn't know what else to do.

I'd order chastity belts for the two of them, but 1. it's not on formulary, and 2. that probably counts as some kind of restraint order, which needs renewing every three hours. And well, I like my sleep far too much for that.

My first death threat

A nurse paged me to her ward today, saying that a patient's husband wanted to talk to the doctor right away. I checked her chart. No consent form to speak to the husband. No way was I going to tell him anything.

ME

Hello?

MAN

[breathing heavily]

Yes.

ME

[after 30 seconds of silence]

Um, may I help you?

MAN

Who is this?

ME

This is Dr. Wu. Who is this?

MAN

I'm Mr. Smiths. You're holding my wife there illegally.

ME

Sir, I cannot tell you who is and who isn't at the hospital.

MAN

Are you telling me I have to get on a fucking plane and drag my ass over to the hospital so that I can take her home with me?

ME

Sir, I'm not saying anything like that. I'm saying that I cannot give you any information.

MAN

Shit bitch. All right, you wanna play that way? I'll get on a fucking plane to-fucking-night, and you will pay for this. Shit will go down, and you're gonna be in the middle of it. Watch yourself. [hangs up]

My first death threat! Oh I love my job I love my job I love my job. Weird thing is, the patient has been divorced for twenty years, and her daughter claims there's no relationship there anymore, and he definitely wouldn't care if she was alive or dead, much less if she were in the hospital. So now I'm just confused who the heck that guy was.

Superstar

ME

We just admitted a patient to our ward. He thinks he's Jesus Christ. He's also an ER doctor.

CO-RESIDENT
That's a strange delusion: to think you're God AND a doctor?

ME
Oh, the doctor part's not a delusion. But I'm pretty sure the Jesus Christ part is.

CO-RESIDENT

Hm, strange. Are you sure he's not a surgeon? Those are usually the ones with the God complexes, you know.

---

He's smart. Really smart. Went to an amazing undergrad. Went to an even more amazing medical school. On a full scholarship. Seriously. Who is this kid? Five months into his intern year, he has his first psychotic break. His program forces him into an outpatient clinic; he's stabilized. Three months before graduation, and three months into moonlighting, he starts to exorcise demons from his patients. His program takes away his moonlighting privileges, but let him graduate.

And now he's my patient. 

It makes me just a little bit worried. I'm two months in, but hopefully not anywhere near to suffering my own first psychotic break.

P.S. Is it unethical to ask him to sign my prescriptions for me since I'm not fully licensed yet?

10,000 photos

I haven't fallen completely in love with Los Angeles yet.



But I'm getting there.

Take a good look at me now

Two months and still accident free. 

Who's a female Asian driver now, eh??

Please don't let this jinx me. Please don't let this jinx me.

Well, if you ask me like that...

PATIENT

WHAT THE FUCK DO YOU WANT?

ME

Sir, please lower your voice. I'm just dropping by to see what's going on.

PATIENT

You aren't giving me the right drugs, that's what the fuck is going on, bitch!

ME

Oh?

PATIENT

DON'T FUCKING PLAY WITH ME, YOU FUCKING BITCH. I'M GONNA CUT OUT YOUR FUCKING HEART AND FUCKING EAT IT IF YOU DON'T GET ME MY MARIJUANA.

ME

Sir, really, I don't need to hear that kinda language. Especially when you're trying to get me to do something for you.

PATIENT

If you're not gonna give me my fucking medical marijuana, then get your fat ass in here and suck my cock, bitch. I haven't had sex in four days! I fucking have needs!

---

Dear God,

I would really appreciate it if you could give me one day when my patients aren't cursing me out and asking for uppers and pain killers. Just one day. If you have time.

Thanks,
Michelle

P.S. Is it bad that in that entire diatribe, I was most offended by the "fat ass" comment? I blame the free meals at County.

Tell me more

My favorite patient right now is this 25 year old guy who looks just like a cartoon character. Seriously, he looks just like the anime character pictured. Minus the giant muscles. And plus a hospital gown that he insists on wearing like a cape. He's super animated and has these giant puppy eyes that make you want to believe everything he's saying to you. Except the things he says make no sense whatsoever. I can't quite figure him out. I can't figure out what he's trying to tell me. And I can't figure out how to fix him. So, I'll just keep on waiting until the antipsychotics reach max dosing and hopefully he clears up soon and can tell me something coherent so that I can help him with discharge planning. But for now, I'll just continue to have my nonsensical conversations with him, and keep on biting my cheek to prevent myself from laughing at some of his remarks. A T-rex! Seriously.

