As I did last year, this morning I decided to dig up my New Year's Resolutions from the previous year to see how I did.
Behold, last year's list:
1. Make sure to go out and do something social at least every other week (while simultaneously avoiding people who drive me nuts).
I got better at this during the second half of the year. So yes, goal accomplished. We even ventured out to new places a few times.
2. Avoid making eye contact with the people on the running path (provided I have time to run) as they tend to look one up and down which is unnerving/compete less with others in the pool.
I don't even run on the path anymore now that I live in West Philly. I still run, but there are fewer people on this side of the river who also run, and I have never been checked out by those who are running over here. As for the pool, yes I have given up being competitive in the water too, though I still hold out hope that I can improve.
3. Remind self regularly that I actually don't have to be a doctor if this year really sucks. Also, figure out how to incorporate research into clinical life.
I was HIGHLY successful at the first part of this. I am still working on the second part. I think this is going to have to be a work in progress.
4. Sleep as much as possible + get up early whenever possible.
Yes on the first part. Sometimes on the second part. I was pretty proud of the fact that even without an AM appointment, I can get myself out of bed at 6:30 or so *without* an alarm clock. This is probably because I am good at going to bed on time.
5. Beat self up less about mistakes.
I think I am getting better about this, but I could still be better.
6. Make friends who have no association with the medical field and learn how to tell medical stories so that they don't shock non-medical people.
I have definitely done the first part of this, but this can be attributed to the fact that I am doing PhD stuff now and thus SEE non-medical people more often. And it has made me a much happier person! I never really learned to tell medical stories, so now I just try to resist the urge to tell them at all, since non-medical people never seem to understand anyway.
7. Occasionally read a book that has nothing to do with becoming a doctor
FAIL. Ok, not total fail. However I really would like to do more pleasure reading. I'm on page 124 of Anna Karenina now, and started it in September. The problem is every time I pick it up I feel like I ought to be doing reading for my project instead.
8. Watch less tv
We don't even have cable anymore, just Netflix. So, Suc-CESS! I do like to have it on in the background when I work at my computer. The flickering light is soothing to me.
9. Finish epi paper I was supposed to finish a year ago
FAIL! But this is not my fault alone. And, I will be working on it again in a few hours... I hope.
So, not a bad year overall.
This year I think I will try to.....
1. Get less frazzled when I'm not getting work done at the rate at which I feel I should.
2. Spend more quality time with Luca.
3. Walk more.
4. Yell less at my computer.
5. Get grant written.
6. Not worry so much about the fact that I am forgetting my clinical knowledge.
Thursday, December 31, 2009
What are you doing?
For New Year's Eve?
As per tradition in the Luca and OMDG household, we are going to bed early, and getting up at sunrise (or earlier). Then we're going for a walk. It's nice to be out early so we can have the city to ourselves.
We haven't gone to a New Year's party in 5 years at least.
As per tradition in the Luca and OMDG household, we are going to bed early, and getting up at sunrise (or earlier). Then we're going for a walk. It's nice to be out early so we can have the city to ourselves.
We haven't gone to a New Year's party in 5 years at least.
Wednesday, December 30, 2009
Rule #5
Rule #5 of the hidden curriculum:
Your residents and attendings are permitted to blame patients for their bad outcomes. They may say these things in front of you, the medical student, on rounds, in the hallway in front of the patient's room, to each other.
You, the medical student, must say nothing.
- If you agree, you will be told that it is unprofessional to blame the patient.
- If you disagree, you will be told that you are naive.
It is best to nod. If a vocalization is required, a grunt should suffice. If you have a tail, wag it.
Allow me to provide an illustration of such a scenario:
Case: Patient gets high with his friends on some crack/meth/speedballs/whatever. Decides to race his friends down a country road at 100 MPH. Drives into a telephone pole. Oh yeah, seat belts are for pussies. Comes to trauma bay. Dies. Kills friend in passenger seat and 2 year old child in road.
A tragic situation? Yes. Was the patient behaving stupidly in a way that directly led to his death and the deaths of others? Yes.
If you, as the medical student, feel you MUST say something, ONLY the following is permissible: "Oh that is SO SAD!!" You'll probably get yelled at for blaming the patient even for saying something relatively benign such as, "If only he had been wearing his seat belt."
Remember med students: You are the golden retrievers of the medical profession. Eager to please, ready to fetch anything at anytime for anybody, and always happy and positive. And preferably silent as well.
You are not allowed opinions. And if you have them, nobody cares anyway.
Your residents and attendings are permitted to blame patients for their bad outcomes. They may say these things in front of you, the medical student, on rounds, in the hallway in front of the patient's room, to each other.
You, the medical student, must say nothing.
- If you agree, you will be told that it is unprofessional to blame the patient.
- If you disagree, you will be told that you are naive.
It is best to nod. If a vocalization is required, a grunt should suffice. If you have a tail, wag it.
Allow me to provide an illustration of such a scenario:
Case: Patient gets high with his friends on some crack/meth/speedballs/whatever. Decides to race his friends down a country road at 100 MPH. Drives into a telephone pole. Oh yeah, seat belts are for pussies. Comes to trauma bay. Dies. Kills friend in passenger seat and 2 year old child in road.
A tragic situation? Yes. Was the patient behaving stupidly in a way that directly led to his death and the deaths of others? Yes.
If you, as the medical student, feel you MUST say something, ONLY the following is permissible: "Oh that is SO SAD!!" You'll probably get yelled at for blaming the patient even for saying something relatively benign such as, "If only he had been wearing his seat belt."
Remember med students: You are the golden retrievers of the medical profession. Eager to please, ready to fetch anything at anytime for anybody, and always happy and positive. And preferably silent as well.
You are not allowed opinions. And if you have them, nobody cares anyway.
Monday, December 28, 2009
To Do:
Over this Xmas I have successfully FINALLY accomplished one thing on my to do list: Cleanse the grant critiques I wrote so that they could be sent to the people who wrote the grants.
Still on the list:
1. Finish database exam (It took me a week to make Access 2007 obey me. What a pain!)
2. Finish changes on AcuOA paper and send back to PI.
3. Read articles on why telling patients about medical errors is good.
4. Incorporate said papers into grant I am supposed to be working on.
5. Start reading Rothman textbook.
In truth, it's not as though I've done *nothing* on the other tasks. I did spend the better part of last week making Access 2007 my bitch, and have read all the way to page 10 of Rothman.
It has been dense reading! Give me a break!
So tomorrow I vow to really truly finish the database exam. For real this time. Then perhaps I can move onto the paper that will not die on Wednesday.
It's just hard to motivate when there is an endless supply of movies on Direct TV and a dog to stroke. What can I say.
Still on the list:
1. Finish database exam (It took me a week to make Access 2007 obey me. What a pain!)
2. Finish changes on AcuOA paper and send back to PI.
3. Read articles on why telling patients about medical errors is good.
4. Incorporate said papers into grant I am supposed to be working on.
5. Start reading Rothman textbook.
In truth, it's not as though I've done *nothing* on the other tasks. I did spend the better part of last week making Access 2007 my bitch, and have read all the way to page 10 of Rothman.
It has been dense reading! Give me a break!
So tomorrow I vow to really truly finish the database exam. For real this time. Then perhaps I can move onto the paper that will not die on Wednesday.
It's just hard to motivate when there is an endless supply of movies on Direct TV and a dog to stroke. What can I say.
Saturday, December 26, 2009
Psychotic
I've been at my parent's house now for 2 days and already I've begun to go a little stir crazy. Though we did have a DELICIOUS Christmas dinner consisting of rack of lamb (my favorite) and these potatoes with cheese that are the most amazing potatoes I have ever eaten.
So today I started doing some work again and felt instantly better.
The dogs appear to be getting along though, which we were relieved by, though Boo vomited all the way up to CT in the car. 6 times. Despite the Dramamine we gave her.
We're taking her to the vet up here on Monday to get an Rx for some Acepromazine for the trip back, which I hope helps. I had talked about getting a script for this when we saw the vet last Tuesday, and now I am kicking myself for not just doing it.
Interestingly, when I heard the name Acepromazine I immediately thought its name sounded like an anti-psychotic. But then I thought that perhaps I didn't know what I was talking about, so I didn't ask the vet because I didn't want to look stupid (adaptive behavior from med school, what can I say). It turns out I was right. As a matter of fact, Ace is closely related in structure to Thorazine, which is an old-school typical antipsychotic. Thanks Wikipedia!
And then I wondered: Why can't dogs take Compazine? Do they get dystonias? Is Ace just doggy Compazine? Would it have the same effects?
... and then I remembered The HAM. That is, the receptors that Thorazine acts on: anticholinergic, muscarinic, and histamininc (as well as the dopamine receptors). Because Ace is an old school antipsychotic, then she is less likely to get dystonias because of all the anticholinergic action of the medication that mitigates some of the dopaminergic actions...
(Probably don't really have to worry about TDs either, come to think of it, though it could happen it's not as likely as say with haldol...)
As a side note, I will ALWAYS remember what Thorazine does because of Terminator 2. Thank you James Cameron! It does crack me up that it is billed as an "anti-anxiety" medication in animals. Yes, I'm sure it does that too. If you're conked out in the back of the car, you probably aren't feeling very anxious either, are you doggie?
The other up side to this was that at least I know I haven't forgotten *everything* from med school yet!
And I can feel safe in the fact that my dog will not have hallucinations in the car or think that the tv is sending special messages to her that only she can understand. Thank goodness for that.
