About a month ago there was a dog park meeting. Since we had just joined, Luca and I received only one notice about the meeting 1 day before it was going to take place. As it happened, we had dog school that night, so were unable to attend.
Apparently this was not an uncommon problem. There are 125 members, but only 25 of them attended the meeting.
During the meeting, the people present complained about this apparent lack of devotion to the dog park by the other members. About how part of the requirement for membership is that you perform community service for the park. About how they're going to make people accountable for the community service by refusing to allow people to renew who haven't done enough of it.
So. I signed up to do the website design.
A friend of mine signed up to be the beautification chair. He'd been trying to get a beautification day organized for some time -- about 6 months or so, but he doesn't know a lot about plants. He asked the people who had been in charge of beautification before him to tell him which were the plants we wanted to keep, and which were the weeds. He requested their help numerous times over 6 months, and received exactly NO response.
Then he organized a beautification day. Of course it rained, but he and 2-3 other people came after the rain stopped and did some gardening. It looked nice, actually. I mean, I don't know what the general plan for the park is, but to me it looked fine.
But then the people who never responded to his requests for assistance started complaining that he had ripped out some perennials. They complained to some of the older members of the park about how awful this new person was, and how he shouldn't have done anything without consulting them first. How much of their previous work had been destroyed.
And then people who a) never had any interest in beautification, and b) provided no feedback to my friend whatsoever BEFORE the beautification took place (and he sent many, many requests out) are all bitching and moaning about how awful he is.
!!
It's kind of remarkable to me, but when I say anything about it to Luca, he just says that this is how volunteer organizations work.
I'm now wondering if I've made a huge mistake to sign up for the website. Am I going to piss off people who want it done some other way? I am hoping that people will just be pleased to see pictures of the park and their dogs online, and that it will facilitate membership lists, logging volunteer hours, and payment, but given the outspoken opposition to the new person taking initiative to do beautification when nobody else stepped up to the plate for a year, I wonder if people will complain no matter what I do with the website as well.
Oh well, at very least it will be a good way to procrastinate.
Saturday, July 31, 2010
Friday, July 30, 2010
Deep Breaths
Today I met with the Administrator of the MSTP program. It was a great conversation. Very useful. And it confirmed some of the things I've been thinking about career-wise for myself lately.
The long and the short of it: How am I going to integrate my research career with clinical medicine? What type of residency / fellowship should I plan on doing? What programs have people who are interested in the types of problems I have been researching? What programs have jobs for people like me?
I know, graduation's still 4 years away (well, a little less now....). But I really do have to decide what type of residency to pursue well in advance of that.
Here's what my final year will look like:
Final Year of Program
Apr - wrap up dissertation
May - defend dissertation (c/b April)
Jun - clinical elective
Jul - clinical elective
Aug - clinical elective
Sep - clinical elective
Oct - elective? step 2 CS if not already done
Nov - Dean’s ltr out Nov 1; elective? research? interviewing? step 2 CK if not already done
Dec-Jan - interviewing (and elective? research?)
Feb-Apr - bioethics, CSI, elective? research? etc
May - graduate
I'd like to know a year in advance of the final year what type of residency I'd like to pursue. This is to give me the chance to do some clinical time on a regular basis with a faculty mentor in my field of choosing. The idea is a) that I will look like less of an idiot when I rejoin clinical medicine, and b) I'll have someone who would (I hope) be willing to write me a letter of recommendation. That choice needs to be made in less than 2 years. (One if I'm going to do the PhD in 3 yrs.... which is probably not going to happen, haha.)
!!!!
And how will I do that if I'm not actively in the clinics, you may ask? Well, I can go shadow, I can attend grand rounds and seminars in the departments I'm interested in, I can do something (shift? shadow? both?) in the ER or MICU, have coffee with various people who work in different departments, network, etc. My assignment from this meeting was to actually set something up for myself that is oriented towards figuring out what field I want to pursue each and every week.
AHHHHH!!!!!!
I think it's going to be a good idea, but I am a little terrified for some reason!
So let's do a quick rundown of the fields that are still on the table:
1. Neurology -- I love neurology. I love the nerds who go into it. I love the imaging, the path, the fact that there's a lot of medicine, but the focus is not on gout and CHF. I love the neuro exam and the anatomy. But the problem is, I'm not sure most neurologists really "get" what I do. I've talked to them, and told them what my research is in, and I get a "huh, I don't know what that is, and I don't care to" kind of attitude. I get this a little less with the clinical researchers, but even most of them are more basic science oriented. And while it's true that it means the field is wiiiiiiiddddeeeee open, it also means that there may not be any jobs available doing research in what I'm interested in. And THAT could be a big problem down the line.
2. Internal Medicine -- I loved my sub-i, but I did not love my medicine rotation. And unfortunately, it was mostly because of the people I worked with. Even more unfortunately, that trend has continued somewhat since I started my PhD. Sure, there are medicine people I really like, but a few of the fellows who do the specialty that I am most interested in my department seem to have gone out of their ways to be dicks to me. And I'm sorry, it's really a turn off. But on the "pro" side, I love taking a history, coming up with an assessment and plan, and then following the patient through a hospital stay. I love the social issues. I love that you have to know a bit about everything. And for my research -- my research IS general internal med research. I know for a fact that there are people who have the kinds of careers I want who are internists. There are jobs. And also? People in IM "get" what I do. That's a huge plus.
