And Get These Kleenex Boxes Off My Feet!

Surgery's officially over. It's time to rejoin society.

(Actually, I really might have failed this test this morning, so maybe it's not quite over. I definitely got a few questions right, and they give us a generous curve because the test covers surgical subspecialties and not everyone has done those rotations, but still. I felt pretty crappy all day about it.)

Omigodomigodomigod

Note to self: it is NOT a good idea to watch a scary movie the night before your test.

I studied all day, and I still have a little left to do before turning in, but I needed a break. I just got some new movies on Netflix and decided I'd watch some of "28 Days Later." Oh man oh man. Some people just went by outside and I nearly jumped out of my skin. The worst part, as is true in every scary movie, is those "What are you doing?! Don't go in there! Nooooo!" moments. Come on, Jim. You don't need to watch those home movies. You don't need to go into the burger shack. Screw exploration, man! Fucking moron. Now you're going to get bit by the infected devil-child. Like, it's bad enough that I'm terrified by stuff going down in this post-apocalyptic world, the characters also have to make me cringe and smack my head. God, they're just walking around? Carry a weapon at all times, people! Groan.

Anyway. The worst part is, Diane isn't even home -- she went down to DC to spend the weekend with her husband -- so I'm all alone. Then again, maybe if she were around, every noise she made might make me start. Here's to a sleepless night ahead.

Conscience

Ever since I started med school, I've had the prickly feeling of my conscience raising its head every few weeks or so. Specifically, what's bothering me is that I think our family housekeeper, Sara, should have health insurance, and more to the point, my family should provide it. She's been our housekeeper, who used to visit every day to tidy up and also babysit me (ever since I was two months old or so, I think), and now visits every other day during the week. She's a wonderful, kind human being, and hasn't been to the doctor in years. I see women her age in the hospital who come in, for instance, with shortness of breath, and discover that they have advanced lung cancer. Or have had uncontrolled diabetes for years and are starting to lose nerve and eye function. I don't have any reason to suspect that she has some lurking medical condition, I just want her to get plugged into the health system. I've approached my parents about it in an oblique way, and they've both sort of shrugged their shoulders, and I haven't pressed it. I think I'll press the issue a little more now. I'll volunteer my Jeopardy! money, as far as that will go, toward getting her some insurance. We've fallen down on the job.

FYI

I am now available for all manner of social activities. Only coffee and meals until Friday, and then carousing, movies, weekend outings... anything goes. My last day on the surgery service was today, and now all I have to do is pass my practical exam tomorrow and my written exam on Friday morning, and I'm free! Just easy rotations for the rest of the year.

Ah, Sweet Studying

Books, how I missed ye. I have my surgery test next Friday, so today I buckled down. I did pretty well, doing all but half an hour of my allotted studying. I also got to go to Ikea with my sister-in-law and nephews. The whole reason Maggie called to ask if I wanted to come with them was Isaac, my 13-month-old nephew, said "Nornie" (my other nephew's nickname for me). But the whole time I was with them he didn't say it. He's also going through the whole separation anxiety thing, so I didn't even get to hold him much. Another fun thing: I got to have dinner out with four of my friends here (which was underwhelming but still a good time).

Another Thing

I just finished "The Motorcycle Diaries," which was fantastic. I highly recommend it to anyone. I don't know if I'll say it's on my Top Ten list of movies, but only because I don't know if I'll see it again and again. But this one viewing will stick with me for a long time, anyhow.

Real Quickly

I just want to say this: I played four-square today! It was a beautiful warm day, must've been in the 60's here in Philly, and I was walking around Center City on errands (love those post-call afternoons). As I walked to the supermarket, I saw a bunch of college-age kids playing four-square in this pretty park at the corner of 11th and Pine Streets, and it made me grin as I passed. I wanted to join them -- there was even a message in chalk at the entrance to the park "Philly 4-Square -- Come Join!" but I felt too old and too yuppie. I went back and forth in my head, on the way to and from the supermarket, should I, shouldn't I, would I have approached these people in college, i.e., am I really just getting more timid and boring? I hadn't made a decision by the time I passed by them again, with my groceries, but they made the decision for me. They called to me, "Come play four-square!" So I went home, put my food away, left my purse and jacket at home, and went to play an elementary school playground game with lots of made-up rules ("Okay this time, you have to say the name of a superhero as you hit the ball," e.g.) for an hour and a half in the soft spring sunshine. I came home grinning.

