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.