The next question with IM is: If I were to do IM, then what kind of fellowship would I do? Would I want to fast track (trade a year of residency for an extra research year in fellowship)? Can you even do that with critical care? Would I want to do a general internal med fellowship like my mentors from U Chicago did? And also, if I did any of this, would I like the people in IM better at other institutions? What institutions would that be?
3. Emergency Medicine -- Better lifestyle than IM, and the people are a lot of fun. I love being in the ED. I love being in the hospital at wacky hours. Also, there is a sh*t-ton of clinical research done by ED people who actually have the time to do it! The injury epi people in my department are some of the coolest people I've met at my institution, and I would love to collaborate with them, should my life go down that path. I also love that you do procedures in the ED, and that you see such a wide variety of patients. You have acuity, and you have primary care for poor people who can't get it elsewhere. You even have a bit of peds. The only issues are a) I like talking to my patients, and there's not so much time for that in the ED, b) they mostly stabilize and leaving a lot of the differential diagnosis part for the medicine folks upstairs. On the other hand, I love the pace. Something to think about anyway.
4. Psychiatry -- You all know how I love this field. The quirky doctors AND the quirky patients. But it has some of the same problems as Neurology has. I also worry that I'd miss the rest of medicine.
5. Anesthesia -- Has fallen on my list somewhat. The problem is that I really like critical care, and most doctors who do this do it via IM. That is because, once you've trained to be an OR doc, why would you want to do 2 more years of fellowship to take a 100K pay cut and work longer hours. Also Anesthesiologists don't get to talk to their patients. Well, at least not how I want to talk to them. I do so love taking that history and writing that plan! And there's the problem of getting protected time to do your research. Since Anesthesia is so well reimbursed, hospitals tend to prefer that you spend your time in the OR rather than doing research. This isn't a universal truth, but it is true a lot of places.
And God, then we started talking about where in the country I would do residency/fellowship. While I network, I guess I also have to figure out where there are jobs. What institutions are interested in people who do the kinds of research I want to do.
Can I get another AHHHHHHHHHHHHHH!!!!!!!!!!!!!!
Of course this gets even more complicated with the husband in the picture, because we need to ultimately find him a job wherever I go as well. Ok, scary thoughts. I don't even want to think about it right now!
I really should get back to my SAS.
The long and the short of it: How am I going to integrate my research career with clinical medicine? What type of residency / fellowship should I plan on doing? What programs have people who are interested in the types of problems I have been researching? What programs have jobs for people like me?
I know, graduation's still 4 years away (well, a little less now....). But I really do have to decide what type of residency to pursue well in advance of that.
Here's what my final year will look like:
Final Year of Program
Apr - wrap up dissertation
May - defend dissertation (c/b April)
Jun - clinical elective
Jul - clinical elective
Aug - clinical elective
Sep - clinical elective
Oct - elective? step 2 CS if not already done
Nov - Dean’s ltr out Nov 1; elective? research? interviewing? step 2 CK if not already done
Dec-Jan - interviewing (and elective? research?)
Feb-Apr - bioethics, CSI, elective? research? etc
May - graduate
I'd like to know a year in advance of the final year what type of residency I'd like to pursue. This is to give me the chance to do some clinical time on a regular basis with a faculty mentor in my field of choosing. The idea is a) that I will look like less of an idiot when I rejoin clinical medicine, and b) I'll have someone who would (I hope) be willing to write me a letter of recommendation. That choice needs to be made in less than 2 years. (One if I'm going to do the PhD in 3 yrs.... which is probably not going to happen, haha.)
!!!!
And how will I do that if I'm not actively in the clinics, you may ask? Well, I can go shadow, I can attend grand rounds and seminars in the departments I'm interested in, I can do something (shift? shadow? both?) in the ER or MICU, have coffee with various people who work in different departments, network, etc. My assignment from this meeting was to actually set something up for myself that is oriented towards figuring out what field I want to pursue each and every week.
AHHHHH!!!!!!
I think it's going to be a good idea, but I am a little terrified for some reason!
So let's do a quick rundown of the fields that are still on the table:
1. Neurology -- I love neurology. I love the nerds who go into it. I love the imaging, the path, the fact that there's a lot of medicine, but the focus is not on gout and CHF. I love the neuro exam and the anatomy. But the problem is, I'm not sure most neurologists really "get" what I do. I've talked to them, and told them what my research is in, and I get a "huh, I don't know what that is, and I don't care to" kind of attitude. I get this a little less with the clinical researchers, but even most of them are more basic science oriented. And while it's true that it means the field is wiiiiiiiddddeeeee open, it also means that there may not be any jobs available doing research in what I'm interested in. And THAT could be a big problem down the line.