So today I started doing some work again and felt instantly better.
The dogs appear to be getting along though, which we were relieved by, though Boo vomited all the way up to CT in the car. 6 times. Despite the Dramamine we gave her.
We're taking her to the vet up here on Monday to get an Rx for some Acepromazine for the trip back, which I hope helps. I had talked about getting a script for this when we saw the vet last Tuesday, and now I am kicking myself for not just doing it.
Interestingly, when I heard the name Acepromazine I immediately thought its name sounded like an anti-psychotic. But then I thought that perhaps I didn't know what I was talking about, so I didn't ask the vet because I didn't want to look stupid (adaptive behavior from med school, what can I say). It turns out I was right. As a matter of fact, Ace is closely related in structure to Thorazine, which is an old-school typical antipsychotic. Thanks Wikipedia!
And then I wondered: Why can't dogs take Compazine? Do they get dystonias? Is Ace just doggy Compazine? Would it have the same effects?
... and then I remembered The HAM. That is, the receptors that Thorazine acts on: anticholinergic, muscarinic, and histamininc (as well as the dopamine receptors). Because Ace is an old school antipsychotic, then she is less likely to get dystonias because of all the anticholinergic action of the medication that mitigates some of the dopaminergic actions...
(Probably don't really have to worry about TDs either, come to think of it, though it could happen it's not as likely as say with haldol...)
As a side note, I will ALWAYS remember what Thorazine does because of Terminator 2. Thank you James Cameron! It does crack me up that it is billed as an "anti-anxiety" medication in animals. Yes, I'm sure it does that too. If you're conked out in the back of the car, you probably aren't feeling very anxious either, are you doggie?
The other up side to this was that at least I know I haven't forgotten *everything* from med school yet!
And I can feel safe in the fact that my dog will not have hallucinations in the car or think that the tv is sending special messages to her that only she can understand. Thank goodness for that.
Wednesday, December 23, 2009
Boo
So I took Boo to the vet yesterday, who was nice, but a bit aspergers-y in a way.
Anyway, she was healthy and the walk wore her out, which pleased me. She'd put on 3.5 pounds since her surgery a month ago, which is good since she's still a bit underweight. We go to CT to visit my parents and their Standard Poodle William who loves to play with other dogs tomorrow, which we are very excited about. Hopefully she won't puke in the car. I'm planning on giving her some Dramamine as a preventive measure.
Some more observations about her:
1. She is a very hungry girl, but would really prefer that we stand next to her while she eats. Otherwise she'll eat half the food and then come curl up on the couch next to us and graze on the rest later in the day.
2. Her favorite game is to race across the house at top speed and then hurl herself into the couch. Then race back and hurl herself into me. I'm not sure how much I like this game.
3. Her second favorite game is "blue towel" which we play when we bring her in from a walk. We use the blue towel to wipe the ice and salt off her feet and then throw it over her head.
4. She also enjoys our game, "Obedience School," which consists of leash training, sitting, staying, and coming. She even goes into and out of her crate on command. She's not such a fan of "down" but we're getting there.
5. When she sits next to you on the couch, she will wedge herself between me and the back of the couch.
6. She snores like a chainsaw. Luca and I have started calling her Miss. Piggy.
7. She doesn't beg at all. I can sit eating breakfast on the couch, and she will come over to sniff. But if I tell her no, she curls up in a ball at the other end of the couch and goes to sleep.
8. She is beginning to get the hang of walking on a leash. Last night Luca commented that she was so good about not pulling that sometimes it felt like there wasn't a dog at the end of the leash, and he had to look to make sure she was still there.
9. So admission -- she is probably part pit, though we don't know for sure. However she has been really friendly with all the dogs and people we have met. Waggy tail and sniffing all around. Sometimes people give her a wide berth or make negative comments about her pit-ness, but then I take a look at the snarling ball of fur on the end of their leashes and think, "But YOU'RE the one with the aggressive animal!"
10. When Luca comes home, her favorite thing to do is lie on her back on the couch for a tummy scratch. You should hear the snorting then!
Her words:
Boo
Sit
Walk
Treat
Crate
Come
Stay
No
So that's it. She's a really sweetie. I hope she likes William when we visit my parents. If so, it should be a real treat for both of them.
Anyway, she was healthy and the walk wore her out, which pleased me. She'd put on 3.5 pounds since her surgery a month ago, which is good since she's still a bit underweight. We go to CT to visit my parents and their Standard Poodle William who loves to play with other dogs tomorrow, which we are very excited about. Hopefully she won't puke in the car. I'm planning on giving her some Dramamine as a preventive measure.
Some more observations about her:
1. She is a very hungry girl, but would really prefer that we stand next to her while she eats. Otherwise she'll eat half the food and then come curl up on the couch next to us and graze on the rest later in the day.
2. Her favorite game is to race across the house at top speed and then hurl herself into the couch. Then race back and hurl herself into me. I'm not sure how much I like this game.
3. Her second favorite game is "blue towel" which we play when we bring her in from a walk. We use the blue towel to wipe the ice and salt off her feet and then throw it over her head.
4. She also enjoys our game, "Obedience School," which consists of leash training, sitting, staying, and coming. She even goes into and out of her crate on command. She's not such a fan of "down" but we're getting there.
5. When she sits next to you on the couch, she will wedge herself between me and the back of the couch.
6. She snores like a chainsaw. Luca and I have started calling her Miss. Piggy.
7. She doesn't beg at all. I can sit eating breakfast on the couch, and she will come over to sniff. But if I tell her no, she curls up in a ball at the other end of the couch and goes to sleep.
8. She is beginning to get the hang of walking on a leash. Last night Luca commented that she was so good about not pulling that sometimes it felt like there wasn't a dog at the end of the leash, and he had to look to make sure she was still there.
9. So admission -- she is probably part pit, though we don't know for sure. However she has been really friendly with all the dogs and people we have met. Waggy tail and sniffing all around. Sometimes people give her a wide berth or make negative comments about her pit-ness, but then I take a look at the snarling ball of fur on the end of their leashes and think, "But YOU'RE the one with the aggressive animal!"
10. When Luca comes home, her favorite thing to do is lie on her back on the couch for a tummy scratch. You should hear the snorting then!
Her words:
Boo
Sit
Walk
Treat
Crate
Come
Stay
No
So that's it. She's a really sweetie. I hope she likes William when we visit my parents. If so, it should be a real treat for both of them.
Tuesday, December 22, 2009
Star-Struck!!!
I think I may have blogged about this before way back when..... but it's a well known fact that a) my department is a boy's club, and b) to get in good with the head of my department, one must play squash with him.
It's kind of a bummer that I don't play squash, huh.
Well anyway, I know I mentioned that this new hot shot woman PI swims in the morning, and I've been talking to her at the pool lately. And THIS morning I met another hot shot woman PI who is married to another hot shot PI that I did a mini-project with a few years back.....
And she used to work where my husband works, and lived in the carriage house of one of the most famous scientists at that company when she first moved to the area.
AND both hot shot woman PIs were on a first name basis with the new head of my husband's division.
(Sorry about not using names here.... trying to maintain some vestige of anonymity and not get my husband fired....)
Anyway, I was totally star-struck. I was like, "These important women are TALKING to me!!!! They're involving me in their conversation!!! OMG!! Palpitations!"
And also, there is NO WAY I am giving up swimming at the pool here. Because the networking is too fantastic to pass up.
Take THAT Mr. Squash man.
It's kind of a bummer that I don't play squash, huh.
Well anyway, I know I mentioned that this new hot shot woman PI swims in the morning, and I've been talking to her at the pool lately. And THIS morning I met another hot shot woman PI who is married to another hot shot PI that I did a mini-project with a few years back.....
And she used to work where my husband works, and lived in the carriage house of one of the most famous scientists at that company when she first moved to the area.
AND both hot shot woman PIs were on a first name basis with the new head of my husband's division.
(Sorry about not using names here.... trying to maintain some vestige of anonymity and not get my husband fired....)
Anyway, I was totally star-struck. I was like, "These important women are TALKING to me!!!! They're involving me in their conversation!!! OMG!! Palpitations!"
And also, there is NO WAY I am giving up swimming at the pool here. Because the networking is too fantastic to pass up.
Take THAT Mr. Squash man.
Monday, December 21, 2009
Babies + Residency
I got this comment today from an Anonymous reader. Since I don't know much about the subject of residency at this point, I thought I would post it here and see if any of my readers who knew about such things wanted to opine.
Do you think the fact that you will have a baby about 2 months before a residency program begins will hurt you in the application/interview process?
My wife is 33 and applying for residency. She is a also pregnant, due well before residency would begin. A friend of ours just said we should hide her pregnancy from the interviewers because it would hurt her. In addition to the legality of it, it seems illogical to me that it would hurt her application -- would you prefer someone who has clearly planned a family around a residency or someone who might wait to take off in the middle? I would appreciate your thoughts, if anyone looks at this thread.
My feelings on the subject are.... it probably won't *help* her application since babies have a tendency to be.... time consuming. Especially after they are born. Legally, the program can't ask about her pregnancy or discriminate against her, but that doesn't mean they won't. That's pretty much how it would go down in the non-medical profession private sector anyway.
However, I could be wrong about this. There may be some residency programs that are particularly accommodating to parents, and I know that some specialties that are better about these sorts of things (Peds for instance).