ME

Hey M--, how are you doing today?

PATIENT

Squeak, squeak.

ME

M--, I don't know what that means. Can you translate that into English for me?

PATIENT

They tell me I am a mouse. Squeak.

ME

Hm. Are you still hearing voices?

PATIENT

[nods] 

They tell me to eat pizza.

ME

Oh. And does anything happen if you don't eat pizza?

PATIENT

Me? They tell me tropical. Smokie in face.

ME

Hm, what do you mean?

PATIENT

Me? I was born a tadpole.

ME

Okay. And where were you born?

PATIENT

Outer space.

ME

Hm, okay, and how did you get here?

PATIENT

Me? I came here on a turtle.

ME

Hm. A turtle.

PATIENT

I was born for the special cartoon marathon.

ME

Oh?

PATIENT

Yeah. I'm scapularis. So's my mom.

[pauses for 2 seconds] 

I'm a T-REX!!

ME

I see. And M--, if you were to leave today, where would you go?

PATIENT

I would eat a cookie.

[nods solemnly]

ME

And where would you eat this cookie?

PATIENT

Desk.

ME
The desk?

PATIENT
Yeah. Inside drawer! Duh.
---

Man, I love my job. And the whole not-having-to-work-weekends bit isn't bad either.

You drive me crazy

ME

Oh man. I admitted this crazy patient today...

MARTIN

Michelle, you do realize that all of your patients are crazy, right? So you can drop the 'crazy' adjective and save yourself some saliva.

Brighter than the sun

I swear

My senior resident only went to court once last year as an intern.

In just two weeks, I've gone three times.

Three times. Three!

Now, there is a reason why I didn't even consider going into law. There is a reason why I never participated in Mock Trial. There is a reason why I was never a part of student government.

I hate speaking in public.

In fact, I'm deathly afraid of it. I get full on diaphoresis, tachycardia, dyspnea, chest pain, you know -- the works.

And court? It's the real deal. It's just like on TV - with a judge and a bailiff and a secretary recording your every word in some strange shorthand. But for those who are wondering, no, the judge does not wear a powdered wig, George Washington style.

I do have to do the whole state your name for the record, raise your right hand and swear to tell the whole truth, and please be seated. And I give my testimony, answer questions for my attorney, the D-freaking-A (who coincidentally looks just like Alex Cabot for you Law and Order:SVU enthusiasts), and then I get cross examined by my patient's advocate.

So I sat through four other trials before I got called up to the stand. And as I watched the other psychiatry residents go through the process, I started squirming in my seat, sweating galore out of my armpits, kneepits, elbowpits, you-name-it-pits.

PATIENT ADVOCATE

Sir, you diagnosed my client with schizophrenia. And you believe, based on your clinical judgment, that he should be forced to stay at the hospital involuntarily for another fourteen days.

RESIDENT

Yes.

PATIENT ADVOCATE

Hm, well sir - I just looked at your title. And correct me if I'm wrong, but it says you're a D.O.?

RESIDENT

Yes, but --

PATIENT ADVOCATE

So you're not an M.D.

RESIDENT

No, but--

PATIENT ADVOCATE

So, are you allowed to practice medicine in the US?

RESIDENT

[exasperated]

Yes!

That was the first case.

Second case, different resident, different patient, different patient advocate. Same craziness with the cross-examining.

PATIENT ADVOCATE

Doctor, what year are you in residency?

RESIDENT

I'm in my second year.

PATIENT ADVOCATE

Are you fully licensed to practice psychiatry?

RESIDENT

I've taken and passed Step 3 and am currently applying for my license.

PATIENT ADVOCATE

Oh, so you're not licensed. Should you be seeing patients if you're not licensed??

RESIDENT

I am supervised by an attending - who is fully licensed - on all of my cases.

PATIENT ADVOCATE

So you're nothing better than a medical student.

I think this is when I started quaking in my boots. And before I knew it, I was up. Up on the stand, wanting to throw up.