2. Internal Medicine -- I loved my sub-i, but I did not love my medicine rotation. And unfortunately, it was mostly because of the people I worked with. Even more unfortunately, that trend has continued somewhat since I started my PhD. Sure, there are medicine people I really like, but a few of the fellows who do the specialty that I am most interested in my department seem to have gone out of their ways to be dicks to me. And I'm sorry, it's really a turn off. But on the "pro" side, I love taking a history, coming up with an assessment and plan, and then following the patient through a hospital stay. I love the social issues. I love that you have to know a bit about everything. And for my research -- my research IS general internal med research. I know for a fact that there are people who have the kinds of careers I want who are internists. There are jobs. And also? People in IM "get" what I do. That's a huge plus.
The next question with IM is: If I were to do IM, then what kind of fellowship would I do? Would I want to fast track (trade a year of residency for an extra research year in fellowship)? Can you even do that with critical care? Would I want to do a general internal med fellowship like my mentors from U Chicago did? And also, if I did any of this, would I like the people in IM better at other institutions? What institutions would that be?
3. Emergency Medicine -- Better lifestyle than IM, and the people are a lot of fun. I love being in the ED. I love being in the hospital at wacky hours. Also, there is a sh*t-ton of clinical research done by ED people who actually have the time to do it! The injury epi people in my department are some of the coolest people I've met at my institution, and I would love to collaborate with them, should my life go down that path. I also love that you do procedures in the ED, and that you see such a wide variety of patients. You have acuity, and you have primary care for poor people who can't get it elsewhere. You even have a bit of peds. The only issues are a) I like talking to my patients, and there's not so much time for that in the ED, b) they mostly stabilize and leaving a lot of the differential diagnosis part for the medicine folks upstairs. On the other hand, I love the pace. Something to think about anyway.
4. Psychiatry -- You all know how I love this field. The quirky doctors AND the quirky patients. But it has some of the same problems as Neurology has. I also worry that I'd miss the rest of medicine.
5. Anesthesia -- Has fallen on my list somewhat. The problem is that I really like critical care, and most doctors who do this do it via IM. That is because, once you've trained to be an OR doc, why would you want to do 2 more years of fellowship to take a 100K pay cut and work longer hours. Also Anesthesiologists don't get to talk to their patients. Well, at least not how I want to talk to them. I do so love taking that history and writing that plan! And there's the problem of getting protected time to do your research. Since Anesthesia is so well reimbursed, hospitals tend to prefer that you spend your time in the OR rather than doing research. This isn't a universal truth, but it is true a lot of places.
And God, then we started talking about where in the country I would do residency/fellowship. While I network, I guess I also have to figure out where there are jobs. What institutions are interested in people who do the kinds of research I want to do.
Can I get another AHHHHHHHHHHHHHH!!!!!!!!!!!!!!
Of course this gets even more complicated with the husband in the picture, because we need to ultimately find him a job wherever I go as well. Ok, scary thoughts. I don't even want to think about it right now!
I really should get back to my SAS.
My little experiment
Luca just came back from a conference in Salt Lake City last night. It was great to see him again, since he'd been gone for 5 days.
To entertain myself in his absence, I'd been watching The Hills on Netflix, which he finds to be insipid. And it is, but I've been enjoying it anyway. My favorite thing to do while watching that show is to replace the word "kiss"(as in, "Did you kiss him?" or "We went back to his place and kissed," which I swear is uttered at least once an episode) with "have sex with." Because we all know that's what's really happening. Little hos.
Anyhow.
So Luca had asked me if I wanted to come to SLC with him, and it sounded like a good idea..... until I realized that he'd be at the conference from 8A-10P every day and I'd be sitting on my ass in his hotel room. Oh sure, I could go out by myself, but what would be the point? And we'd have had to board the Boo.
Plus, I wanted to do an experiment with the Boo that required Luca's absence.
What's this, you say? You're experimenting on your dog? What kind of person are you?
Don't be idiotic.
You see, Miss. Boo sleeps in the crate every night right next to our bed. The bed is too tall for her to jump up comfortably -- well, she used to jump up until she fell on her ass once, little klutz -- so every night we lift her up before bed for a tummy rub and wallowing in the blankets session. Then we tell her "Crate" and she hops off and goes to lie down in her crate. It's really cute actually.
My experiment was that I wanted to see how Miss. Boo would take to sleeping on the bed ALL NIGHT LONG. And now that it's over? Well, I wouldn't say that it was a complete failure..... but let's just say Miss. Boo really likes her crate.
The first night started off ok, until I heard a bang at about 1AM. Poor Miss. Boo had fallen off the bed! I decided that was enough bed for one night and sent her to her crate, where she happily slept the rest of the night.
The second night she slept pretty well at the foot of the bed, repositioning herself a few times. What amazed me was how much the bed bounced around when she moved though. There was one crotch licking session that had to have lasted for 10-15 minutes at 3AM. It's just not what a girl wants to be woken up to, is all I have to say.
The third night went a little better. A few awakenings, and she then very cutely came up from the foot of the bed to snuggle with me before we got up in the morning.
The fourth night however, she decided she actually wanted to snuggle ALL NIGHT, and kept coming up to put her head on my pillow. Gah!