During my Neurology externship one of the residents was out of there before 6 everyday to pick up his daughter at daycare. Practically every. single. resident. had a baby or toddler, and they were very laid back about the whole deal. Granted, he was a senior resident, and it was an easier rotation.... but I gotta say it helped sell me on Neurology, since I'd never even seen an attending do that on any of my other electives.
Also, Neurology is awesome.
BTW -- Kudos to your wife for tackling med school and having a baby in her late 20's/early 30's. I keep saying that I refuse to let becoming a doctor get in the way of the rest of my life, it's just easier said than done sometimes. It's good to see some people actually put that plan into action.
Anybody have any thoughts on this?
Do you think the fact that you will have a baby about 2 months before a residency program begins will hurt you in the application/interview process?
My wife is 33 and applying for residency. She is a also pregnant, due well before residency would begin. A friend of ours just said we should hide her pregnancy from the interviewers because it would hurt her. In addition to the legality of it, it seems illogical to me that it would hurt her application -- would you prefer someone who has clearly planned a family around a residency or someone who might wait to take off in the middle? I would appreciate your thoughts, if anyone looks at this thread.
My feelings on the subject are.... it probably won't *help* her application since babies have a tendency to be.... time consuming. Especially after they are born. Legally, the program can't ask about her pregnancy or discriminate against her, but that doesn't mean they won't. That's pretty much how it would go down in the non-medical profession private sector anyway.
However, I could be wrong about this. There may be some residency programs that are particularly accommodating to parents, and I know that some specialties that are better about these sorts of things (Peds for instance).
During my Neurology externship one of the residents was out of there before 6 everyday to pick up his daughter at daycare. Practically every. single. resident. had a baby or toddler, and they were very laid back about the whole deal. Granted, he was a senior resident, and it was an easier rotation.... but I gotta say it helped sell me on Neurology, since I'd never even seen an attending do that on any of my other electives.
Also, Neurology is awesome.
BTW -- Kudos to your wife for tackling med school and having a baby in her late 20's/early 30's. I keep saying that I refuse to let becoming a doctor get in the way of the rest of my life, it's just easier said than done sometimes. It's good to see some people actually put that plan into action.
Anybody have any thoughts on this?
Sunday, December 20, 2009
Doggie Pics and Snowy House
Here is Boo. On our couch.
And again.
And again.
And playing with Luca.
Close up.
And here is the house in the snow.
And Luca's incredibly skillful driveway shovel.
Maybe later we can get some of Boo IN the snow with her new orange fleece. She moves pretty fast though. We'll see if we can get some good ones.
And again.
And again.
And playing with Luca.
Close up.
And here is the house in the snow.
And Luca's incredibly skillful driveway shovel.
Maybe later we can get some of Boo IN the snow with her new orange fleece. She moves pretty fast though. We'll see if we can get some good ones.
Saturday, December 19, 2009
Leaves
There's a guy on my block -- a professor at the business school associated with my university no less -- who has not raked the leaves off his sidewalk ONCE this entire fall. Our neighbor finally caved last week and did it for him because you literally could not pass on the sidewalk there were so many leaves.
He's also ruining the garden the previous owners of the house planted by not watering or weeding it, and by letting the leaves accumulate all over it.
And I know he's home. I see the light on in the basement every night. I wonder if he's playing video games or writing more fantasy sports software, since I know from his profile that's one of his hobbies.
He's so LAME.
It really bothers me.
So, when Boo pissed on the leaves that were collecting at the bottom of his steps, can you really blame me if I didn't tell her no?
Ah, neighborly love.
He's also ruining the garden the previous owners of the house planted by not watering or weeding it, and by letting the leaves accumulate all over it.
And I know he's home. I see the light on in the basement every night. I wonder if he's playing video games or writing more fantasy sports software, since I know from his profile that's one of his hobbies.
He's so LAME.
It really bothers me.
So, when Boo pissed on the leaves that were collecting at the bottom of his steps, can you really blame me if I didn't tell her no?
Ah, neighborly love.
Friday, December 18, 2009
Holy Cow!
They're expecting 14 inches of snow here by Sunday! It's going to start tonight!
I asked Luca to go grocery shopping tonight on his way home. Because we may not be leaving the house for a few days.
I guess it was fortuitous that Netflix gave us 4 videos at a time this week. Hopefully we won't go through them all tomorrow morning.
Oh well, at least we have the dog to play with. I wonder if she's ever seen snow before....
I asked Luca to go grocery shopping tonight on his way home. Because we may not be leaving the house for a few days.
I guess it was fortuitous that Netflix gave us 4 videos at a time this week. Hopefully we won't go through them all tomorrow morning.
Oh well, at least we have the dog to play with. I wonder if she's ever seen snow before....
Parenthood
Thursday was Luca's and my last day of unfettered freedom. At least for several years. That's because we adopted Boo, one of the Vet school spay dogs, yesterday.
(pictures later)
Last night we crated her when we went to bed and she cried for about 30 minutes until we told her to stop, without coming down to see her. Then she was quiet for most of the rest of the night.
My husband was freaked out of his mind. He found the crying really really upsetting. Perhaps this is a foreshadowing of what it will be like when we are Ferberizing our (future) offspring?
It didn't bother me that much to listen to her. I think that's because Iam a heartless bitch was expecting it. I do remember when we got Polly when I was 12, how upsetting it was to listen to her wail from the crate the first night we had her.
A few observations:
* I have never seen a dog attack a rawhide like she does. It is seriously incredible. She has already eaten through 1 end of the one we got her.
* She has a lot of energy and will need a lot of exercise (thank god we have a big house).
* She is not aggressive over her food at all. She let me move her bowl several times while she ate this morning. Even left it for a while to make sure that Luca and I were still around.
* Which will be fine once I get her to stop pulling on the lead. This is something I have to learn how to do, since all my dogs before were yard dogs, and only rarely walked. Any tips on how I do this?
We plan to crate her at night, and when we go out, and I'm going to be working at home most of the time for the next months or so while we get used to this transition.
Any other tips would be most appreciated.
(pictures later)
Last night we crated her when we went to bed and she cried for about 30 minutes until we told her to stop, without coming down to see her. Then she was quiet for most of the rest of the night.
My husband was freaked out of his mind. He found the crying really really upsetting. Perhaps this is a foreshadowing of what it will be like when we are Ferberizing our (future) offspring?
It didn't bother me that much to listen to her. I think that's because I
A few observations:
* I have never seen a dog attack a rawhide like she does. It is seriously incredible. She has already eaten through 1 end of the one we got her.
* She has a lot of energy and will need a lot of exercise (thank god we have a big house).
* She is not aggressive over her food at all. She let me move her bowl several times while she ate this morning. Even left it for a while to make sure that Luca and I were still around.
* Which will be fine once I get her to stop pulling on the lead. This is something I have to learn how to do, since all my dogs before were yard dogs, and only rarely walked. Any tips on how I do this?
We plan to crate her at night, and when we go out, and I'm going to be working at home most of the time for the next months or so while we get used to this transition.
Any other tips would be most appreciated.
Thursday, December 17, 2009
Citations
Of all the things I do in the name of research on a daily basis, FAR AND AWAY the least fun of them all is managing my citations.
BLEGH!!!
Which (of course) is what I am doing today.
Sit me in front of a database programming variables? Not a problem compared to this.
God, I hate EndNote.
BLEGH!!!
Which (of course) is what I am doing today.
Sit me in front of a database programming variables? Not a problem compared to this.
God, I hate EndNote.
The sight of a Luna bar makes me want to puke
Sometimes I look back on my pre-clinical years with a certain amount of nostalgia. It was at that time of my life that I could pretty much pee when I wanted and eat when and what I wanted. It was during the days before it became really really important to have that #2 before I walked out the front door in the morning.
I'm sorry to get graphic on you, dear readers. But alas, it is what it is.
I used to carry a big pink Nalgene and drink water out of it during class. I would snack too. And of course I peed every hour on the hour. I had adopted this habit sometime during my research job, and old habits die hard.
I think there's a reason that they had the Renal block so close to when our clinical rotations started. They wanted to tell us, "Students, despite what the media tells you, you do not have to have pale urine in order to be healthy. In fact, you will never have pale urine. Ever. Again." (Though I don't think they used those *exact* words....) In fact one of our esteemed professors was on NPR during our block dispensing with that very myth.
******
I started my clinical rotations that January with Peds, which was a nice way to make the transition. Though I was certain it would have been frowned upon to take an emergency potty break during rounds, I am also certain that it would not have been THAT a big deal. Also, the bathrooms were relatively plentiful, and as long as I peed before 8:30 when rounds started, I knew I'd be ok.
And they gave us lunch practically every day at noon teaching conferences! And there was even enough food for the lowly medical students. Usually.
I found that if I stopped gulping down water all the time, I didn't have to pee as often. Funny how that works. Remember how during elementary school when you didn't drink constantly throughout the day? And how somehow it was ok then, and you peed 2-3 times at school at most? My revelation was kind of like that.
And I have to say, it was kind of nice not to be ruled by my bladder anymore.
Then I moved on to OB/Gyn, my first surgical rotation. I was told to bring Luna bars with me so that I wouldn't starve during the 15 hour days. And I did. But I found that in between surgeries I was *usually* able to run down to the cafeteria, eat, and be back within 15 minutes or so.
It didn't happen every day though, and by the end of that rotation I couldn't look at a Luna bar without feeling nauseated. Every time I think of having to substitute eating a meal by eating a Luna bar it makes me feel a little depressed. They're not tasty like candy, and they don't provide sustenance like real food. To be honest, I can't stand them. I guess they're marginally better than PowerBars, but only by a little.
