You probably shouldn't say this to a girl

ME

Man, look at these old pictures of me. I was so skinny! Look! I wasn't even trying to suck in my stomach!

MARTIN

It's okay, now you're plump with life!

ME

...

MARTIN

...

ME

...

MARTIN

...I meant to say full of life.

ME

...

MARTIN

...

ME

[glares]

MARTIN
I mean,  I love you?

Flowers for Algernon

I was studying at Starbucks next to a few other girls, all of us with our headphones dutifully plugged in, to give off that extremely studious, please don't try soliciting anything from me, vibe. Then, I heard loud gasps all around me, and so I looked up to see a boy, tastefully but casually dressed in a dress shirt tucked into some trouser pants, holding out a bouquet of flowers for the girl sitting next to me.

[Here's where I confess that I don't actually listen to any music when I'm studying, but I wear my headphones so that when the homeless person comes in to ask for money, I can just shrug them off without having to actually listen to their sob story. Yes, I realize this makes me heartless, but hey, I have rent to pay and books to read.]

He held out the bouquet of flowers, and he launched into a spiel about how he's loved her ever since she first walked into their English literature class, ten minutes late, and through the wrong door. The other girls were listening and I could see Taylor-Swiftian hearts melting around me. But then I surreptitiously stole a look at the girl the speech was intended for, and all I could see was abject horror. Realizing that others were now watching and listening, she sputtered, "Those flowers aren't meant for me!" He paused in the middle of his grandiosity, shocked silent mid-speech, "..uh, but they are for you." "No no!" she shot back, "all this that you're doing? This is meant for someone else...you -- you will find someone else who this is meant for."

The flowers were now awkwardly between them, as he held them out, and she continued to obstinately refuse to take them. He tried to save face, saying that despite what her response was to his declaration, he had bought the flowers for her. But she just looked down, not willing to make any further eye contact.

By this time, everyone was busy trying not to make eye contact as well, as we all realized how amazingly awkward this all was. Everyone stared at their phones, their books, their coffee sleeves - at anything! - to avoid making eye contact, as the boy looked around at the scene of his complete and utter humiliation.

He turned around, put the flowers down on an unoccupied table next to the door, and then walked out the door.

The busy hum in the Starbucks resumed, and the flowers remained untouched, like a memorial to spurned teenage love.

That poor boy. I still have no clue how that girl was able to continue studying after all that awkwardness. (And this coming from the self-proclaimed queen of awkward!)

Love you more

I'm horrifyingly nostalgic tonight.

Maybe it was because Lisa sent out an email asking for everyone's addresses, and although I always knew it, somehow seeing all the different zip codes made me really grasp how far flung across the continent we are. Maybe it was seeing everyone's titles and positions in their email signatures. Maybe it was realizing that we were using proper email instead of AIM group messages full of improper capitalization and emoticons. Maybe it's because I just found and listened to my very first Lifehouse album that soundtracked our freshman year so perfectly.

My friends, we've grown up.

I miss that I'm not as close to anyone in residency as I was with them. I miss how I can't just wander into my neighbor's kitchen and plop down in my oversized dorm t-shirt, complete with a double entendre slogan, and just wallow in self-pity or group-pity or whatever it was that we did at 3am in the morning on far too many occasions. I miss the ten different viewpoints to our arguments, I miss laughing over our awkward encounters, I miss our group breakfasts and dollar-store mugs full of coffee, I miss everything.

I miss us. Because I can't help but feel like I'm never going to be able to recreate our crazy group chemistry.

I miss what we used to have.

I guess they were right. College really was the best years of my life.

In which I try to make the judge read between the lines

Today, I had a probable cause hearing in which I had to testify in front of my extremely sweet, but extremely psychotic and paranoid sixteen-year-old patient. The thing is, I'd been doing therapy with him for two weeks, and even though he was absolutely convinced that everyone else was out to get him, he had started to trust me and tell me things...like how everyone else was out to get him. So now I had to give my testimony  and use the right words so as to not set off my patient and keep our therapeutic relationship intact.

Sounds easy enough, but I found myself trying to wink my way through it, hoping that the judge would understand the hidden meanings behind my words.

JUDGE

All right Dr. Wu. So can you tell me why this child should stay in the hospital?

ME

Um, yes sir. Our patient has had a very troubled past and had terrible things happen to him, including things that no child should go through...[and here I fought the urge to actually physically wink at the judge]. He has very firm beliefs that others are conspiring against him and the other patients and feels it is necessary to protect them at all costs. 

JUDGE

Hm. I see. Well Sam, would you like to say anything?

SAM

Yes sir. I need to get out of here, because they're trying to kill me. I'm not the one who needs to be here sir. There's a man in the walls who's a shape-shifter and he's going to kill us all unless I get out of here. I'm begging you, Your Honor, you gotta let me go so that I can avenge all of our deaths!!!

So much for trying to side step around the issue.

Please don't let me be the only doctor on this plane

The most stressful two minutes in my life aren't the two minutes I have to wait for the nurses to draw up an emergency intramuscular injection for my psychotic patient who is raging high on drugs and willing to take out the nearest person standing between him and his chosen manifest destiny. No, in those two minutes, I'm surrounded by trained nurses and sheriffs with tasers and hard restraints.

So those minutes are bliss compared to this.

I think every psychiatrist dreads it. And yet, it seems to happen to me more than any other physician I know. On my most recent plane trip home from Europe, I was in the midst of breathing deeply to avoid thinking about turbulence and birds flying into engines and having to land emergently on the Hudson River, when  a girl started frantically screaming that her mother had stopped breathing. Oh crap. Flight attendants rushed down the aisle, and then inevitably, the flight attendant leader's voice came on overhead to calmly ask, "If there are any medical personal aboard, please make yourself known to our crew by pressing your call light."

I didn't press my call light. Instead, I held my bated breath for someone else to press their call light. Surely, there was an emergency medicine doctor or an internist or a trauma surgeon on board. Surely, there was someone with more CPR experience than me.

Instead, all I got was silence.

Shit.

And then, a woman stood up and made her way towards the commotion. "I'm a retired nurse," she told the crew.

I exhaled.

But I kept one ear open, because I was fully aware that I was shirking my physician duties, and oh man, was this going against every oath that I had taken upon graduating from medical school?

What I heard was not pleasant:

NURSE

Oh shoot.

FLIGHT ATTENDANT

What?

NURSE

I can't feel her pulse.

HYSTERICAL DAUGHTER

MY MOM HAS NO PULSE???!?!?!?