And the final night, she just couldn't get comfortable and kept walking around the bed trying to reposition herself. I think she might have been cold, so I turned the A/C up a few degrees and that seemed to help.
I should add, Miss Boo also slept very soundly during the DAYS when Luca was away. Perhaps the Boo was not sleeping well either those nights?
Anyway, last night Luca was back, and we were a little worried that the Boo would not want to go back to the crate. Um..... nope! It was like she was saying, "Thank God you're home daddy and I don't have to sleep on this f-ing bed anymore with OMDG!" This morning she awoke refreshed and had a long drink from my toilet (her new discovery of late) ready to go for her morning walk
I think someone is a little attached to her crate, don't you? Poor Miss. Boo! I promise I won't experiment on you (much) in the future. And definitely not with your sleeping arrangement!
To entertain myself in his absence, I'd been watching The Hills on Netflix, which he finds to be insipid. And it is, but I've been enjoying it anyway. My favorite thing to do while watching that show is to replace the word "kiss"(as in, "Did you kiss him?" or "We went back to his place and kissed," which I swear is uttered at least once an episode) with "have sex with." Because we all know that's what's really happening. Little hos.
Anyhow.
So Luca had asked me if I wanted to come to SLC with him, and it sounded like a good idea..... until I realized that he'd be at the conference from 8A-10P every day and I'd be sitting on my ass in his hotel room. Oh sure, I could go out by myself, but what would be the point? And we'd have had to board the Boo.
Plus, I wanted to do an experiment with the Boo that required Luca's absence.
What's this, you say? You're experimenting on your dog? What kind of person are you?
Don't be idiotic.
You see, Miss. Boo sleeps in the crate every night right next to our bed. The bed is too tall for her to jump up comfortably -- well, she used to jump up until she fell on her ass once, little klutz -- so every night we lift her up before bed for a tummy rub and wallowing in the blankets session. Then we tell her "Crate" and she hops off and goes to lie down in her crate. It's really cute actually.
My experiment was that I wanted to see how Miss. Boo would take to sleeping on the bed ALL NIGHT LONG. And now that it's over? Well, I wouldn't say that it was a complete failure..... but let's just say Miss. Boo really likes her crate.
The first night started off ok, until I heard a bang at about 1AM. Poor Miss. Boo had fallen off the bed! I decided that was enough bed for one night and sent her to her crate, where she happily slept the rest of the night.
The second night she slept pretty well at the foot of the bed, repositioning herself a few times. What amazed me was how much the bed bounced around when she moved though. There was one crotch licking session that had to have lasted for 10-15 minutes at 3AM. It's just not what a girl wants to be woken up to, is all I have to say.
The third night went a little better. A few awakenings, and she then very cutely came up from the foot of the bed to snuggle with me before we got up in the morning.
The fourth night however, she decided she actually wanted to snuggle ALL NIGHT, and kept coming up to put her head on my pillow. Gah!
And the final night, she just couldn't get comfortable and kept walking around the bed trying to reposition herself. I think she might have been cold, so I turned the A/C up a few degrees and that seemed to help.
I should add, Miss Boo also slept very soundly during the DAYS when Luca was away. Perhaps the Boo was not sleeping well either those nights?
Anyway, last night Luca was back, and we were a little worried that the Boo would not want to go back to the crate. Um..... nope! It was like she was saying, "Thank God you're home daddy and I don't have to sleep on this f-ing bed anymore with OMDG!" This morning she awoke refreshed and had a long drink from my toilet (her new discovery of late) ready to go for her morning walk
I think someone is a little attached to her crate, don't you? Poor Miss. Boo! I promise I won't experiment on you (much) in the future. And definitely not with your sleeping arrangement!
Thursday, July 29, 2010
Getting offended about psychotic patients
I remember on my medicine rotation (2 years ago now!) I picked up a patient who had just been transferred from the ICU. I think she had c diff? Otherwise I really don't remember what she was in the hospital for.
I do remember this: she was psychotic. She was on fluphenazine, and carried a diagnosis of schizoaffective didsorder. She had some pretty major problems and was on a 1:1. When I saw her, she was ranting and raving to anyone who would listen to her. She called the 1:1 nurse a n*****, she accused him of trying to rape her, she said there were gremlins in her room. She was wackadoo, I'm telling you.
I guess what surprised me the most was the reaction the staff had to her. I mean, don't get me wrong, her behavior was offensive. But she was clearly psychotic. Not in her right mind. Sick.
The 1:1 nurse came out and told me that he was not going to take this verbal abuse any longer. That she was hateful and he refused to sit with her anymore.
Guys, I've seen hateful. This woman wasn't hateful. She was off her rocker. I guess what surprised me was that as a medical professional, her nurse wasn't able to look past the insults and see that she was just a sick person, and that she really couldn't help herself.
The thing is, there really are hateful patients. But it's just not the same thing as psychotic. A hateful patient is just rude, demanding, insulting, and hostile. It would piss me off, and I would tell them to stop acting like that. A psychotic patient by contrast could rant and rave at me and call me any name under the sun and it wouldn't phase me. Why? Because they're not in control of themselves, and no amount of tsk tsking on my behalf is going to change that. It's counter-productive and a waste of time to get offended by psychotic behavior. As a medical professional, you have to be bigger than that.