*****
It was during my final rotation of the year: Surgery, when I finally got the biological needs managed down to a science. Usually, I would eat breakfast at 5AM, be at the hospital by 5:30. Round. Eat a large breakfast sandwich at 7 and buy a bottle of water. I only allowed myself to take a few sips though, because I didn't want to have to pee in the next 6 hours at least. Of course if I drank nothing at all, I ran the risk that I would vagal at some point during the surgery, so that was not an option.
Then I would go help prep the patient and prepare for the first case of the day. At some point, someone would say, "Med student, you should go scrub," so I would run to the bathroom, pee, and then scrub in.
And I'd be good to go until at least 4. Sometimes later, though I'd be really really hungry by then. Never pass out hungry, just cranky headachey hungry. My stomach would have typically given up alerting me to its empty status by then, so I sometimes couldn't identify why I was so tired and cranky until I got home and ate some food.
But as long as I had that breakfast sandwich, the day felt survivable to me.
*****
And then I remember driving up to CT for Xmas that winter after finishing my surgery rotation and finding that I actually didn't have to pee during the 5 hour drive. And I didn't get hungry. It didn't matter that there was no food in the house and that "lunch" didn't occur until 5PM. I didn't absolutely *have* to eat on a schedule. It was quite liberating, actually.
*****
Now during my PhD, I'm back to working in front of my computer much of the day, and I find that it's easy to fall back into those pre-rotation rhythms. I eat lunch at 11AM because I am bored. I can use the bathroom when I want to, so I do. But there's no more pink Nalgene, so at least it's not every hour on the hour anymore.
While I wouldn't endorse my surgery routine as either healthy or desirable, I will say that I feel like it made me feel I had more control over my body than I had ever had before. It's kind of amazing what you can do if you have to.
And I never EVER want to have to resort to Luna bars again. Such a pathetic excuse for food, it's a pity they even have to exist. I would *almost* rather not eat at all.
I'm sorry to get graphic on you, dear readers. But alas, it is what it is.
I used to carry a big pink Nalgene and drink water out of it during class. I would snack too. And of course I peed every hour on the hour. I had adopted this habit sometime during my research job, and old habits die hard.
I think there's a reason that they had the Renal block so close to when our clinical rotations started. They wanted to tell us, "Students, despite what the media tells you, you do not have to have pale urine in order to be healthy. In fact, you will never have pale urine. Ever. Again." (Though I don't think they used those *exact* words....) In fact one of our esteemed professors was on NPR during our block dispensing with that very myth.
******
I started my clinical rotations that January with Peds, which was a nice way to make the transition. Though I was certain it would have been frowned upon to take an emergency potty break during rounds, I am also certain that it would not have been THAT a big deal. Also, the bathrooms were relatively plentiful, and as long as I peed before 8:30 when rounds started, I knew I'd be ok.
And they gave us lunch practically every day at noon teaching conferences! And there was even enough food for the lowly medical students. Usually.
I found that if I stopped gulping down water all the time, I didn't have to pee as often. Funny how that works. Remember how during elementary school when you didn't drink constantly throughout the day? And how somehow it was ok then, and you peed 2-3 times at school at most? My revelation was kind of like that.
And I have to say, it was kind of nice not to be ruled by my bladder anymore.
Then I moved on to OB/Gyn, my first surgical rotation. I was told to bring Luna bars with me so that I wouldn't starve during the 15 hour days. And I did. But I found that in between surgeries I was *usually* able to run down to the cafeteria, eat, and be back within 15 minutes or so.
It didn't happen every day though, and by the end of that rotation I couldn't look at a Luna bar without feeling nauseated. Every time I think of having to substitute eating a meal by eating a Luna bar it makes me feel a little depressed. They're not tasty like candy, and they don't provide sustenance like real food. To be honest, I can't stand them. I guess they're marginally better than PowerBars, but only by a little.
*****
It was during my final rotation of the year: Surgery, when I finally got the biological needs managed down to a science. Usually, I would eat breakfast at 5AM, be at the hospital by 5:30. Round. Eat a large breakfast sandwich at 7 and buy a bottle of water. I only allowed myself to take a few sips though, because I didn't want to have to pee in the next 6 hours at least. Of course if I drank nothing at all, I ran the risk that I would vagal at some point during the surgery, so that was not an option.
Then I would go help prep the patient and prepare for the first case of the day. At some point, someone would say, "Med student, you should go scrub," so I would run to the bathroom, pee, and then scrub in.
And I'd be good to go until at least 4. Sometimes later, though I'd be really really hungry by then. Never pass out hungry, just cranky headachey hungry. My stomach would have typically given up alerting me to its empty status by then, so I sometimes couldn't identify why I was so tired and cranky until I got home and ate some food.
But as long as I had that breakfast sandwich, the day felt survivable to me.
*****
And then I remember driving up to CT for Xmas that winter after finishing my surgery rotation and finding that I actually didn't have to pee during the 5 hour drive. And I didn't get hungry. It didn't matter that there was no food in the house and that "lunch" didn't occur until 5PM. I didn't absolutely *have* to eat on a schedule. It was quite liberating, actually.
*****
Now during my PhD, I'm back to working in front of my computer much of the day, and I find that it's easy to fall back into those pre-rotation rhythms. I eat lunch at 11AM because I am bored. I can use the bathroom when I want to, so I do. But there's no more pink Nalgene, so at least it's not every hour on the hour anymore.
While I wouldn't endorse my surgery routine as either healthy or desirable, I will say that I feel like it made me feel I had more control over my body than I had ever had before. It's kind of amazing what you can do if you have to.
And I never EVER want to have to resort to Luna bars again. Such a pathetic excuse for food, it's a pity they even have to exist. I would *almost* rather not eat at all.
Tuesday, December 15, 2009
The hidden curriculum: part 3
I remember the first two weeks of my medicine rotation. It was over a year and a half ago(!), and my team was great. Everyone seemed relatively relaxed, and were pleasant to each other. Even post-call. Even the attending. And the interns were brand-spanking-new and were still all wide eyed with terror.
I remember how my attending used to crack jokes on her service. We all laughed. Because her jokes were funny, not because we felt we had to.... though we would have laughed anyway.
One day we were rounding and had to go upstairs to see another patient, and she led the way (obviously). I brought up the rear (also obviously). And then she held the door for everyone at the top of the stairs so we could all walk through.
Panting (medicine is not so fantastic for the physical fitness), I arrived at the top of the stairs and kidded, "Aw, you didn't need to hold the door for me! That's my job!"
Apparently, the attending did NOT find this amusing.
At the end of the week, she told me that I really needed to be careful about the self-deprecating humor. And wouldn't you know, girlfriend wrote that in my review! (Don't you all fret now, I still got a good grade. I know you must be terribly concerned. And FYI, she was one of the better attendings I had on that rotation.)
So, lesson #3: Only the attending's jokes are funny.
And lesson #4: Never ever joke about the hidden curriculum. See, while in reality it may be the med student's job to hold the door for the team, fetch things, do other various scut, one must never actually poke fun at the role.
I still can't really figure out why rule #4 exists. Maybe because if you joke about the hidden curriculum, it implies that you haven't really bought into it hook, line, and sinker. And if you don't buy into it, that means you will be a bad, unprofessional (my favorite word) doctor.
For the record, I continued to flagrantly disregarded that rule during most of my rotations anyway, and usually people laughed. But also, usually these people were not attendings. I bit my tongue when they were around. That much I learned during my medicine rotation.
I remember how my attending used to crack jokes on her service. We all laughed. Because her jokes were funny, not because we felt we had to.... though we would have laughed anyway.
One day we were rounding and had to go upstairs to see another patient, and she led the way (obviously). I brought up the rear (also obviously). And then she held the door for everyone at the top of the stairs so we could all walk through.
Panting (medicine is not so fantastic for the physical fitness), I arrived at the top of the stairs and kidded, "Aw, you didn't need to hold the door for me! That's my job!"
Apparently, the attending did NOT find this amusing.
At the end of the week, she told me that I really needed to be careful about the self-deprecating humor. And wouldn't you know, girlfriend wrote that in my review! (Don't you all fret now, I still got a good grade. I know you must be terribly concerned. And FYI, she was one of the better attendings I had on that rotation.)
So, lesson #3: Only the attending's jokes are funny.
And lesson #4: Never ever joke about the hidden curriculum. See, while in reality it may be the med student's job to hold the door for the team, fetch things, do other various scut, one must never actually poke fun at the role.
I still can't really figure out why rule #4 exists. Maybe because if you joke about the hidden curriculum, it implies that you haven't really bought into it hook, line, and sinker. And if you don't buy into it, that means you will be a bad, unprofessional (my favorite word) doctor.
For the record, I continued to flagrantly disregarded that rule during most of my rotations anyway, and usually people laughed. But also, usually these people were not attendings. I bit my tongue when they were around. That much I learned during my medicine rotation.
Monday, December 14, 2009
Learning something
As I was working on a final project in which we have to review other peoples' grants, I realized that I actually knew how to design their studies now. In a way that I had no idea how to do at the beginning of the semester.
Sure, there's an awful lot I still don't know. But it made me feel SO MUCH BETTER to realize that I have actually learned something this block. Especially since I have so often felt that I know absolutely NOTHING as I go through this program for the past several months.
It feels pretty good, I have to tell you.
Still a long way to go, but little signs of progress are always encouraging. I think that this may really end up being worth it in the end.