NURSE

No...well...I just can't feel it. Maybe?

HYSTERICAL DAUGHTER

IS MY MOM DEAD?!?!?!!?!?

FLIGHT ATTENDANT

No, she's fine. Miss, you need to stop yelling. You're being hysterical. And that's not going to bring your mom back.

HYSTERICAL DAUGHTER

[bursts into further wailing]

Fabulous. I craned my head to look at the mom five rows back. I could see her chest rise and fall, so clearly she was breathing; she was pink, and she most definitely wasn't dead. A flight attendant was walking by me, so I tugged on his arm. "Hey, I'm a psychiatrist, do you need my help?" He brushed me off, "No, we have a retired nurse."

I had just been absolved of any duties.

And then I realized that the flight attendant probably didn't realize that I was a doctor. Didn't realize that a psychiatrist is a real full-fledged MD. And the nurse was making the daughter even more freaked out. So I unbuckled myself, despite the seat belt warning sign, and made my way towards the patient. Everything was in chaos. The patient had a mask on her face, but the oxygen wasn't connected. The nurse had her hand pressed up against the patient's carotid, pressed so tightly that her own fingers had lost blood flow. And the daughter kept shaking her mother, loudly instructing her to "wake up!"

I went into doctor mode and tried to not think about my own insecurities and turbulence anxieties as the plane dropped and weaved in the air. "Hello ma'am, I'm Dr. Wu, and I'm going to take care of you okay?" She nodded at me and squeezed my hand as I held hers and checked for her pulse. "Do you take any meds?" Her daughter hysterically started crying again, loudly saying, "No, my mom is completely healthy! She doesn't take anything!!" But the mom squeezed my hand again and looked at me. I pulled her mask away so that she could answer me. "Cymbalta and Wellbutrin," she whispered faintly to me.

Slam dunk. This was one of mine.

Feeling slightly more reassured that I could handle her emergency, which was seeming more and more like a panic attack, I smiled at her. "Is that for depression or anxiety?"

"Anxiety."

Yes. Definitely one of mine.

I sent a flight attendant to get me some ginger ale, and sat down on the aisle and worked through some breathing exercises and guided imagery. When the flight attendant returned, I prayed to the placebo gods, and gave it to the mom, telling her "Ginger ale is perfect for nausea, and you know what? You're probably a little dehydrated, so this will help with that too." The placebo effect worked, as she took a sip and immediately smiled, saying, "Oh I do feel much better now."

She took off her oxygen mask and I made my way back to my seat.

Just as I was starting to drift back off into my jet-lagged sleep, the flight attendant came by with paperwork for me to fill out. So, instead of resting, I filled out all the random documents that needed to be signed. And realizing that my name was now connected to this patient, I felt compelled to turn around to look at her every fifteen minutes, to make sure that she was still alive and breathing.

So much for the Good Samaritan rule.

The icing on the cake? My seat neighbor, upon seeing that I wasn't going to sleep anymore, immediately launched into all of her own sleep and bowel movement problems, and didn't stop talking for the remaining five hours of our flight.

Dr. Meanie Bikini knows.

Just watched the pilot episode of the CW's "Emily Owens, MD" and dude..the mean attending on that show might be Dr. Meanie Bikini's doppelganger.

....and the character's name is awfully close to Dr. Meanie Bikini's real name.

Holy crap!

I've been compromised!! My cover is blown!

Shut everything down! Initiate evacuation plan #4!! Save yourself!!

Pew pew pew!

What a trick or treat consult

ME

This is Michelle from psychiatry! 

INTERN

Oh, hi, thanks for calling back. I wanted to place a psych consult?

ME

Sure, what's going on?

INTERN

We want you to come evaluate our patient to see if she needs to be put on a hold for grave disability.

ME

Okay...why do you think she's gravely disabled?

INTERN

She stopped eating yesterday.

ME

Did she say why?

INTERN

No, but she looks sad.

ME

Hm, was she eating before?

INTERN

Yeah, it's really weird. She's pretty cooperative with everyone, but she just stopped eating yesterday. There's been 0% intake since yesterday at lunch time.

ME

Huh. That is pretty weird. Let me do a quick chart review to see if she's ever seen psych before. I'll call you back.

---

On chart review, I found out that the patient had a small bowel obstruction, and was scheduled for surgery today. And when you're going for surgery, you don't get to eat the night before. 

The patient was just following the surgeon's instructions.

Yes.

This was a real consult.

Halloween humor

Seriously.

Well, if all Asians look the same

This morning, I walked into the hospital like I always do, but instead of going to get my usual morning cup of coffee, my jaw dropped.

My patient was meandering around the lobby, loudly trying to get a security guard to help him.

And me? I was freaking out.

Because my patient was on a psychiatric hold. And unless my attending had decided to pull rank and come into the hospital early to discontinue the hold, my patient should have been in the locked unit, and not on the verge of eloping, just mere feet away from the entrance/exit and out of my psychiatric jurisdiction.

How did this happen? While my mind thought a million dark thoughts at the county nurses and their inability to pay attention to anything other than their cell phone texts, I tried to smile serenely at my Spanish-speaking-only patient.

"Hola senor! Soy su doctora! Por que...outside....aqui?" I asked him as I tried to figure out which of the few Spanish words I knew could apply to this situation.

He looked at me, confused, but thankfully, not attempting to escape.

"Vien con moi..." I motioned to him to follow me, as I started conjugating French verbs, hoping that the languages were similar enough that he would understand me.

He followed me passively back to the unit. Didn't raise a fuss when I swiped my badge to unlock the doors, wasn't perturbed when I hissed at the security guard for allowing this to happen, and followed me all the way to his room.

"Here you go sir. I'll come talk to you in about thirty minutes okay?" He had no idea what I was saying, but nodded pleasantly at me. I led him into his room, and then led him straight back out of it.

Because my patient was sleeping soundly in bed. And this man who had been following me around, was apparently not my patient after all.

I awkwardly grabbed his arm to look at his patient ID wristband, realized he was supposed to be on the sixth floor, and took him back to his proper room. And then I went and got a big plate of tater tots for the security guard to apologize for my earlier death glares.

J's wedding

"Why are you visiting Atlanta?"
"Oh, my best friend is getting married."
"How nice! Are you the maid of honor?"
"Hahaha, no, this is my best guy friend."
"Ah. [awkward pause] So is this a Julia Roberts' My Best Friend's Wedding kinda situation?"
"Oh GOD no."
---
J got married yesterday.