Tough Day

An 18-month-old boy died today in the ER. I didn't see him. He apparently came in blue and cold, in respiratory failure, barely able to breathe. The doctors could not save him -- they don't even know what happened. All they knew was, he'd had a cold for a week. Scary.

My resident and I were sitting nearby, working on another patient's case, and trying not to listen to the mother screaming in grief, twenty feet away. The ER was unnaturally quiet otherwise, with the staff walking around doing work, red-faced, puffy-eyed. I had to walk away a couple of times as I felt my face contort and the tears start to rise up inside me. I took deep breaths, as if fighting nausea, and calmed back down. Back to work... it felt so unnatural.

Yada Yada Yada

I'm currently watching "Million Dollar Baby" that I got from Netflix. Pretty emotional so far, and yet there's a matter-of-fact-ness to it that keeps me from getting too moved. Maybe it's because people spoiled the ending for me. That's what I get for never seeing good movies in the theater. Also, there were a bunch of medical points I disagreed with, which sort of deflated it for me. Stupid knowledge getting in the way of good art.

Random thoughts: I love Morgan Freeman's acting. Maybe if I had a daughter I'd name her "Morgan." That might be cool, but it flies in the face of my "no male names for girls" rule. "Clint" is a good name too, but it's sort of intimidatingly badass, just by association.

So... do you like... stuff?

I'm definitely gaining weight on this rotation, as I did in my last rotation (OB/GYN). On the whole, I'm fully five pounds heavier than I was in early January. You might think, "only five pounds! don't worry about it" but I know better. I do not lose weight. I've only lost weight once in my life, and it was when I first went on the pill. I stayed at that "after" weight for 5+ years, never fluctuating beyond a pound or two here and there, even on a relatively binge-y weekend at Mohonk. Luckily, the rotation's almost over (only a week left in the hospital!) and I have ophthalmology next (score! a one-hour workday!), so I'll make sure to work out a lot.

And here's the other thing -- hopefully I'll be able to eat better when I leave surgery. Take today, for example. I didn't have time to go food shopping, so I didn't have any milk for my cereal this morning. So I had a bagel with cream cheese instead (always delicious, but not the healthiest choice) from Dunkin Donuts, along with something on my Top Ten List of Favorite Things, a large DD tea with cream and sugar. (Although, mindful of my recent weight gain, I got the tea today with skim milk and Splenda, and it still tasted great. Mmmm sweet dark lord of Lipton.) Anyway, I had the bagel at 5am. This lap G-tube placement went really long this morning (8am-12:15pm), and there was a case set to start at 12:30pm, so if I wanted to eat at all, I had to run down to the cafeteria and get a slice of pepperoni pizza to go, which I then inhaled on the elevator back up to the OR. I just mean, I try to make good food choices in general, but this lifestyle is one that doesn't make healthy eating easy.

So I guess there's hope that I might lose the weight when I get off this rotation. But it really all depends on whether my "set point" has been reset. Here's hoping it hasn't.

P.S.

I feel like my latest posts have been somewhat downer-ish, so I thought I'd mention that today was a great day. I got to see a lot of different procedures and do a lot of different things. For example, I debrided this guy's hip ulcer and got to do a beautiful subcutaneous closure on this woman's pacemaker repair. Ah, nothing like the sub-Q closure. No visible stitches! I did a nice job, unlike the last one I tried, so I was proud of myself. Ooh, and I got to help sew a guy's skin graft on, and as the attending watched me take the needle through and tie the knot down, he remarked, "You're a natural plastic surgeon!" He was probably just being nice, but I was tickled. And after being busy and having fun all day (I even think I picked up an abnormal heart sound on one patient I checked today! Although my team didn't care. Typical surgeons), I got to leave way early, at 4:45pm. Now, the weather is crap, but if that's the only bad thing about my day, I'll take it. Huzzah.