Sure, there's an awful lot I still don't know. But it made me feel SO MUCH BETTER to realize that I have actually learned something this block. Especially since I have so often felt that I know absolutely NOTHING as I go through this program for the past several months.
It feels pretty good, I have to tell you.
Still a long way to go, but little signs of progress are always encouraging. I think that this may really end up being worth it in the end.
Sunday, December 13, 2009
Bebeeze
My husband only just now tells me that my mother-in-law was afraid that if we got a dog, we would no longer want babies.
(Since when was it babIES, anyway?)
I guess her fears were assuaged when she spoke to a friend. Apparently her friend had a son, and they got a dog and she worried about the same thing: that she would never have grandchildren. But her friend assured her that once her son saw he could handle having a dog, the first grandchild came shortly thereafter.
It's great to know that if nothing else, my reproductive capacity is valued. And now it makes more sense that they think a dog is a good idea all of a sudden.
:-P
(Since when was it babIES, anyway?)
I guess her fears were assuaged when she spoke to a friend. Apparently her friend had a son, and they got a dog and she worried about the same thing: that she would never have grandchildren. But her friend assured her that once her son saw he could handle having a dog, the first grandchild came shortly thereafter.
It's great to know that if nothing else, my reproductive capacity is valued. And now it makes more sense that they think a dog is a good idea all of a sudden.
:-P
Saturday, December 12, 2009
Happiness Project
For more thoughts on how to be an "anti-perfectionist" click here. I think this woman hit the nail on the head.
Show no fear
I was speaking to a colleague the other day about physical activity in girls. How it was true: at the beginning of 7th grade, all the kids -- girls included -- would run outside for recess, swing on the swings, jump rope, play. How we all participated in gym.
And then, sometime in the middle of 7th grade it suddenly became uncool to run to the swing set. To jump rope. Girls started sitting out in gym class "because they had their period." And it was accepted.
Eventually by the middle of 8th grade, I was one of only three girls who participated during gym.
I didn't really know what had happened. I clearly wasn't privy to the decision that had been made that running around and playing sports were uncool.
So I asked my colleague, as someone who studied this sort of thing: Did she know what happened? Did she know why girls stopped being active? How did they talk about this sort of thing with each other?*
She didn't know, but what she said next surprised me. She said, "Well, you were probably one of the popular girls in high school since you like sports so much." Sneering, biting tone of voice.
I was a bit taken aback For the record, I was not popular. See, I liked the wrong sports. At my high school only field hockey, soccer, ice hockey, and lacrosse were cool. This is what I told her.
Anyway, I wondered whether I looked or acted a particular way that reminded her of some girl who had been mean to her in high school. I've run across people like this myself, and I get this visceral reaction. Like, UGH! I can't stand this person! They're going to make me feel crappy about myself. They're going to gather all their friends and be collectively mean to me. Just like KH did in high school.
And they terrify me.
But then I have to remind myself that I am not actually in high school anymore, and that this isn't KH. I stomp my feelings of aversion and dislike to the background and act as though -- Of course this person is going to like me! Why wouldn't they! They aren't going to know that *I* feel this way unless I act like I do. I will show no fear, act like I belong. And then maybe I will. Enough to pass, anyway.
And so far, the strategy has worked. I've done really well with several of the residents and attendings to whom I've had this visceral "UGH!" reaction. And I've glad I've gotten to the point where I can fight these visceral feelings and work well with people like this. Even when they have acted like KH in some ways that make me cringe. I feel like I am able to push my feelings and fear out of the way *just* well enough to pass. Even if it's not the happiest, most pleasant thing for me at first, and I wouldn't want to have to do it all the time.
And once in a while, I discovered that my "Ugh!" feelings were completely wrong, and I'm glad that I didn't react to them. Because some of these people have actually turned out to be quite awesome.
Thank goodness I don't have to go through high school again.
*Do any of you guys know? I'm afraid I wasn't cool enough to be in the know about this sort of thing at age 12.
And then, sometime in the middle of 7th grade it suddenly became uncool to run to the swing set. To jump rope. Girls started sitting out in gym class "because they had their period." And it was accepted.
Eventually by the middle of 8th grade, I was one of only three girls who participated during gym.
I didn't really know what had happened. I clearly wasn't privy to the decision that had been made that running around and playing sports were uncool.
So I asked my colleague, as someone who studied this sort of thing: Did she know what happened? Did she know why girls stopped being active? How did they talk about this sort of thing with each other?*
She didn't know, but what she said next surprised me. She said, "Well, you were probably one of the popular girls in high school since you like sports so much." Sneering, biting tone of voice.
I was a bit taken aback For the record, I was not popular. See, I liked the wrong sports. At my high school only field hockey, soccer, ice hockey, and lacrosse were cool. This is what I told her.
Anyway, I wondered whether I looked or acted a particular way that reminded her of some girl who had been mean to her in high school. I've run across people like this myself, and I get this visceral reaction. Like, UGH! I can't stand this person! They're going to make me feel crappy about myself. They're going to gather all their friends and be collectively mean to me. Just like KH did in high school.
And they terrify me.
But then I have to remind myself that I am not actually in high school anymore, and that this isn't KH. I stomp my feelings of aversion and dislike to the background and act as though -- Of course this person is going to like me! Why wouldn't they! They aren't going to know that *I* feel this way unless I act like I do. I will show no fear, act like I belong. And then maybe I will. Enough to pass, anyway.
And so far, the strategy has worked. I've done really well with several of the residents and attendings to whom I've had this visceral "UGH!" reaction. And I've glad I've gotten to the point where I can fight these visceral feelings and work well with people like this. Even when they have acted like KH in some ways that make me cringe. I feel like I am able to push my feelings and fear out of the way *just* well enough to pass. Even if it's not the happiest, most pleasant thing for me at first, and I wouldn't want to have to do it all the time.
And once in a while, I discovered that my "Ugh!" feelings were completely wrong, and I'm glad that I didn't react to them. Because some of these people have actually turned out to be quite awesome.
Thank goodness I don't have to go through high school again.
*Do any of you guys know? I'm afraid I wasn't cool enough to be in the know about this sort of thing at age 12.
Friday, December 11, 2009
And speaking of the hidden curriculum....
Another thing they teach us without teaching us in med school is that people who need sleep to function are lazy. That your worth as a person is partially based on how little sleep you can survive on. That anything more than 6 hours is indulgent. That you haven't sufficiently filled your day with productive activity unless you are up at 5 and in bed at 11. That not sleeping is the only way you can truly be a good doctor *and* spend time with people you love.
And for the record, while I can't speak to motherhood (I hear it can be rough on the sleep for the first few years) I can tell you that there is no reason that you need to sleep deprive yourself during med school for the sake of studying. I didn't. Not once. Yet students talk about this all the time. And then ask, why am I so tired?
A great example of this is at topic days at Mothers in Medicine where the ladies are posting a "typical day in the life." Almost all of them abide by 5AM-11PM (or later!) schedule. I think there are only one or two who don't mention a bedtime at all..... but not a single one admits to getting a minute over 6 hours of sleep per night, even if their children are over the age of 10.
I did notice that the neurosurgeon attending doesn't need to tell us she only gets 6 hours of sleep per night. Maybe that's because she's already considered "tough" because she is a neurosurgeon, telling us that she's in the hospital from the moment she wakes up until she goes to bed at night, never seeing her family..... No need to brag about how little sleep *she* needs.
On one hand I'm thinking, "Maybe these people only really need 5-6 hours of sleep a night?"
On the other hand I'm thinking, "Maybe this is why so many of the 30-40 year old woman docs I know with children are such unpleasant snipey people?"
Or maybe they're really justbragging telling us that they are busy, hardworking people, who destroy themselves to take care of their patients and families. All while appearing happy and pert, making it look easy. Another metric of perfection, see?
I can tell you that I really need 8 hours of sleep to function properly. Even cutting to 7 every night wears me out if it's every night. 6? I will get sick-as-shit after about 2 weeks of this. And, really? You don't want to know me if I'm chronically sleep deprived because I become a totally different person. In a bad way (psychotic-bitch is an oft-used term). And I don't believe for one second that all of these ladies can truly "function" on so little sleep.
Oh and I'm sure that someone is going to comment that they *wish* they could get more than 6 hours, but they are just too busy to do so. That I am fortunate that my schedule permits me the "luxury" of 8 hours. My in-advance retort: Honey, I make sleep a priority because I can't do a good job without it. Life is too short to go through it as a sleep deprivedbitch unpleasant person.
So I'm holding out hope that I don't become (or have to become) like any of these mothers in medicine. EVER. Because it sounds uniformly horrible.
And no matter what, I'm never going to become someone whobrags talks about how little sleep I get in order to show everyone how hard working I am. Because frankly, that is just pathetic.
And for the record, while I can't speak to motherhood (I hear it can be rough on the sleep for the first few years) I can tell you that there is no reason that you need to sleep deprive yourself during med school for the sake of studying. I didn't. Not once. Yet students talk about this all the time. And then ask, why am I so tired?
A great example of this is at topic days at Mothers in Medicine where the ladies are posting a "typical day in the life." Almost all of them abide by 5AM-11PM (or later!) schedule. I think there are only one or two who don't mention a bedtime at all..... but not a single one admits to getting a minute over 6 hours of sleep per night, even if their children are over the age of 10.
I did notice that the neurosurgeon attending doesn't need to tell us she only gets 6 hours of sleep per night. Maybe that's because she's already considered "tough" because she is a neurosurgeon, telling us that she's in the hospital from the moment she wakes up until she goes to bed at night, never seeing her family..... No need to brag about how little sleep *she* needs.