Ten years ago, if you had told me that J would be the first of us to get married, I would have snorted Coke out my nose in disbelief. But here he is. Married, with an adorable kid and a slightly manic dog, making mortgage payments on a cute little apartment in Seattle.

I don't really know what I expected from the wedding weekend. J and I barely have time to talk these days, instead relying on figuring out snatches of our lives from quick texts and one-liner emails. But he still has an uncanny ability of knowing exactly when I need to hear from him. True story: he texted me exactly eight hours after my disastrous car crash, before any mention of it went up on the blog or on facebook. I guess that's why he just might be a fantastic psychiatrist.

The thing is, J and Lisa made me believe in true love. Because that's what we've got for each other. True, unadulterated - completely platonic, yes - but absolute, total, and undying love. It's okay that we don't have those long JLM homemade dinners, where we depended a little too much on our guaranteed acceptances into medical school to completely slack off and watch Bravo reality TV marathons for hours on end. We don't have time for that anymore, what with our actual jobs and the whole being states apart instead of mere blocks away.

But I will always remember that J always knew my idiosyncrasies. That he would bring me two halves to a bagel, that he'd throw snowballs in my face, that he'd go grocery shopping with me and tell me to start my day off with a big bowl of pink cereal, that he'd give me his honest truth, no matter how hurtful it might be at times. J knows me. Just like how I know that he dances like an absolute dork, that he watched every episode of Smallville religiously because of his unwavering love for Kristin Kreuk, that when he falls in love he loses sight of everything else (including organic chemistry unit tests), that it doesn't matter how much he's eaten, if you put another plate of food in front of him, he will eat it and yet, it will never show up on his nonexistent gut. Yes, I know J, too.

And so, even though he denied it, I knew he got misty-eyed when his bride started her walk down the aisle. I knew he got a bit choked up on his vows but instead just gruffed them out as quickly as he could. I knew he was nervous when he first walked out to take his spot, forgetting to smile until me and Lisa beamed slightly-crazed grins at him. And that's when I knew that this was far from the end of our friendship. No, I won't deny it -- when Jeff smiled back at our over-the-top grins, I got a bit misty-eyed too, so happy that my best friend has found someone who can take care of him the way he took care of us, someone who doesn't deny him his friendships, someone who loves him and his somewhat annoying quirks.

We're expanding our JLM trio into an AJLM quartet. We're still separated by state lines and time differences, but it doesn't matter. None of it matters. What matters is that, as corny as it sounds, we're friends forever.

I love my residency

Camp Hess Kramer

Malibu Ropes Course

USC Psychiatry Residency Retreat 2012

The vicious cycle

Somewhere along the way, I became Dr. Meanie Bikini.

No, I take that back.

I'm Dr. Meanie No Bikini. (I did gain the intern twenty after all.)

I don't know how it happened. It feels like it happened overnight. I didn't feel myself becoming meaner, more bitter, more burnt out.

I didn't see it happening. But it happened.

The abused has become the abuser.

I'm not proud of it. But I'm realizing that I'm getting frustrated at the lack of professionalism that my med students exhibit, the lack of respect they have for psychiatry, the lack of initiative that I thought every med student had ingrained into them on day one of clerkships.

I had a patient who was in florid myxedema coma, and I had to emergently transfer her somewhere - anywhere! - that could get some thyroid meds into her veins. I asked my medical student to help me get her most recent vitals for the transfer paperwork. He sighed loudly, unhappily, and then said, "Can it wait? I just need five more minutes and then I'll be done with this note." I looked at him pointedly and said, "Patient emergencies are not things that you can wait on. You came to medical school to help patients, not to write notes. And right now, the best thing you can do to help this patient is to go get her most recent vitals. The note can wait."

In case you were wondering, yes, the medical student was following this patient. And that note he was writing, was for an extremely stable, just waiting for placement, patient.

But the cherry on top? I can willingly admit that I was a bit harsh. But then he snapped right back at me. "Well, why do I have to do it? If you're transferring her, I'm not going to follow her any more, so how is this educational?"

I mean, seriously? Seriously??

To this day, he still has no idea what myxedema coma is. It might be my fault, but he had no interest in learning, no interest in knowing what qualified as a patient emergency, no interest in finding out how to triage in those kind of situations, no interest in anything but going home before 3pm.

I like teaching. I really do. But I don't know how to teach this student.

Remembering

How do they do that??

Seriously, so cool.

Guess the bleeps

[in response to "Why are you in the hospital?]

"Are you **** asking me why I'm in the **** hospital? What the ****! How would you feel if you got ***** butt ***** every ***** fifth **** night in the ******, you *******. *****! Go ****** experience the ******* world of ******** gang ******* and then you can ******* come back in here and ******* ask me why the ****** I'm in the ***** hospital. Until ***** then, you can ****** shut your ***** mouth, ******."

Oh, lovely.

I'm so glad I'm not primary.

I love psych C&L

ME

Hi, this is psychiatry!

ORTHO INTERN

Hi, I wanted to place a consult.

ME

Sure, what's the consult for?

ORTHO INTERN

Well, we have a guy who broke both his legs and we were hoping you could come assess him for depression.

ME

Oh no. How did he break his legs? Suicide attempt?

ORTHO INTERN

No no, he got into a bad car accident. We're actually going to operate and he should be fine. 

ME

Is he refusing the surgery?

ORTHO INTERN

No, not at all. But he's depressed.

ME

Oh, what did he say?

ORTHO INTERN

Oh, I didn't talk to him. But he looks sad.

Inner monologue

I got a psych consult the other day for "patient refusing insulin." Now, our consult service is simply too large, too overworked, too busy that we don't have the time to see routine capacity issues. Every physician can do it, so we usually defer those things to the primary team. But, before I call up the primary team to refuse a consult, I always go see the patient to see if there's something else going on.

So I walk into the room, and meet this very sweet and pleasant 63 year old lady, and ask her why she's in the hospital.

"Well, I have an umbilical hernia, and I started to have a lot of pain..."

Hm, this all seems rather non-crazy and straightforward.

"...and so I went to the bathroom, and there was a lot of blood!"

Oh crap, did they mean to call surgery? Why was psychiatry called?

"...and then my head started to hurt..."

Still plausible.

"...and then a baby was born from my head!"

Ah. That's why I'm here.


P.S. I kept the consult.

Learned helplessness

ME

Hi, this is Michelle from psychiatry. You placed a consult on this patient?

INTERN

Oh hi! Yes. Are you going to see the patient soon?

ME

Um, it depends. Can you tell me what the specific question is?