You do need to put safety first and be careful around patients like this, but this patient was in restraints. She wasn't able to do anything to anybody.
Mostly I just felt sorry for her. People with her problems can't advocate for themselves, and are at the mercy of the system. It's really a shame that some health care professionals can't see them through the psychosis for what they are.
*I should also say thanks to Agraphia for being my inspiration for this post. I had totally forgotten about it until I read his post this morning.
I do remember this: she was psychotic. She was on fluphenazine, and carried a diagnosis of schizoaffective didsorder. She had some pretty major problems and was on a 1:1. When I saw her, she was ranting and raving to anyone who would listen to her. She called the 1:1 nurse a n*****, she accused him of trying to rape her, she said there were gremlins in her room. She was wackadoo, I'm telling you.
I guess what surprised me the most was the reaction the staff had to her. I mean, don't get me wrong, her behavior was offensive. But she was clearly psychotic. Not in her right mind. Sick.
The 1:1 nurse came out and told me that he was not going to take this verbal abuse any longer. That she was hateful and he refused to sit with her anymore.
Guys, I've seen hateful. This woman wasn't hateful. She was off her rocker. I guess what surprised me was that as a medical professional, her nurse wasn't able to look past the insults and see that she was just a sick person, and that she really couldn't help herself.
The thing is, there really are hateful patients. But it's just not the same thing as psychotic. A hateful patient is just rude, demanding, insulting, and hostile. It would piss me off, and I would tell them to stop acting like that. A psychotic patient by contrast could rant and rave at me and call me any name under the sun and it wouldn't phase me. Why? Because they're not in control of themselves, and no amount of tsk tsking on my behalf is going to change that. It's counter-productive and a waste of time to get offended by psychotic behavior. As a medical professional, you have to be bigger than that.
You do need to put safety first and be careful around patients like this, but this patient was in restraints. She wasn't able to do anything to anybody.
Mostly I just felt sorry for her. People with her problems can't advocate for themselves, and are at the mercy of the system. It's really a shame that some health care professionals can't see them through the psychosis for what they are.
*I should also say thanks to Agraphia for being my inspiration for this post. I had totally forgotten about it until I read his post this morning.
Wednesday, July 28, 2010
Things I like about West Philadelphia
1) Trees! Japanese maples, oaks, poplars, you name it. In the springtime there are blooming pink and white cherry trees literally on every block.
2) Gardens. People get really into gardening here. There are lovely flowers on every street you can wander down.
3) The air moves (unlike in center city), and it doesn't smell bad.
4) Community. There is actually a community here of people who don't work as doctors. Sometimes in center city it feels like the only people you ever run into are med students, residents, and attendings.
5) Beautiful rambling old houses with 5 bedrooms and back staircases.
6) The dog park. With members only (fewer idiots!), a water tub, grass, balls, chairs, and shade. Much better than the dust bowl (with idiots) that is the Schuylkill river dog park.
7) The community pool for those sweltering summer evenings.
8) Parking. It's actually possible to do that here.
9) Nice neighbors. I lived in a high rise in center city for 2 years and I don't think I met a single person who lived on my floor. Maybe even worse is that I'm glad I didn't. Too many Wharton students.
10) Local 44, which has a great atmosphere and the best beer selection I've found in Philly to date. I LOVE their pastrami sandwiches and fries.
2) Gardens. People get really into gardening here. There are lovely flowers on every street you can wander down.
3) The air moves (unlike in center city), and it doesn't smell bad.
4) Community. There is actually a community here of people who don't work as doctors. Sometimes in center city it feels like the only people you ever run into are med students, residents, and attendings.
5) Beautiful rambling old houses with 5 bedrooms and back staircases.
6) The dog park. With members only (fewer idiots!), a water tub, grass, balls, chairs, and shade. Much better than the dust bowl (with idiots) that is the Schuylkill river dog park.
7) The community pool for those sweltering summer evenings.
8) Parking. It's actually possible to do that here.
9) Nice neighbors. I lived in a high rise in center city for 2 years and I don't think I met a single person who lived on my floor. Maybe even worse is that I'm glad I didn't. Too many Wharton students.
10) Local 44, which has a great atmosphere and the best beer selection I've found in Philly to date. I LOVE their pastrami sandwiches and fries.
Tuesday, July 27, 2010
ICU
There's a woman who I know from the pool who works as a nurse in one of the ICUs. She's a little weird. I always feel like no matter how positive and friendly I am to her, she has something negative or disapproving to say to me.
Oh well. Her problem I suppose.
Anyway, the other week I ran into her again at the pool.
"Hey R, how are you? You know, one of my friends just started as an intern, and she's been in your ICU for past few weeks," I said.
"As a med student?" she asked.
"No, as an intern. I didn't know if you shared any patients, but I told her to look out for you," I said.