America

The song "America" by Simon and Garfunkel is a very powerful love song for me. Stephen played it for me in college because he thought my arrangement of a song for my singing group began the same way it does, with the same sort of humming. Then we listened to it a few more times because we liked it.

It just takes me in my imagination to that bus ride described in the song. Really, it just captures the feeling of being in love and taking off somewhere, ready to explore a new place together, that feeling of time stretching out. Adventure, youth, the great wide open made less scary by the presence of someone you love beside you. But still a touch of loneliness and desolation in there, in the lines when he talks to his sleeping girlfriend, saying he's lost, empty and aching.

Not many songs put me in such a specific mood, where I'm imagining myself on a Greyhound, watching the fields go by. Hearing it just now made me realize that recorded songs can take up such a specific place in one's brain, that they can produce that electric key-into-lock sudden recall that most people get only from certain scents. I mean, everyone associates smell with memory, but I'd say that recorded song can produce that same sort of emotional vertigo, of being suddenly awash in a different time and place.

Scattered Showers

I've gotten used to crying without being alarmed that I'm crying. I'll be listening to a sad song or watching a particularly moving film or TV show, by myself, and I'll just begin crying. And after a minute or two, the tears go as suddenly and smoothly as they came. It feels like a summer squall coming through, briefly intense but refreshing.

Dumdededumdededumdededum Shiny Scalpel...

I am not cut out for surgery (pun not intended); in what other specialty can you go from completely relaxed to strung out, nauseated, fat, unwashed, unfocused, and braindead-feeling, in the space of, oh, 16 hours?

Sigh. :(

I was sick last night, and had to sleep in this morning. I actually felt mostly better by 9am and could have gone into work, but my fellow med student on the surgery rotation emailed me and said that the busy OR day was not actually that busy, so it wasn't like they needed my help. So I spent the day at home.

I napped and futzed around on my laptop as I watched The 40-year-old Virgin, as I stretched out listless on the couch, and I read some more of Stiff, which started out hilarious but is now a just okay book. I went to the Last Drop, which is a nice hipster coffee shop with sullen workers, and I had herbal tea and a bagel with cream cheese and read The New Yorker. The bathroom is cool there, with a lot of shards of mirrors, in the wall, sort of like the Magic Gardens. I ended up not getting any radio reception there, and I couldn't study with the chatter and music there after all, so I came home, fixed some more tea, and worked longer.

All day I've been feeling more blah than I have in a long time. Nothing appeals to me. No energy, don't want to work, don't enjoy lying around. Maybe this is all just what-do-I-do-with-my-life angst. Or maybe it's having worked my arse off for six months (not including christmas break) without any sense of balance. All I know is, I don't feel centered. No exercise, no control over my schedule, can't muster the energy to call anyone. Also, I realize that this is the longest I've gone without dating anyone in more than five years. Feeling a little awkward and apprehensive at the thought of dating again. I'm sure my general ennui will dissipate in a couple days, but right now I'm sort of lazily miserable.

First, You Drop Your Load

That is the standard answer to any situational pimping, e.g., "what do you do if you cut the common bile duct?"

I think it's an appropriate response to "what do you do if you have to think about your future?" Talked to my dad for an hour this afternoon about it, and cried a little bit. I am so not ready to gear up for the away-rotation-scheduling, letters-of-recommendation-getting, step-2 scheduling, etc, all the while actually trying to figure out what you want to do. I'm just too much in a survival mode right now. :-/ One step at a time...

Oh-wee-oh, wee-ohhhhhh-oh

My plodding life reminds me of those guards in "The Wizard of Oz." I'm postcall and tired tired tired. I had a meeting with my student dean to discuss my fourth year scheduling and he printed something out for me and at the end I zoned out for five seconds as I examined the slightly loose staple in the pages. Zooooone.

But this weekend I have totally off. I'm going to do a few hours of studying tomorrow, but other than that, the weekend is all about sleeping, eating well, exercising, cleaning, and in general restoring some sense of normalcy.