INTERN

Oh, our patient has dementia, and we were hoping you could help us figure out the etiology?

ME

Hm, so dementia is usually worked up by neurology.

INTERN

Oh okay.

ME

All right then, I'm going to cancel this consult okay? But if he starts to--

INTERN

Wait, what! Why??

ME

Because dementia is a neurology issue. So you should consult neurology.

INTERN

Oh.
[3 second pause] 
Um, do you know the number for neuro consult?

Crash and (almost) burn

So I thought I was having a bad week.

I was wrong.

I was having the worst week of my life.

Because this happened.

Don't worry. Me and Martin are completely fine. We dashed out of the car with nothing more than a couple of scratches and a nasty seat belt burn across my neck. But my beautiful 2005 Toyota Corolla, with no more than 41,000 miles on it, is basically dead, thanks to that fire hydrant.

I want to cry. But I am thankful that the fire hydrant wasn't a pedestrian, that me and Martin were totally okay and fine, and that no one else was hurt in this terrible car accident process. And many thanks to everyone for telling me how much worse it could have been. That the speeding red-light running car could have T-boned my car and broken both my legs in half. That my car could have gone up in flames. That I could have hit that light pole instead of the fire hydrant. That I could have this and I could have that, but thankfully, in the end, everyone is okay.

And a big sentimental thank you to my beautiful Corolla, for the many road trips to Wisconsin, Michigan, and those drives up and down PCH and Lakeshore Drive. Thank you for being the car I learned how to drive in, the getaway car we used during med school, the car that made the cross-continent trek from Illinois back to Southern California with me, the car that got me through intern year, and the car that saw me break down and cry many many times. Like Martin says, she's off to the Corolla farm, where she'll get to drive 80+mph to her heart's content and go off-roading as much as she wants to. She was a good car, and the best first car a girl could have possibly asked for.

I'm okay. And everyone else is okay. And that's most important.

The messenger just got shot

It's been a rough couple of days. I didn't go to med school to engage in politics, yet for the last few weeks, I've been thrust smack dab in the middle of it. And me? I don't like confrontation. I don't like arguing. I'm not a fan of discord. I usually just concede to whatever demands are being demanded, while sweat pools down my armpits and kneepits. Ask Martin. I'm a disgusting mess when it comes to arguments.

This is a soapbox kinda post, so skip along to the next blog if you're looking for fun and humor. For the less soap-inclined: Judy's blog has got some nice intrigue going on if you're into changing haircuts and loving yourself for you, but finding that you just can't stop thinking about the boy. Damn it, freckles, indeed.

But anyways, back on to the soapbox.

This was always my first choice for residency.

And I was overjoyed when I opened up my match letter, and there it was in nice big bold letters. My number one choice.

I knew it wasn't the best residency. It wasn't even ranked. They hadn't tried to court me, didn't flatter me, didn't send me gifts. My interview invitation was addressed to a Melissa.

Yes. Clearly I was high on their rank list.

But this was where the boy was, and after thinking about the Empire State of it all, I decided that my family and my romantic life were more important to me than US News and World Review rankings.

Like I said, I knew it wasn't the best residency. Even in the Los Angeles area, it's not even close to being the best. But there's so much potential. We see some amazing psychopathology, we have fabulous exposure to forensics, and we're not afraid to medicate our patients. So why weren't we attracting better med students, better interns, better faculty?

I joined the admissions committee this year. Joined the residency review committee. Joined the graduate medical education committee. Joined the AAMC review board. Because I wanted to make our program better. Because I wanted to put our program on the map. Because it actually deserves to be on the map. Because maybe I do care a little bit about the US News and World Review.

Now, I don't know about you, but I started residency with the expectation that I would be working my tailbone off. We were always taught that you just get things done. If a patient is refusing to stay in the hospital because they must get home to feed their cat, you find a way to feed that cat. Who cares if you spend hours google-mapping the address, calling the take-out place across the street to find out the name of the landlord, so that you can meet him there after your workday so that you can personally feed the cat yourself? You have to get it done. If you have to personally accompany your patient to the airport to make sure they don't freak out on the TSA and cause one of the world's largest and busiest airports to shut down, then you have to do it. If there's a problem, you figure it out and you solve it five times over. Medicine is about so much more than antibiotics and chest xrays and urinary infections, it's about caring for the whole person. So you do what you need to do for your patient. Even if it means staying a little late, going a little farther, spending a little bit more money. Be like Nike, and just do it.

But somewhere along the way, we lost the reason why we wanted to go into medicine. We started looking for shortcuts. Started trying to do as little work as possible. Started pushing it off onto others, and excusing ourselves by saying, "oh, it's not educational, so we shouldn't do it." What happened to caring for the patient? What happened to going the extra mile...for patient care?

If you're still reading this, I applaud you. Because I'm talking in riddles. Trying to vent my frustrations without actually divulging what has got me so upset. Trying to process and figure out solutions when I can't even tell you what the problem is.

But basically, my program is changing. For the better, in my opinion. Sure, it means a little extra work for all of us. But in the end, our program will be stronger, our patients will be better, and we'll all be part of a revolution.

I take it back. The program is trying to change. But it's meeting a ton of resistance from residents who are apparently just too sleep-deprived to care, but not too tired to throw the messenger into the lion's den, unwilling to appreciate the bigger picture. We're lost in the forest, and all they're seeing is the extra trees of work they need to do.

So now I'm sitting here and wondering why I even bother.

Ugh. Sigh. Blargh. And a whole multitude of other noises.

Truth.

I'm better before you really know me.

More than words

I'm at a loss for words. Literally.

Well, not my words exactly.

I've lost my syntax.

Because words? Words I have, but they no longer flow together smartly, wittily, intelligently. It's like I've got a big bag of Scrabble letters, but I'm having trouble creating a word, much less one that's going to get me a triple score. See, while I can apparently thesaurus my way out of a bad sentence (see above), I just can't bring things together coherently anymore.

No, I didn't have a stroke. I'm not suddenly aphasic. But I do feel like I haven't been able to blog at all, because nothing comes together the way it used to. A little bit of me blames my six month stint of no weekends and overnight call every fourth night. Some of me blames the fact that I've been making powerpoints and reading scholarly articles instead of drifting off into gorgeous-take-your-breath-away-fantasy-lands in read-into-the-wee-hours-of-the-night novels. But a lot of me blames plain ol' exhaustion. It's hard to be inspired when you fall asleep in your car before you can make it in your own front door to your actual computer.