On one hand I'm thinking, "Maybe these people only really need 5-6 hours of sleep a night?"
On the other hand I'm thinking, "Maybe this is why so many of the 30-40 year old woman docs I know with children are such unpleasant snipey people?"
Or maybe they're really just
I can tell you that I really need 8 hours of sleep to function properly. Even cutting to 7 every night wears me out if it's every night. 6? I will get sick-as-shit after about 2 weeks of this. And, really? You don't want to know me if I'm chronically sleep deprived because I become a totally different person. In a bad way (psychotic-bitch is an oft-used term). And I don't believe for one second that all of these ladies can truly "function" on so little sleep.
Oh and I'm sure that someone is going to comment that they *wish* they could get more than 6 hours, but they are just too busy to do so. That I am fortunate that my schedule permits me the "luxury" of 8 hours. My in-advance retort: Honey, I make sleep a priority because I can't do a good job without it. Life is too short to go through it as a sleep deprived
So I'm holding out hope that I don't become (or have to become) like any of these mothers in medicine. EVER. Because it sounds uniformly horrible.
And no matter what, I'm never going to become someone who
Take Care of Your Brains!
I got a call from my dad a few months back. He was really excited.
"I read this article that says that there's a form of Alzheimer's disease that you get from repeated head injury! Maybe my Grandpa X had THAT and not the genetic kind!"
My parents are beginning to get a little older, you see, and are terrified that they are going to develop dementia. My Dad especially.
You see, Grandpa X was diagnosed with Alzheimer's disease, back in the 70's or 80's, and ended up dying at the age of 89 in a nursing home after a long and unpleasant decline. But Grandpa X had also been a boxer when he'd fought during WWI. My dad was thinking: Maybe repeated head injury had caused his dementia, and not a defective ApoE gene!
Kind of like what you see in all those football players who become demented at age 45.
Machismo is a funny thing. They've been benching quarterbacks for a week these recent weeks when they get concussions, and it's been a pretty controversial high profile thing. I think many of the players think not going back in after you've been hit hard is a sign of weakness. In fact, one player made comments before the game started a few Sunday's ago, that he thought that the quarterback on his team was kind of a sissy -- certainly not a good leader -- for not playing following a concussion.
It made me think, "Wow, this man is really trashy."
I guess I find it a little scary that there's actually controversy surrounding this decision. And what's even scarier is the number of players that are ending up being benched.
As for my dad, I kind of hope he's right about grandpa X. Because I don't want that gene either.
"I read this article that says that there's a form of Alzheimer's disease that you get from repeated head injury! Maybe my Grandpa X had THAT and not the genetic kind!"
My parents are beginning to get a little older, you see, and are terrified that they are going to develop dementia. My Dad especially.
You see, Grandpa X was diagnosed with Alzheimer's disease, back in the 70's or 80's, and ended up dying at the age of 89 in a nursing home after a long and unpleasant decline. But Grandpa X had also been a boxer when he'd fought during WWI. My dad was thinking: Maybe repeated head injury had caused his dementia, and not a defective ApoE gene!
Kind of like what you see in all those football players who become demented at age 45.
Machismo is a funny thing. They've been benching quarterbacks for a week these recent weeks when they get concussions, and it's been a pretty controversial high profile thing. I think many of the players think not going back in after you've been hit hard is a sign of weakness. In fact, one player made comments before the game started a few Sunday's ago, that he thought that the quarterback on his team was kind of a sissy -- certainly not a good leader -- for not playing following a concussion.
It made me think, "Wow, this man is really trashy."
I guess I find it a little scary that there's actually controversy surrounding this decision. And what's even scarier is the number of players that are ending up being benched.
As for my dad, I kind of hope he's right about grandpa X. Because I don't want that gene either.
Wednesday, December 09, 2009
How I learned to stop asking questions in medical school
If you ever take a class with residents, fellows, or doctors, you might notice that nobody ever asks any questions. Well, maybe not nobody. But it is a rare occurrence.
Allow me to introduce you to the hidden curriculum of medical school. The one in which we become brainwashed into thinking that questions, sleep, intellectual curiosity, and anything other than helping your patients at all times are evil Evil EVIL.
Questions are evil because they waste other people's time. You should just look it up yourself you lazy med student! God.
I used to be a question asker. Now, not so much. Oh, I'll still ANSWER questions if asked. But not nearly so much as before medical school. And I've gotten so I kind of enjoy when an attending is teaching me in class now, and he's trying to get the class to participate. And NOBODY will ask a question.
I feel like, you or someone like you TRAINED me to be this way, buddy. Now EAT IT.
Anyhow.
When did I stop asking questions?
I was on rounds one day, and the attending was talking about sick euthyroid syndrome. I couldn't hear something she said, so I said, "What?"
And she said, "YOU," (She didn't know my name even though I'd been on her service over a week at that point.) "You're doing a presentation on this for tomorrow before rounds."
"I didn't say 'what' because I didn't understand what you were talking about. I DIDN'T HEAR YOU," I said.
Didn't matter.
From that point on I never uttered a word during rounds.
Let this be a lesson to you. Medical students are to be seen and not heard. And apparently, attendings are not to be heard either.
And that, my friends, is how I learned to stop asking questions during medical school.
Allow me to introduce you to the hidden curriculum of medical school. The one in which we become brainwashed into thinking that questions, sleep, intellectual curiosity, and anything other than helping your patients at all times are evil Evil EVIL.
Questions are evil because they waste other people's time. You should just look it up yourself you lazy med student! God.
I used to be a question asker. Now, not so much. Oh, I'll still ANSWER questions if asked. But not nearly so much as before medical school. And I've gotten so I kind of enjoy when an attending is teaching me in class now, and he's trying to get the class to participate. And NOBODY will ask a question.
I feel like, you or someone like you TRAINED me to be this way, buddy. Now EAT IT.
Anyhow.
When did I stop asking questions?
I was on rounds one day, and the attending was talking about sick euthyroid syndrome. I couldn't hear something she said, so I said, "What?"
And she said, "YOU," (She didn't know my name even though I'd been on her service over a week at that point.) "You're doing a presentation on this for tomorrow before rounds."
"I didn't say 'what' because I didn't understand what you were talking about. I DIDN'T HEAR YOU," I said.
Didn't matter.
From that point on I never uttered a word during rounds.
Let this be a lesson to you. Medical students are to be seen and not heard. And apparently, attendings are not to be heard either.
And that, my friends, is how I learned to stop asking questions during medical school.
Tuesday, December 08, 2009
Never ever buy a Lenovo
Next week we are doing a Mock Study Section in one of my classes. The twist is that the PhD students (i.e. me) are reviewing the grant applications of our classmates and presenting our comments to the group in a public forum.
Now, usually this would only be a little weird, but in this case it is especially so because one of my former attendings is in the class, and we are reviewing her grant.
As we were signing up to take the lead on these grants earlier today, I made sure I wasn't going to be the primary reviewer for hers. I am tertiary. Thankfully.
Still, it's a little awkward.
And I know she thinks so too because at the end of class today she came up to the group of us PhD students and asked who was primary reviewer. I could see a trace of relief when she found out it wasn't me.
*****
In other news, my computer crapped out again. It seems that once Lenovo got such fantastic reviews on Consumer Reports they thought to themselves, "Fantastic! I can install crappy components now and those suckers will continue to buy our product for at least another year!"
I wonder if this happens often. Someone should really do a study on it..... I can see it the headline now: Products that start to suck after CR gives good rating. Coincidence or Intentional?
At least I am pretty much backed up.
God it's annoying though.
*****
Luca and I are revisiting the idea of getting a dog. There is a VMD-PhD in Epi who I've been talking to who has been telling me about dogs they get through their spay program. I guess every week 10 or so shelter dogs come to the vet school and the students get to practice spaying them. Then they try to get their friends to adopt them.
Did you know? Spaying is a TAH-BSO (Total Abdominal hysterectomy - bilateral salpingo-oopherectomy) which I didn't realize. My friend showed me pictures of herself doing her first surgery, while another student was the anesthetist. Honestly? Being a vet student sounds AWESOME.
So we're looking at a dog this Friday. She is really cute.
So folks, please weigh in: Pit-lab mix. Pro? Con? We want a dog that is active and not tiny, but also that won't eat any future (human) offspring that we may have. I have big time reservations about the Pit part. Also, I've heard of people getting their homeowner's insurance dropped because they got a breed of dog thought to be aggressive.
Thoughts would be appreciated.
And no, we will NOT be getting a puppy. That would be way too much work.
Now, usually this would only be a little weird, but in this case it is especially so because one of my former attendings is in the class, and we are reviewing her grant.
As we were signing up to take the lead on these grants earlier today, I made sure I wasn't going to be the primary reviewer for hers. I am tertiary. Thankfully.
Still, it's a little awkward.
And I know she thinks so too because at the end of class today she came up to the group of us PhD students and asked who was primary reviewer. I could see a trace of relief when she found out it wasn't me.
*****
In other news, my computer crapped out again. It seems that once Lenovo got such fantastic reviews on Consumer Reports they thought to themselves, "Fantastic! I can install crappy components now and those suckers will continue to buy our product for at least another year!"
I wonder if this happens often. Someone should really do a study on it..... I can see it the headline now: Products that start to suck after CR gives good rating. Coincidence or Intentional?
At least I am pretty much backed up.
God it's annoying though.