"Oh. I don't know the names of most of the housestaff. We don't really interact with them," she said. Matter of factly. Flatly.
I had to chuckle. Nurses complain that residents don't learn THEIR names all the time. I can only imagine what would have gone down had the tables been turned and *I* said that to *her*.
Also, it's not really the case that nurses don't interact with housestaff in the ICUs. I can say that as a med student, I interacted with nurses ALL THE TIME when my patients were in the unit. They saved my ass is what they did!
I don't know. Maybe she's just weird.
Oh well. Her problem I suppose.
Anyway, the other week I ran into her again at the pool.
"Hey R, how are you? You know, one of my friends just started as an intern, and she's been in your ICU for past few weeks," I said.
"As a med student?" she asked.
"No, as an intern. I didn't know if you shared any patients, but I told her to look out for you," I said.
"Oh. I don't know the names of most of the housestaff. We don't really interact with them," she said. Matter of factly. Flatly.
I had to chuckle. Nurses complain that residents don't learn THEIR names all the time. I can only imagine what would have gone down had the tables been turned and *I* said that to *her*.
Also, it's not really the case that nurses don't interact with housestaff in the ICUs. I can say that as a med student, I interacted with nurses ALL THE TIME when my patients were in the unit. They saved my ass is what they did!
I don't know. Maybe she's just weird.
My dog is so tolerant
This is what I do when I am procrastinating from working on a presentation. I teach Miss. Boo to use the mouse with her striped paw! Here honey, move it to the running man icon and click! No no! Do not eat it. That is the OTHER kind of mouse, silly girl.
SAS is so easy, even a ferocious pit bull can run it.
(She is so tolerant of me.)
She gazes at me inquisitively when I start singing along with Pandora (off key) with my headphones on. Don't worry honey, mommy isn't talking to you, she's just crazy.
And then when my stats aren't working and I say, "Goddammit SAS, why won't you run?!?!?" she runs away and cowers in the corner. We really need to work on that.
SAS is so easy, even a ferocious pit bull can run it.
(She is so tolerant of me.)
She gazes at me inquisitively when I start singing along with Pandora (off key) with my headphones on. Don't worry honey, mommy isn't talking to you, she's just crazy.
And then when my stats aren't working and I say, "Goddammit SAS, why won't you run?!?!?" she runs away and cowers in the corner. We really need to work on that.
Monday, July 26, 2010
Saturday, July 24, 2010
The fine line between doormat and gunner
Everybody hates a gunner. A gunner takes all the interesting cases, hogs the attending time, and thinks about only him/herself. At the same time, nobody will look out for you except you. Ultimately, as a medical student, you have to ensure that you get to see what you need or want to see, and that you get the attending time you need so you can actually learn something. Ninja wrote about this a few days back, and truly it can be a hard line to walk.
I usually tried to be fair when I was on my rotations. If there were too many medical students for the number of surgical cases, or the number of consults, I'd keep a running tally in my head of who got to do what. That way when I asked to do something, I'd KNOW that I wasn't "hogging the good cases" or trying to see more patients than the other students. I could then refer to those tallies when the accusations flew.
And they did fly, kids. Medical students aren't anything if not selfish brats sometimes.
Most of the time this didn't matter much. As I got more experience being in the hospital, I learned how to distance myself from the other students so that we weren't constantly encroaching on each other's territory. It's so much easier to avoid conflict than to resolve it!
But sometimes it's so tempting to just take a case, even if you know it's someone eles's turn. I remember there was this one patient who had a head laceration in the trauma bay, and the other medical student needed help getting started sewing her up. The lac was a weird asterisk shape, and we discussed what would be the best way to approximate the various flaps of skin that needed closing. It was his first lac, and I'd already done several, so I helped him gather the supplies, and then watched as he *painfully* slowly started sewing. I took a few stitches myself, and was amazed at how effortless it felt. I could have closed it in 5 minutes, it felt like.
Then I made myself stop. I put my needle driver down, and I walked away and found something else to do. Taking the other student's potentially one and only lac repair would have been completely unfair, especially since I'd already done a bunch myself.
Other times, it was necessary to assert myself. I remember doing my neurosurgery rotation -- AWESOME rotation -- at the same time as two rotating sub-is from other universities. They were both completely obsessed with getting attending time, and often came in an tried to kick me out of cases that I had already scrubbed in on.
One in particular was a complete f***er about it. He told me flat out that I should just concede every good case to him because I wasn't going to be a surgeon, and essentially his whole life (as he saw it) depended on getting cases with XYZ surgeon and impressing him. And you know? If he'd been less of a douche about it, I might have been more accommodating. I was pretty damn accommodating as it was. We'd try to work out who would do which cases, but if he found out later the case we'd agreed that I would scrub in on was going to be interesting, he'd just come in to the OR and try to boot me out anyway.
Ultimately I told him that while I did see his point and I did sympathize with his anxiety about matching, but this was going to be the ONLY time in my life that I'd get to see these kinds of surgeries, and I needed to be able to scrub in and do things in the OR to get a decent education. By contrast, he'd get to see and do this sort of thing for the rest of his career. I don't think he liked that argument, and he still tried to weasel is way into the cases I was already in on. Fortunately he ultimately decided that he was better off trying to impress the chairman, and I got to scrub in with a bunch of attendings and residents whom I hit it off with who'd let me do stuff, and it worked out. But sheesh. He sure was a brat about it!