But now I'm back on psychiatry, so what's my excuse? Well, the light at the end of the tunnel lied, and the hours on psych aren't all that different from medicine, peds, or neuro. And I swear that sitting in three digit temperatures, while making a 40-minute traffic-filled commute, is turning my brain to mush. Liquid tofu, in fact. But thanks to Lee-Arng and John Green's literary canon, I think my brain is finally starting to wake up again.

Here's hoping I learn how to make those synaptic connections again.

I honestly had the best intentions

I've been sick for the past few days, and today I woke up feeling worse than ever. My throat was scratchy, I could barely breathe because of my stuffy nose, and the moment I stood up, I almost blacked out from my headache and dizziness.

But even though I had a temperature of 101.2F, I had to get to work. I had a family meeting to facilitate, a patient to discharge, and a conservatorship application to file. So I popped some sudafed and tylenol, got in the shower, banged my head on the showerhead, and got ready to drive to work. 

I got in my car, turned my key, heard one loud click, and then nothing. No engine turning over. It didn't even have the decency to try.

It worked perfectly yesterday. I got myself to work and back without incident. I didn't leave any lights on accidentally, didn't accidentally have the engine running all night. 

So long story short, I didn't go to work today. Instead, I sat in my car, waited for AAA to come get me out of my jam, and called my attending to tell her that hey, both me and my car are sick, so we can't get to work today, mmkay?

Worst yet, Martin came home twenty minutes later...and he has all the same symptoms I have, on a two day delay.

So sick. Ugh.

Ironic or coincidence?

We sat in Row Q.

[insert knee-slapping laughter]

When you wish upon a star

I love Disneyland!

...and we both just got our annual Disneyland Season Pass!!

Buzz Lightyear, here we come!

It's going to be a very good - and magical - year.

Why you should always have an extra pair of scrubs

My pager went off just a little past midnight.

"Doctor! Patient emergency!! COME QUICK!"

I was fumbling for my glasses, as the nurse continued to freak out over the phone. "Your new admission is on the floor, not moving, completely unresponsive!" As she slammed the phone down, I could hear her ordering someone else to grab the reserve oxygen tank.

Shit.

I had admitted him three hours ago, and he seemed like my typical schizophrenic, refusing to talk to me, claiming that I was going to do "Pentagon experiments" on him, which was so wrong, because didn't I know that he is the Chief of ALL police?!!? Please, he had terrorists and aliens to go apprehend, and I was keeping him from performing his civic duty.

I dashed out of my call room and started running toward the ward, my past six months of neurology/internal medicine/pediatrics training in place and in gear, as I tried to figure out everything that might have gone wrong. Did he have a seizure? I gave him a smaller dose of antipsychotic because he was older, but maybe it was still too much? Did he have an allergy? What did I miss? What had I forgotten?

I got to the unit, and the moment my key turned in the lock, the nurses surrounded me, each trying to tell me what they had seen. "He said he needed to use the bathroom, and then before I knew it he was on the ground," "He said he needed to use the bathroom? He told me he was hungry and then he sat down on the ground," "Well at least that's what his sitter said..."

I made my way to his room, where my patient was lying, flat on his back and as stiff as a board, on the floor, with his arms folded across his chest, mummy-style. "Mr. Tagg, can you hear me?" He didn't respond, but he opened his right eye just a sliver, saw me looking at him, and then shut it tightly again.


The nurses swarmed into the room at that time, "DOCTOR! SEE? He's not answering! Should we call 911? Do you want the oxygen tank?!?!"   

"No, don't call 911. What are his vitals? Why does he need oxygen?" I responded, as I pushed him onto his side. "Oh, we didn't do his vitals yet," the nurses told me. "Oh hm, well, let's get those first," I responded as the nurses bustled around me. I pulled out my stethoscope and was about to listen to his lungs when my patient let out the smelliest, loudest, biggest fart. "Heh heh heh" he chuckled to himself, all while still refusing to answer to his name.

"Doctor, here are his vitals: Pulse 83, blood pressure 115/78, oxygen saturation 100%."

"Yeah, we don't need to call 911. And he doesn't need that oxygen, so please, don't open that nasal cannula packet," I responded as I continued my physical exam.

Since my patient refused to respond, he was still lying on the ground, also refusing to move. So I crouched around him, as I tried to maneuver his arms off his chest so that I could listen to his heart. Then, all of a sudden, my feet were wet. And so were my knees.

And my patient started chuckling.

He had just peed all over the floor. And subsequently, had soaked my scrubs.

I jumped up instinctively, and he then jumped up as well and ran to the bathroom.

The best part? As I was leaving the unit (still urine-soaked), one of the nurses stopped me. "Doctor, do we need to call 911? Urinary incontinence -- that means he had a seizure right??"

No, that just means he's being a difficult schizophrenic patient.

Our first movie and a dinner date in months

...and holy smokes Spiderman!  Andrew Garfield just might be my new nerdy hipster celebrity crush. (Sorry Joseph Gordon-Levitt.)

P.S. I think every girl should be spun around by biocable webs and kissed like there's no tomorrow. Seriously, so sexy. Sigh. Don't mind me, I'm just swooning over here.

Always

Driving home after a long day of call at our inpatient psych hospital in Compton, I saw a lot of fireworks.

A lot of illegal fireworks, that is. Fireworks being shot off of roofs, parking lots, swimming pools, cars, etc.

And I gotta say, I really miss those fabulous Lake Michigan firework displays.

Chicago, you will always have my heart.

Parlez vous francais?

So much for intern of the year.

My first day was a nightmare come to life.

Except I was wearing clothes.

Yet, I couldn't help but feel that being clothed was worse than being naked. Because, maybe if I were naked, everyone would be better distracted from my complete and utter incompetence.

"I don't know." "Uh, I'll have to review the chart." "Er, I'm not sure." "Let me get back to you about that." "I'll have to look into that." "Oh, good point. Uh, yeah, I'll keep that in mind." "No, I don't know." "Um, which one is my patient again?"

I haven't felt this lost since French III Honors.

Fingers crossed that I'll find my bearings. And soon.

Why, I might be blushing

Well, this definitely makes me feel better about all those sleepless call nights during intern year.

Yes, my friends, it's surprising but true. I won the intern of the year award. Take that Northwestern, who's the black sheep now?

Now, I just gotta live up to it.

Retrospective

One year ago, I was learning how to drive. One year ago, I was having dreams about tripping over gurneys and patients while running through the hospital halls...naked. One year ago, I was moving into my first apartment without a roommate, and assembling all of my IKEA furniture without a man or power tool to guide me.