*****
Luca and I are revisiting the idea of getting a dog. There is a VMD-PhD in Epi who I've been talking to who has been telling me about dogs they get through their spay program. I guess every week 10 or so shelter dogs come to the vet school and the students get to practice spaying them. Then they try to get their friends to adopt them.
Did you know? Spaying is a TAH-BSO (Total Abdominal hysterectomy - bilateral salpingo-oopherectomy) which I didn't realize. My friend showed me pictures of herself doing her first surgery, while another student was the anesthetist. Honestly? Being a vet student sounds AWESOME.
So we're looking at a dog this Friday. She is really cute.
So folks, please weigh in: Pit-lab mix. Pro? Con? We want a dog that is active and not tiny, but also that won't eat any future (human) offspring that we may have. I have big time reservations about the Pit part. Also, I've heard of people getting their homeowner's insurance dropped because they got a breed of dog thought to be aggressive.
Thoughts would be appreciated.
And no, we will NOT be getting a puppy. That would be way too much work.
Sunday, December 06, 2009
Couch Time
Luca and I went swimming this morning. It was a great workout. The thing that sucks though is that I usually come home to a mountain of work to do, when all I really want to do is eat mountains of carbs and lie on the couch.
This has a tendency to put me in a bad mood.
So today I allowed myself to lie on the couch for a few hours while I watched skiing with Luca on Universal Sports. Drifting in and out of consciousness, sandwiched comfortably between my husband and a nice warm blanket.
Now I'm awake and have to work. But! I'm not in a foul mood about it.
We'll see how this strategy works today. Maybe I'll have a productive evening too.
Sometimes a girl just needs a little couch time.
This has a tendency to put me in a bad mood.
So today I allowed myself to lie on the couch for a few hours while I watched skiing with Luca on Universal Sports. Drifting in and out of consciousness, sandwiched comfortably between my husband and a nice warm blanket.
Now I'm awake and have to work. But! I'm not in a foul mood about it.
We'll see how this strategy works today. Maybe I'll have a productive evening too.
Sometimes a girl just needs a little couch time.
Friday, December 04, 2009
Dear Clarissa
I received a question from a reader the other day having to do with medical school and its rigors.
Here it is below:
This is totally off topic, but assuming that you finished at the top of your class at UChicago, how hard have you found medical school? What has been the greatest challenge? Is the workload overwhelming? I'm trying to figure out if you can direct me to a specific website that explains the rigors of med school.
Just a background on me. I am in my second year of school at XXXX, getting a degree in psychology, while completing all premed requirements. I know, you must be thinking psych is a blow off major, and I think it is, but definitely would love to hear your opinion.
It just so happens that I was discussing this very topic with a friend of mine. I think this falls into the "is medical school really as hard as they say it is?" category.
Let's take these one by one:
1. How hard have you found medical school?
On a scale of 1-10, probably about a 6 or 7. My school does an excellent job of spoon feeding you the material and allowing you *just* enough free time to study. If you don't like something, it will usually be over in less than 6 weeks. Actually attending medical school hasn't been 1/2 as hard as realigning my life so that I could actually GO to medical school. Sure there has been a lot of work, but at least no matter what at the end of it all I will be a doctor. That means A LOT.
Do I work all the time? Yes. Do I have a social life? Not really. Do these things bother me? No. Let me give you an example day from 1st or second year:
7AM wake up
8AM-1PM Class (5 minute breaks each hour)
1PM-2PM lunch
2PM-3 to 5PM class/seminar of some sort
5PM-10PM study (possible break for workout/dinner)
10PM call/hang out with husband
11PM sleep
I remember thinking after I took the MCAT while working full time and I kept a similar schedule thinking, "Wow, I'm glad I never have to do THAT again."
Ha.
2. What has been the greatest challenge?
What has been hard (for me) about medical school has been finding where I fit in. Creating a new community here for myself. I had an awesome life in Chicago that I left when I came to medical school, and I am only now starting to find that here in Philadelphia. And I am a 4th year. It's really hard to go through medical school without a good support network, and medical school essentially takes a bunch of people who don't know each other, moves them to an unfamiliar city away from friends and family, and then doesn't give them enough time to make friends.
That is what has been hard for me about medical school.
3. Is the workload overwhelming?
Sometimes it feels like you are drinking information out of a fire hose. I always felt very overwhelmed at the beginning of a new block. Like there was no way I'd ever be able to learn all of that material. But if you study consistently and practice, you will do well, and I always did well in the end.
The people who get into trouble are the ones who try to put things off until the last minute and cram. If you instead take the attitude that you want to make this information a part of you, then you will benefit in the long run.
4. I'm trying to figure out if you can direct me to a specific website that explains the rigors of med school.
The reason doctors will try to dissuade others from becoming doctors themselves is that you really do work very hard for a very long time with not that fantastic payoff. A lot of people go into medicine and they have NO IDEA what having a job is like, let alone what it's like caring for patients or working 80 hours a week for 10 years of your life. Then they end up hating it and being bitter. And they don't realize that all their friends who became consultants, lawyers, and investment bankers are miserable too.
Remember, though you are at a very competitive college and everybody will tell you that you have to become a Dr. Lawyer, Consultant, Investment Banker, or PhD Academic -- THAT IS NOT TRUE!!! There are a ton of great careers out there that won't make you a slave. You might not get paid as much, but then, this is your life we're talking about. You just have to follow your passion.
Incidentally, why are you majoring in Psych if you think it "is a big blow off?" Do you even like it? You should be using this time to figure out what you love, not just jumping through the hoops you need to go on to the next step! What do you like to DO? I remember that this was a very hard question for me, and I just didn't know what I liked when I was 19 years old. It took years for me to figure out what I wanted and to have the balls to go for it.
In the end, medical school is hard. It has been worth it for me, and the workload has been manageable though all-consuming at times. The challenges you will face probably won't be what you expected. Don't let the hard work scare you away. Be scared if you don't know it's what you really want to do, and you haven't explored any other options.
As for websites? I don't know.... maybe www.medschoolhell.com. He left medicine completely though, and I don't know if he still posts. Some of his earlier stuff might be what you're looking for.
Here it is below:
This is totally off topic, but assuming that you finished at the top of your class at UChicago, how hard have you found medical school? What has been the greatest challenge? Is the workload overwhelming? I'm trying to figure out if you can direct me to a specific website that explains the rigors of med school.
Just a background on me. I am in my second year of school at XXXX, getting a degree in psychology, while completing all premed requirements. I know, you must be thinking psych is a blow off major, and I think it is, but definitely would love to hear your opinion.
It just so happens that I was discussing this very topic with a friend of mine. I think this falls into the "is medical school really as hard as they say it is?" category.
Let's take these one by one:
1. How hard have you found medical school?
On a scale of 1-10, probably about a 6 or 7. My school does an excellent job of spoon feeding you the material and allowing you *just* enough free time to study. If you don't like something, it will usually be over in less than 6 weeks. Actually attending medical school hasn't been 1/2 as hard as realigning my life so that I could actually GO to medical school. Sure there has been a lot of work, but at least no matter what at the end of it all I will be a doctor. That means A LOT.
Do I work all the time? Yes. Do I have a social life? Not really. Do these things bother me? No. Let me give you an example day from 1st or second year:
7AM wake up
8AM-1PM Class (5 minute breaks each hour)
1PM-2PM lunch
2PM-3 to 5PM class/seminar of some sort
5PM-10PM study (possible break for workout/dinner)
10PM call/hang out with husband
11PM sleep
I remember thinking after I took the MCAT while working full time and I kept a similar schedule thinking, "Wow, I'm glad I never have to do THAT again."
Ha.
2. What has been the greatest challenge?
What has been hard (for me) about medical school has been finding where I fit in. Creating a new community here for myself. I had an awesome life in Chicago that I left when I came to medical school, and I am only now starting to find that here in Philadelphia. And I am a 4th year. It's really hard to go through medical school without a good support network, and medical school essentially takes a bunch of people who don't know each other, moves them to an unfamiliar city away from friends and family, and then doesn't give them enough time to make friends.
That is what has been hard for me about medical school.
3. Is the workload overwhelming?
Sometimes it feels like you are drinking information out of a fire hose. I always felt very overwhelmed at the beginning of a new block. Like there was no way I'd ever be able to learn all of that material. But if you study consistently and practice, you will do well, and I always did well in the end.
The people who get into trouble are the ones who try to put things off until the last minute and cram. If you instead take the attitude that you want to make this information a part of you, then you will benefit in the long run.
4. I'm trying to figure out if you can direct me to a specific website that explains the rigors of med school.
The reason doctors will try to dissuade others from becoming doctors themselves is that you really do work very hard for a very long time with not that fantastic payoff. A lot of people go into medicine and they have NO IDEA what having a job is like, let alone what it's like caring for patients or working 80 hours a week for 10 years of your life. Then they end up hating it and being bitter. And they don't realize that all their friends who became consultants, lawyers, and investment bankers are miserable too.
Remember, though you are at a very competitive college and everybody will tell you that you have to become a Dr. Lawyer, Consultant, Investment Banker, or PhD Academic -- THAT IS NOT TRUE!!! There are a ton of great careers out there that won't make you a slave. You might not get paid as much, but then, this is your life we're talking about. You just have to follow your passion.
Incidentally, why are you majoring in Psych if you think it "is a big blow off?" Do you even like it? You should be using this time to figure out what you love, not just jumping through the hoops you need to go on to the next step! What do you like to DO? I remember that this was a very hard question for me, and I just didn't know what I liked when I was 19 years old. It took years for me to figure out what I wanted and to have the balls to go for it.