The thing is, I really did have to stand up for myself in that setting. There is NO REASON that not planning on going into a particular specialty means it's ok to be ignored, or that you have to let the people who are interested in doing that specialty get all the good cases. Plus, some med students claim they're interested in EVERY specialty in order to score points with the team they're on, so you never know if you should take their word for it anyway.
So moral of the story is: don't be a gunner, but also don't allow people to walk all over you. It's your education, and it's up to you to make sure you have the experiences you need to make you an educated doctor. Just try to be fair to the other students while you're doing it. I sometimes feel that as a female, you can feel like you're being a jerk (and others may make you feel this way too) if you try to assert yourself so that you get to do and see your share. But if you're fair and try to help others, then if they hate you anyway, it's their problem.
I usually tried to be fair when I was on my rotations. If there were too many medical students for the number of surgical cases, or the number of consults, I'd keep a running tally in my head of who got to do what. That way when I asked to do something, I'd KNOW that I wasn't "hogging the good cases" or trying to see more patients than the other students. I could then refer to those tallies when the accusations flew.
And they did fly, kids. Medical students aren't anything if not selfish brats sometimes.
Most of the time this didn't matter much. As I got more experience being in the hospital, I learned how to distance myself from the other students so that we weren't constantly encroaching on each other's territory. It's so much easier to avoid conflict than to resolve it!
But sometimes it's so tempting to just take a case, even if you know it's someone eles's turn. I remember there was this one patient who had a head laceration in the trauma bay, and the other medical student needed help getting started sewing her up. The lac was a weird asterisk shape, and we discussed what would be the best way to approximate the various flaps of skin that needed closing. It was his first lac, and I'd already done several, so I helped him gather the supplies, and then watched as he *painfully* slowly started sewing. I took a few stitches myself, and was amazed at how effortless it felt. I could have closed it in 5 minutes, it felt like.
Then I made myself stop. I put my needle driver down, and I walked away and found something else to do. Taking the other student's potentially one and only lac repair would have been completely unfair, especially since I'd already done a bunch myself.
Other times, it was necessary to assert myself. I remember doing my neurosurgery rotation -- AWESOME rotation -- at the same time as two rotating sub-is from other universities. They were both completely obsessed with getting attending time, and often came in an tried to kick me out of cases that I had already scrubbed in on.
One in particular was a complete f***er about it. He told me flat out that I should just concede every good case to him because I wasn't going to be a surgeon, and essentially his whole life (as he saw it) depended on getting cases with XYZ surgeon and impressing him. And you know? If he'd been less of a douche about it, I might have been more accommodating. I was pretty damn accommodating as it was. We'd try to work out who would do which cases, but if he found out later the case we'd agreed that I would scrub in on was going to be interesting, he'd just come in to the OR and try to boot me out anyway.
Ultimately I told him that while I did see his point and I did sympathize with his anxiety about matching, but this was going to be the ONLY time in my life that I'd get to see these kinds of surgeries, and I needed to be able to scrub in and do things in the OR to get a decent education. By contrast, he'd get to see and do this sort of thing for the rest of his career. I don't think he liked that argument, and he still tried to weasel is way into the cases I was already in on. Fortunately he ultimately decided that he was better off trying to impress the chairman, and I got to scrub in with a bunch of attendings and residents whom I hit it off with who'd let me do stuff, and it worked out. But sheesh. He sure was a brat about it!
The thing is, I really did have to stand up for myself in that setting. There is NO REASON that not planning on going into a particular specialty means it's ok to be ignored, or that you have to let the people who are interested in doing that specialty get all the good cases. Plus, some med students claim they're interested in EVERY specialty in order to score points with the team they're on, so you never know if you should take their word for it anyway.
So moral of the story is: don't be a gunner, but also don't allow people to walk all over you. It's your education, and it's up to you to make sure you have the experiences you need to make you an educated doctor. Just try to be fair to the other students while you're doing it. I sometimes feel that as a female, you can feel like you're being a jerk (and others may make you feel this way too) if you try to assert yourself so that you get to do and see your share. But if you're fair and try to help others, then if they hate you anyway, it's their problem.
Friday, July 23, 2010
Really?
How many times can a person write, "This is a secondary analysis of previously collected deidentified data on consented patients," in a single IRB submission. Seriously, I think I have copied and pasted this statement 20 times minimum in my most recent submission.
Now I'm working on a submission for a project where we're going to conduct telephone interviews with patients about their trust of drs. It's seriously invasive stuff, I'm telling you. This is how the risk disclosure section reads:
Since this study only involves us asking you questions about your opinions, there are minimal risks to participation. The main risk of participation is a loss of confidentiality, which could mean that people could find out information about your hospitalization, and about your symptoms of anxiety and depression, or about your trust regarding your doctor. We will safeguard against this by storing your name and contact information separately from any data that we collect about you. We will assign you a random number for the purposes of this study only. All electronic files will be stored on a secure server that only the research team will have access to, and paper records will be stored in a locked file cabinet. All identifying records will be destroyed at the conclusion of the study.