What a difference a year can make.

I'm no longer afraid of driving on freeways and I road rage along with the worst of them. I moved again, and am back to living with a roommate, but I'm now living with this guy. And well, now that I'm about to officially become a senior resident, I'm still stressing out and having dreams about teaching interns and med students and not remembering what the mnemonics DIGFAST and SIGECAPS stand for. (But hey, I'm not naked in my dreams this time around. It's good to know that at least my neuroses can mature a bit from year to year.)

But all in all, I can't believe I'm finally though the proverbial tunnel and basking in the light. Intern year is officially over.

And it's been one heck of a learning process. It's like how that one Charles Dickens' tale starts -- it was the best of times, it was the worst of times. I never want to go through intern year again. Ever. Calls were bad, scutwork was never-ending, and on top of it all, we had to navigate a whole new world called the county system. There were days when I sat in my car and had to cry it all out before I could even start the engine. There were days when I wanted to throw in the towel and just walk out in protest. There were days when I wanted to scream at the top of my lungs and wring a few necks here and there. And there were many days where I went from work straight to the bar and drank a bottle or two of wine.

But looking back at it all now, I wouldn't change a thing.

Because, gosh darn it, we survived. It was a boot camp of sorts and the worst hazing of our lives, but we made it through. I've made some lifelong friends this year - friends that I know I can depend on, friends that I know I can blackmail, friends who can blackmail me in return, and friends that will only tease me a little bit when I inevitably consult them regarding some silly neuro or medicine question like first-line treatment for hypertension.

Above all else, it feels so good to finally be doing what I went to med school to do, what I went to undergrad for, what I've strived for ever since my sister had her asthma attack fifteen or so years ago. I wanted to be a doctor, and this year, that's exactly what I did. I doctored.

I took care of a patient who thought he was a T-rex. I took care of three Jesus Christs - all at the same time. I got slapped by a delusional patient who thought I was his ex-girlfriend. I watched my senior resident sign a death certificate and then have to re-register that patient into our system when he came back from the dead. I took care of brain-dead patients so that families could say their last goodbyes. I threatened to deport delinquent families who refused to care for their grandparents. I took care of kids who were sent to the hospital for neglect or abuse after DCFS intervened. I explained the birds and the bees, and tried to stay away from scabies and bed bugs.  

I think that's what intern year is all about. Sure it's crazy, sure it's busy, but intern year is about realizing that no matter how crazy or busy it gets, everything you're doing is for patient care. It's about realizing that you genuinely care for your patients, even when you can barely communicate with them beyond a few words in Spanish. It's about being responsible for their care, and owning that responsibility. It's the year when you learn to do the right thing. Because you have to. Because these patients depend on you. Sure, there are ACGME rules in place to make sure that you're being supervised and mistakes don't get made, but in the end, the buck ends with you. And having that responsibility is what makes you keep going. And sadly, it is effecting that responsibility that makes intern year so difficult. It's what prevents you from cutting corners, it's what makes you want to read and learn more, and it's the reason for the long hours, the crazy nurses versus doctors warfare, the inevitable long ugly cry when there's a bad patient outcome. Intern year is when you realize that with your MD, comes great responsibility -- a responsibility to always do right by your patient.

So sure, intern year is over. But the responsibility is just beginning.

And starting Monday, it all begins again. 

NO WAY

What!!! HOW IS THIS POSSIBLE??



Seriously, what!!

SO AMAZING.

Truly best friends forever

From: Michelle
To: Lisa, Jeff
Subject: apparently it's best friend day.

so happy best friend day, best friends!

"True friendship isn't about being inseparable, it's about being separated and having nothing change."

Hope you're both doing well in your different time zones. Miss you!

---
From: Jeff
To: Lisa, Michelle
Subject: Re: apparently it's best friend day

They've got a day for everything now...anyhow I hope you guys are doing well too. Soon I'll be able to cut down on the number of different time zones. :)

---
From: Lisa
To: Michelle, Jeff
Subject: Re: Re: apparently it's best friend day

Happy best friend day!! I'll be the lone hold out in a different time zone. Though I will point out it is the ORIGINAL time zone we all met in. :-P

We'll see each other soon (at the very latest in September...)

---
Our ten-year friendship through the ages, in picture format. [Note: although we met in 2002, there are no pictures prior to 2006 because well, phone cameras didn't exist back in the day.]

 JLM, 2006

 JLM, 2007

 JLM, 2008

,

JLM, 2009

JLM, 2011

We've changed, but then again we didn't. Our baby fat just kinda shifted (and in Jeff's case, into an actual baby.)

Big boy cake

I cook, yes. But I don't really bake. Even though stereotypically I should. I mean, I'm a girl, I'm Asian, and I'm on a pediatrics rotation right now. All signs point to me baking.

I don't.

But for Martin's birthday, I decided that I wanted to bake him a cake. And for some odd reason, I got this cake stuck in my head for inspiration: the most delicious cake in the world from Ronald Dahl's Matilda.

I wanted it to be so delicious that Martin would want to eat the WHOLE thing and feel sick. But sick in a good way.

Like the character Bruce Bogtrotters. I mean, look how happy he is!  Even as the Trunchbull is about to whack him over the head!

So I baked Martin a cake for his 29th birthday.  And because he's a big boy, I made sure to double the amount of rum and amaretto the recipe called for.

For your present this year, I will refrain from smashing cake in your face. Even though it makes me so happy to do so.

Happy birthday Martin. <3

Equal opportunity ailments don't care how cute you are

He came to find me while I was admitting another patient.

"What's wrong sweetie?" I asked him, as he pouted his little two-year-old pout. He poked at his G-tube and looked at me inquisitively. "What's that?" I asked. He broke into a big smile. "It's my belly!! Belly, belly, belly!" he sang out to me.

I couldn't help but smile right back.

I finished my physical exam on my other patient, who had blacked out from all the binge drinking she'd done and walked over to him. He lifted up his arms, so I picked him up. And with him on my hip, I finished writing orders while he played with my hair and my stethoscope around my neck.  The nurses tried to take him from him, but each time he would just burrow further into my shoulder.

"All right kiddo, I gotta put you down to bed so I can finally start writing my notes."

I went to go review his chart. He was a DCFS neglect case and had been removed from his abusive mother who had stopped feeding him. I sighed and read through the rest of the history. He had a sister who had suffered much more traumatic abuse and was currently at a different hospital's ICU. His mom had stopped washing him, his G-tube was infected, and he has lice.

Wait.

He has lice.