In the end, medical school is hard. It has been worth it for me, and the workload has been manageable though all-consuming at times. The challenges you will face probably won't be what you expected. Don't let the hard work scare you away. Be scared if you don't know it's what you really want to do, and you haven't explored any other options.
As for websites? I don't know.... maybe www.medschoolhell.com. He left medicine completely though, and I don't know if he still posts. Some of his earlier stuff might be what you're looking for.
Funny thing
Every couple of mornings, I see one of the new hot shot woman faculty members that we just wooed to my institution in the locker room. She is also an avid swimmer. She taught one of my classes, and I *thought* she recognized me, but wasn't sure, so I never said anything.
Plus, you never know how someone is going to react if you start talking to them when they are standing there in a towel.
Well, this morning I decided to break my silence. I was sure that she must have thought I was stalking her since I kept looking over her way in the mirror as I combed my hair.
And it turned out to be a very pleasant conversation. We talked about how my department is a bit of a boy's club, swimming, the head of my department (and how he plays squash with all the man-fellows in the department).
She also mentioned a meeting which took place quite recently in which it was once again debated whether my grad group should recruit MD-PhDs. Oh and how to fund them.
I laughed. That meeting happened because of me and my alleged "lack of focus." Truth? They don't know how to deal with the fact that it may take a little while for an MD-PhD student to pin down ONE research interest after just having his/her eyes opened by medical school. I'm not sure why having more than one interest is a considered a problem.... Anyway.
I was glad I stopped to talk to her. She was really nice, and certainly has an interesting perspective as the new hot-shot woman in the department.
Plus, you never know how someone is going to react if you start talking to them when they are standing there in a towel.
Well, this morning I decided to break my silence. I was sure that she must have thought I was stalking her since I kept looking over her way in the mirror as I combed my hair.
And it turned out to be a very pleasant conversation. We talked about how my department is a bit of a boy's club, swimming, the head of my department (and how he plays squash with all the man-fellows in the department).
She also mentioned a meeting which took place quite recently in which it was once again debated whether my grad group should recruit MD-PhDs. Oh and how to fund them.
I laughed. That meeting happened because of me and my alleged "lack of focus." Truth? They don't know how to deal with the fact that it may take a little while for an MD-PhD student to pin down ONE research interest after just having his/her eyes opened by medical school. I'm not sure why having more than one interest is a considered a problem.... Anyway.
I was glad I stopped to talk to her. She was really nice, and certainly has an interesting perspective as the new hot-shot woman in the department.
Thursday, December 03, 2009
Danskos are not a fashion statement!!!
I don't know if this happens to everyone, but right before my clerkships started I ran out to the comfy-shoe store located near our hospital with a group of like-minded med school friends, and bought myself a pair of Danskos.
We all proceeded to wear them constantly for the next few weeks. Everywhere. To you know, break them in.
Right.
We wore them to class. We wore them out on the weekends. We wore them to visit our relatives over Christmas. I think some of us may have even convinced ourselves that they made us more fashionable.
It was in kind of the same way that med students wear their short white coats in public as a status symbol. Until they realize that there is no status associated with being a med student.
Danskos truly are very comfortable shoes. Especially when you have to stand around for long periods of time.
But there comes a time in every med student's life when we realize that that is all they are. And that they are meant for the hospital and NO. WHERE. ELSE.
I think I came to this conclusion early on because I did a surgical rotation as one of my earlier rotations. The classmate I was paired up with didn't have a pair of Danksos. He wore sneakers instead. And after about a week of OR time, I noticed the blood stains on his shoes.
I thought to myself: surely I must have these on my shoes now too. Only I cannot see them because they are black.
And then I proceeded to imagine myself tracking blood, urine, feces, organs, tumor, and whatever else finds its way to the floor of the OR, not only all over the Philadelphia sidewalks on my walks home from the hospital, but also all over the clean floors of my apartment.
And quite frankly (as you might expect), I found the thought kind of revolting.
I don't know if it was that or the fact that my Danskos became psychologically associated with the hospital (much in the same way that the little nokia phones have become) and that made them very unappealing to wear under normal life circumstances. Kind of like how I never want to wear my work clothes on the weekends.
Suffice to say since I have not been in the clinics, my Danskos have been stored safely in the back of my closet.
Also, they are UG-LY. They make my already large feet look like boats. This is another reason for not wearing them unless necessary. And really? They are only meant to be worn with scrubs. As in: They are not a substitute for Uggs!
But every so often I will still see a classmate -- or even sometimes an ATTENDING -- wearing Danskos around for regular life events. One fellow in my program has a pair of patent leather Danskos that she wears almost every day with her regular clothes (and no she isn't at the hospital every day). I even caught her wearing them with a SKIRT last week.
That would be a fashion-NO kids.
Not to mention that those suckers were highly shiny and reflective if you know what I mean. I wonder how often she catches her patients staring at her shoes.....
So to me, the three giant fashion faux-pas to avoid as a medical professional are:
1. Never wear your white coat outside the hospital (even if you are walking there from home), as it just screams "I am a douche-bag medical student."
2. Never wear scrubs outside the hospital to a friend's house to "hang out" or as pajamas. See above for reason.
3. And never wear your Danskos outside the hospital. You just don't know where those puppies have been. And also, they are just not attractive.
We all proceeded to wear them constantly for the next few weeks. Everywhere. To you know, break them in.
Right.
We wore them to class. We wore them out on the weekends. We wore them to visit our relatives over Christmas. I think some of us may have even convinced ourselves that they made us more fashionable.
It was in kind of the same way that med students wear their short white coats in public as a status symbol. Until they realize that there is no status associated with being a med student.
Danskos truly are very comfortable shoes. Especially when you have to stand around for long periods of time.
But there comes a time in every med student's life when we realize that that is all they are. And that they are meant for the hospital and NO. WHERE. ELSE.
I think I came to this conclusion early on because I did a surgical rotation as one of my earlier rotations. The classmate I was paired up with didn't have a pair of Danksos. He wore sneakers instead. And after about a week of OR time, I noticed the blood stains on his shoes.
I thought to myself: surely I must have these on my shoes now too. Only I cannot see them because they are black.
And then I proceeded to imagine myself tracking blood, urine, feces, organs, tumor, and whatever else finds its way to the floor of the OR, not only all over the Philadelphia sidewalks on my walks home from the hospital, but also all over the clean floors of my apartment.
And quite frankly (as you might expect), I found the thought kind of revolting.
I don't know if it was that or the fact that my Danskos became psychologically associated with the hospital (much in the same way that the little nokia phones have become) and that made them very unappealing to wear under normal life circumstances. Kind of like how I never want to wear my work clothes on the weekends.
Suffice to say since I have not been in the clinics, my Danskos have been stored safely in the back of my closet.
Also, they are UG-LY. They make my already large feet look like boats. This is another reason for not wearing them unless necessary. And really? They are only meant to be worn with scrubs. As in: They are not a substitute for Uggs!
But every so often I will still see a classmate -- or even sometimes an ATTENDING -- wearing Danskos around for regular life events. One fellow in my program has a pair of patent leather Danskos that she wears almost every day with her regular clothes (and no she isn't at the hospital every day). I even caught her wearing them with a SKIRT last week.
That would be a fashion-NO kids.
Not to mention that those suckers were highly shiny and reflective if you know what I mean. I wonder how often she catches her patients staring at her shoes.....
So to me, the three giant fashion faux-pas to avoid as a medical professional are:
1. Never wear your white coat outside the hospital (even if you are walking there from home), as it just screams "I am a douche-bag medical student."
2. Never wear scrubs outside the hospital to a friend's house to "hang out" or as pajamas. See above for reason.
3. And never wear your Danskos outside the hospital. You just don't know where those puppies have been. And also, they are just not attractive.
Wednesday, December 02, 2009
Heat
Ok, I will admit that I like it to be warm when I am studying. This is mostly because when I have to sit still for extended periods of time I get really really cold, start actively shivering, and my fingers cease to be able to type because they become NUMB.
I also understand that when you walk into a room from the outside, it will feel HOT. Much hotter than it would say.... if you sat there for a few hours studying.
And I will notice immediately when the heat is turned off. I did notice.
Why is it that nobody else understands this?
What gets me are the people who waltz into a room -- that isn't even their office -- and turn the heat down without asking anybody if they mind.
And why is it more socially acceptable to want the room cold than hot?
Well let me put it this way, if you can't bring yourself to care if I am cold, then I can't bring myself to care if you are hot.
Leave.
Go back to YOUR office, where you have control over YOUR thermostat. I don't want you here anyway. This is the only place I have to study. You have other choices, why don't you use them?
I have fought the war of the thermostat before. I will win this time too.
I also understand that when you walk into a room from the outside, it will feel HOT. Much hotter than it would say.... if you sat there for a few hours studying.
And I will notice immediately when the heat is turned off. I did notice.
Why is it that nobody else understands this?
What gets me are the people who waltz into a room -- that isn't even their office -- and turn the heat down without asking anybody if they mind.
And why is it more socially acceptable to want the room cold than hot?
Well let me put it this way, if you can't bring yourself to care if I am cold, then I can't bring myself to care if you are hot.
Leave.
Go back to YOUR office, where you have control over YOUR thermostat. I don't want you here anyway. This is the only place I have to study. You have other choices, why don't you use them?
I have fought the war of the thermostat before. I will win this time too.
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