But I kept it together. And somehow, started going through the motions. Stating my name. Naming my medical school. Naming my residency program. How many patients have I seen with psychiatric illnesses? Over 100. How many with schizophrenia? Over 30. Have you been taking care of this patient since she was admitted? No. Why not? The residents just changed rotations.

The whole time, I kept my fingers crossed that they wouldn't ask me how long I'd been a psych resident (four days), how many patients I had been the primary treating doctor for (only six, as opposed to the large numbers I threw up to include patients seen during my medical schooling), how I arrived at the diagnosis (that's what my attending told me), or anything about my licensing (esp since I haven't even looked at a board review book for about a year).

Maybe they were tired. Maybe they knew I was brand new. Maybe he couldn't breathe, sitting next to my patient who hadn't showered in over three months.

Whatever it was, for some odd reason, my patient's attorney went easy on me. And the judge agreed with me and the hospital, denying the writ, and I was able to keep my patient in the hospital for the remainder of her fourteen day hold.

Granted, we then had to petition to give her meds involuntarily. And then when her fourteen day hold expired, I had to go back to court to ask for a 30 day stay. And in about two weeks, I'll have to go back to the same exact courthouse to testify in her conservatorship hearing. But the people are starting to recognize me. The security guards no longer look at my badge. The DA knows my first name. The judge smiles at me. And I'm starting to sweat a little bit less on the stand. So I'm keeping my fingers crossed that I'll start to feel more comfortable up there soon, and less like I'm about to have a heart attack.

E.T.

NURSE

Doctor, your patient just hit his roommate. Unprovoked.

ME

What! [Name redacted], why did you hit your roommate? I thought you guys were friends.

PATIENT

It's not my fault! I have a homunculus in my brain! 

ME

Er, what?

PATIENT

No seriously! A tiny gray man jumped in my eye and now he lives in my brain. But he looks funny, 'cause he has a giant head with great big lips and small tiny arms but a humongous big toe.

ME

Well...that's kinda true.

PATIENT

And he controls my movements.

ME

Hmm. Kinda.

PATIENT

See -- it's not my fault. The homunculus wanted to hit him. Not me.

ME

Ehhhh, that's where your reasoning goes wrong. But you're partly correct about the whole homunculus thing. 

PATIENT

I KNEW IT! I HAVE A MAN IN MY BRAIN!

ME

Oh crap. I didn't mean to say it like that.

Highway to hell

Carmageddon turned out to be more like Car-heaven.

Thanks to a ton of patients acting out, I didn't get out of work until 7pm on Friday. Exactly when the 405 freeway was scheduled to close, and the dreaded Carmageddon was supposed to hit.

This is what I expected my commute to look like.

This was what my commute home actually looked like.

Blue skies and smooth sailing down the 110.

Needless to say, it was pretty freaking fabulous. Normally there's incident traffic so it takes me at least 40 minutes to get home. On Friday, my door-to-door transit time was only fifteen. So glorious. This must be what it's like to live in a non-traffic-infested area.

Here are some nicer media pictures:

You remind me of a girl

[During our team lunch]

MED STUD #1

Michelle, this is going to sound strange, but I've always thought you looked like someone, and I just figured it out. You really look like the daughter from The Incredibles.

SENIOR RESIDENT

Oh, I can see it! 

MED STUD #1

Yeah - I think it's the big eyes and the hair.

ME

Haha, thanks guys! I look like a cartoon! Whose secret power is invisibility! Hopefully you're not commenting on my ability to disappear during rounds....

MED STUD #2

You know, I've always thought Michelle looked like Jack Nicholson's wife from The Shining.

SENIOR RESIDENT

What?!!

ME

I look like a crazy woman? I've never seen The Shining, so I don't know who that is.

SENIOR RESIDENT

I'll Google image it right now.

ME

This might determine whether or not you pass Psychiatry.....

MED STUD #2

...Um, I mean you look like Angelina Jolie! Jennifer Love Hewitt! The most beautiful woman alive!

[Thirty seconds later, this is our image result]

ALL

Hahahahahahaha!!

MED STUD #2

No you just look like her, not necessarily her character!!

ME

Hahaha! I don't know if that makes it better!!

MED STUD #1

Also, I don't think that picture is from the movie! That's just her in real life! Haha!

SENIOR RESIDENT

Hmmmm, so should we scut him out, Michelle?

MED STUD #2

Fine fine. I'll go see the two new admissions now.