What! The DCFS social worker had definitely forgotten to tell me that part.

This seemingly innocent baby who had been burrowing his head into my clothes, who had been playing with my hair and my things for the last two hours, had lice.

I wanted nothing more than to strip down and take a shower, but I still had six hours left of my shift. So what could I do? Nothing except put on a hair net and a yellow gown to prevent my probably already infected self from giving it to my other patients.

Just fulfilling my aunt duties

I know I know, I'm biased, but she's pretty darn cute. 

...even when she's being sassy...

...even when she's sleeping...

...and especially when she's playing peek-a-boo!

Kids. They never trust stuff in books.

ME

Hey, kiddo, how are you feeling today?

PATIENT

I'm okay.

ME

How come you didn't eat any of your breakfast?

PATIENT

Because I was just in a car accident! And they had to staple my stomach back together, and if I eat, my belly will EXPLODE.

ME

It's not going to explode. I promise. Look how delicious this applesauce is! Yum!

PATIENT

How do you know?? You get into a car accident and get your stomach put back together and then you can tell me your stomach won't explode. But until then, I'm not eating. And that applesauce is gross. Blech.

Four years and I still have a lump in my throat

To this day, I regret not dancing with you that night.

I didn't know it would be my last chance.

Love you Grandpa, always and forever.

It's hard out there for a pimp

CO-INTERN

Let's eat out in the student quad.

ME

With all the med students?

CO-INTERN

There are other residents. And pharmacy people too.

ME

Fine.

CO-INTERN

[looking around]

Man, it must be hard being a girl resident.

ME

[essentially inhaling my burger because I am post call and starving]

What do you mean?

CO-INTERN

I mean, it's just hard to look good in scrubs compared to girls dressed in miniskirts and cute tops.

ME

[looking down at my dirty scrubs and then around the courtyard]

...

CO-INTERN

[eating his lunch obliviously]

...

ME

But I'm the only one in scrubs in this entire area...wait, what are you trying to say??

Don't ask me how I knew it was used

Why does this keep happening?

Yesterday night, I was the overnight intern on call. I finished up my admission at 2am, and then quickly ran over to the call room so that I could take a quick nap before my next admission hit the floor. My call room was like it always is. Simple sheet and a pillow. I stole some blankets from the unit, made my bed, took out my contacts, and pulled the sheet aside to jump in.

Except.

There was something on my bed.

Plastic. And circular-ish.

Now, my glasses are not at full strength, because I rarely wear them and can't afford new lenses. So I leaned closer to take a better look. And then I leaned even closer.

And that's when I realized there was a used condom on my call room bed.

It might have been the smell that tipped me off.

Or maybe it's because I touched it and it was a strange mixture of crusty and slimy.  Yeah.

--
To those readers wondering about my first sentence, yes, something similar has happened to me before.

Yes, I realize how ridiculous it sounds

"Security. How can I help you?"

"Hi, um, I need to report a missing purse."

"Uh, ma'am, have you checked with lost and found?"

"Yes, sir."

"Was it stolen?"

"No...not exactly."

"Well, where was the last place you saw it?"

"On the roof of my car."

"..."

Well, it was just one of those days. My pediatrics team had spent three hours rounding. Which sounds normal, until I tell you that we have zero patients. We had won the game! But my attending decided to punish us instead, because he decided we ought to do chart review to make sure we were compliant with all hospital regulations.

Two hours into this mind-numbingly boring exercise, my phone started to go crazy with emails. Turns out that when I opened gmail on the hospital computer, I had unwittingly downloaded a virus and sent it off to everyone I've ever emailed in my life.

Yes, that would include residency program directors and all my deans from medical school.

I spent the majority of the day fielding text messages from strangers and old friends, "Yes, it's been a long time since we've talked....no, ignore the email you got from me...it's a virus" and then making small talk and diagnosing constipation and offering treatment cures for chronic headaches, because I just felt so guilty that I had infected so many computers.

As I headed to my car, I got another text message, from my mother, no less. "You sent me a picture, but I can't see it! Should I download this program to open it?" I promptly freaked out, sending her a million texts to please STOP, do NOT open the program, and for her to please STEP AWAY FROM THE COMPUTER. I put my purse down so that I could use both hands to emphatically text her, all while struggling to get out of white coat. Then I got into the car, as I continued to text my mom.

I peeled out of the parking lot, glad to finally be leaving all the stress of the day behind me, and hoping to get home as quickly as I could to my own non-infected computer where I could change my email password and set all of my many anti-virus programs on quarantine.

It wasn't until this morning that I realized where I had left my purse. 

Yup. On the roof of my car.

Clearly, it wasn't there any more. 

Upside...at least it wasn't a baby?

Not really presyncope after all

He looked at us wide-eyed with horror. "I thought I was going to die!!"

He's nine. And he had almost passed out in the shower. And dripping wet, with the water still running at full blast, he ran to tell his parents that he had almost died. His parents appropriately freaked out and drove him straight to the emergency room.

We were worried about presyncope. Maybe an arrhythmia. Maybe his electrolytes were off. Because fainting? In little kids? That's worrisome.

And then we heard his story. He had a normal day of playing outside with his friends, playing basketball and riding bicycles. He came home stinking of little boy body odor, so his mom had ordered him straight to the showers. Everything was like it's always been, except - and these are his words - "my little bird started to fly!!"

Then, he said, "And everything started to spin around, and I felt like I couldn't breathe anymore! My heart started feeling like it was going to jump out of my chest! And everything got really blurry, and I THOUGHT I WAS GOING TO DIE!!"

My senior resident and I looked at each other and tried to suppress our laughter. My senior resident smiled at our patient and told him that everything was fine. And that when he was older, he would like those feelings. He looked at us in disbelief, "I'm going to like dying??? NO THANK YOU. I don't even drink SODA cause it makes my stomach feel funny!"

We didn't know how to tell him, nor did we know what to tell the parents, but we're pretty sure our patient just had his first erection.

But just in case, we gave him a bolus of IV fluids.

Yes, I become a floozy after a good meal

THANAN

A new lobster roll place opened near the office. I'm going to eat it til the world ends.

ME

Yum!! Lobster roll!! I had the most amazing lobster roll when I was in NYC. Yummmmm!!!

THANAN

No, that was Luke's lobster. This is Claws.

ME

Yummmmmmm

THANAN

Hahahaha

ME

YUMMMMMMM

THANAN

Are you drunk??

ME 

No, just hungry

THANAN

Same thing.

ME

True.

Public service announcement

She waited for the WALK sign, and once it was her turn to go, she started pushing her 8 month old baby boy across the street. Her parents were right behind her.

She heard a squeal and turned to look at the sound. A drunk driver was careening down the street, coming straight at her at sixty miles an hour.

She screamed in horror. She must have. But in the last three seconds she had, she pushed her stroller as far away from her as she could.

Her baby boy ended up safely on the sidewalk. A little shaken, but otherwise fine.

She died immediately on impact.

---

I took overnight call on Cinco de Mayo. And I will never forget the sight of her mother dropping to the ground, slapping the floor in grief, wailing to the heavens, as she was told that her baby, her daughter, was dead.

Please don't drink and drive.

I guess it would be weird if a psych patient gave me this

Reasons why I love peds:

• No team pager going off every thirty seconds.
• No team phone ringing off the hook.
• Nurses who actually will draw a CBC, instead of asking you to come clarify the order because you didn't write "comprehensive blood count."
• Smaller team lists [On medicine, we're capped at 20, my current peds list is 6.]
• Admitting only every fourth day, instead of every day!

...and of course, the patients.

On my third day on peds, my patient sidled up to me and handed me a rolled up piece of paper. "It's a present, Dr. Wu. For you!"

[front]

[back]

I never in a million years would have thought that the sight of SpongeBob SquarePants would make me feel so touched.

Call me back otherwise I'll deport you

I've been taking care of an old Asian grandpa. He came in with acute confusion, unable to talk to anyone. The ER note said that someone from his family dropped him off, and no one had been back to see him in days.

We put a foley in him and out came three liters of urine. I sent off labs, and his PSA came back sky high. Urology came by to see him and confirmed my suspicions: most likely prostate cancer. We needed to talk to the family to decide what they wanted to do.

I called the family.

I called the family again.

Every day for three days I would try calling the family, before rounds, during rounds, after rounds, before lunch, after lunch, while I wrote notes, before signout, after signout. No one ever picked up. And every time I would leave a message.

The voicemails started off pleasantly. "Hi, this is Dr. Wu, and I'm taking care of your family member. He's doing well, but please give me a call back so that I can discuss his care with you."

But as the days passed, and my messages went unanswered, I got more and more terse. "Hi, this is Dr. Wu, and it is imperative that I speak with you about your relative's care."

I started leaving messages on my patient's tray table and white board, imploring the family to call me the minute they came to visit.

Still nothing.

This was inappropriate. Someone had dumped their grandfather in the hospital and taken off. Who does that? Seriously, who does that?!

I was pissed.

So on the third day, when my patient started to get a little worse, I called the family one last time. It went to voicemail. Of course.

"Hi, this is Dr. Wu, and this is now my twentieth voicemail to your family. It is highly inappropriate for you to send your grandfather to the hospital and then not want to participate in his care, especially when he is unable to voice his needs at this time. This qualifies as a form of neglect, and if I do not hear from you by the end of the work day, I will have no choice but to report your family to Adult Protective Services. Again, you know how to reach me."

I slammed the phone down in disgust.

I sat down at the nursing station, unsure what to do next for my patient. I was calling in a social work consult to try to get my patient placed at a nursing home, when the phone started ringing. The nursing supervisor picked up, and all I could hear was her side of the conversation. "Oh! Yes! Thank you for calling, the doctor has been trying to get a hold of you! No? No, just hold on, she's right here and you can talk to her right -- oh what? Mmhmm. No? Oh okay, good to know."

I almost yelled at her. That was the family I was trying to track down on the phone for days! Why did she just hang up?

Then she turned around.

"Doctor Wu? The family that you've been calling for the last three days? They're a Spanish speaking only family who just had their neighbor translate all of your messages. They said they don't have a relative in the hospital, but they got very concerned when you mentioned going to the police, so they want to know what they have to do for Mr. Chen."

I turned beet red. Turns out the number in my patient's file was wrong this whole time. And I had unknowingly been harassing a very nice Hispanic family who were now afraid of being deported if they didn't come to take my Asian patient home.

I'm going to be that annoying aunt who shows off pictures all the time

My older sister gave birth to her first child, and I am officially an aunt.

And while yes, I might be biased, she is really super cute. And already a giant ham for the camera.

Man, I love those baby cheeks.

Bella Sophie Chen, age 10 days

Birthday: April 9, 2012

Welcome to the family, baby girl! 

Sometimes it's just easier to give in

ME

Hello, this is Michelle.

NURSE

[some international accent]

Doctor! You need to clarify discharge order!

ME

Why, what's wrong with it?

NURSE

You write "discharge to home hospice!" 

ME

Yes.

NURSE

So which is it? Home or hospice??

ME

It's home hospice. It's one thing.

NURSE

No, I don't understand. What address do we send patient to?

ME

You send him home.

NURSE

But that's not home hospice!

ME

Hospice will come visit him at home.

NURSE

Doctor, I need an address to send patient to.

ME

[looking in patient's electronic chart]

1234 Main St. Los Angeles.

NURSE

That's his home address!

ME

Exactly. 

NURSE

But!!

ME

You know what, never mind, I will come write a new order.

I thought that was just your middle name

MARTIN

[typing]

Hey, what's that old latin phrase for like blank slate or whatever?

ME

Uh, you mean like carpe dium? Tabula rasa?

MARTIN

Tabula rasa! Yeah!

[five minutes later]

MARTIN

It's not true you know.

ME

What?

MARTIN

Tabula rasa. The idea that you're born blank slate. 'Cause I was born AWESOME!

Yes, I like a little 'mud on the tires'

My fabulous medicine team went out for team lunch yesterday. My attending took one car, and it was somehow decided that I would drive the rest of us.

But as we walked towards my car - me with my two 3rd year med students and my co-intern - I realized that I ought to warn them.

ME

Just so you guys know, my car is a mess.

CO-INTERN

I'm sure it's fine!

ME

No really, it's a giant HIPAA violation, I just toss all our patient lists in my back seat. Also, I feel compelled to tell you guys that I've only been driving for eight months. Just in case you want to drive with our attending instead...there's still time to run over to his car...

MED STUDENT

Somehow, I still trust your driving more.

So then we were off. And as I focused on making sure that I drove safely, I suddenly realized that my two med students were making faces at my co-intern, and when they saw me watching, they all simultaneously burst into laughter.

ME

What!! Why are you guys laughing!

GIRL MED STUDENT

Michelle. You disclaimed all these things...messy car, student driver...but you never told us that you listen to country music!!

---

P.S. $5 to whomever correctly guesses who my attending is in the above picture.