It is also possible that you will find the interview to be burdensome or tiring, or that some of the questions may upset you. If that happens, you may stop the interview at any time to continue later, or to withdraw from the study permanently. All interviewers have received special training in how to pick up on cues from you that you may be getting tired, and have been instructed to remain vigilant to these cues throughout the interview process.
In addition, some patients may find discussing the psychological symptoms to be upsetting. If this happens to you, we can provide you resources with whom you can discuss these issues confidentially if you so desire.
Hopefully they won't object to my use of the phrase "minimal risk." At least I don't have to include anything about death or dismemberment, or about the risks of using a telephone. On second thought, maybe I'd better wait before I say that or else they might make me include something about the dangers of driving while talking on the phone!
Anywho, my IRB has been the joy that has been my week. An absolute joy.
Goal: to have it done and submitted today so that hopefully in a week or two someone can get back to me with all the things I need to revise.
Now I'm working on a submission for a project where we're going to conduct telephone interviews with patients about their trust of drs. It's seriously invasive stuff, I'm telling you. This is how the risk disclosure section reads:
Since this study only involves us asking you questions about your opinions, there are minimal risks to participation. The main risk of participation is a loss of confidentiality, which could mean that people could find out information about your hospitalization, and about your symptoms of anxiety and depression, or about your trust regarding your doctor. We will safeguard against this by storing your name and contact information separately from any data that we collect about you. We will assign you a random number for the purposes of this study only. All electronic files will be stored on a secure server that only the research team will have access to, and paper records will be stored in a locked file cabinet. All identifying records will be destroyed at the conclusion of the study.
It is also possible that you will find the interview to be burdensome or tiring, or that some of the questions may upset you. If that happens, you may stop the interview at any time to continue later, or to withdraw from the study permanently. All interviewers have received special training in how to pick up on cues from you that you may be getting tired, and have been instructed to remain vigilant to these cues throughout the interview process.
In addition, some patients may find discussing the psychological symptoms to be upsetting. If this happens to you, we can provide you resources with whom you can discuss these issues confidentially if you so desire.
Hopefully they won't object to my use of the phrase "minimal risk." At least I don't have to include anything about death or dismemberment, or about the risks of using a telephone. On second thought, maybe I'd better wait before I say that or else they might make me include something about the dangers of driving while talking on the phone!
Anywho, my IRB has been the joy that has been my week. An absolute joy.
Goal: to have it done and submitted today so that hopefully in a week or two someone can get back to me with all the things I need to revise.
Tuesday, July 20, 2010
What PhD Students Dream About
Over the weekend I had a nightmare that caused me to wake up in a cold sweat.
I dreamed that we had a home invasion. Two men approached me as I was walking back to my house with Boo, and then forced me inside at gun point. Took everything.
Take a wild guess as to what I was most freaked out by during this dream.
No, it wasn't death or dismemberment.
I was afraid they would steal all my data, and I didn't have another copy saved anywhere.
So I pleaded with them to just take my computer. To leave my hard drive with me. To take anything but the data!!!!
Then I woke up.
The next day I went to Target and purchased ANOTHER hard drive. This one will be kept in a secure location on campus. Then if the unthinkable ever happens (god forbid), at least I know I'll be all backed up.
Yes, my name is Old MD Girl, and I am a grad student, and I am insane.
I dreamed that we had a home invasion. Two men approached me as I was walking back to my house with Boo, and then forced me inside at gun point. Took everything.
Take a wild guess as to what I was most freaked out by during this dream.
No, it wasn't death or dismemberment.
I was afraid they would steal all my data, and I didn't have another copy saved anywhere.
So I pleaded with them to just take my computer. To leave my hard drive with me. To take anything but the data!!!!
Then I woke up.
The next day I went to Target and purchased ANOTHER hard drive. This one will be kept in a secure location on campus. Then if the unthinkable ever happens (god forbid), at least I know I'll be all backed up.
Yes, my name is Old MD Girl, and I am a grad student, and I am insane.
Choice
The NYT ran a piece the other day about how insurance companies are going to try to sell us all on plans that (again) restrict our choice of doctors. Well, I should say: you can still go to whomever you want, you'd just have to pay.
Slate ran an article on this as well.
People are very upset about this. If there is one thing Americans don't like, it's when you restrict their choices. And I can't say I blame them. A good friend of mine ended up switching from the HMO to the PPO at her job years back because the ONLY doctor that was covered and accepting new patients in the HMO was a boarded up clinic in the ghetto (43rd and MLK* or some such in Chicago), and the only hospital that any of the docs could admit to was one of this shittiest in Chicago. I think that hospital may be closed now.**
Of course it will be the PPO plans or the equivalent that will end up being the "Cadillac" plans that get taxed out the butt. PPOs are pretty standard these days, they just give you a wider network and more coverage if you go outside it.
What, that hadn't occurred to you, dear readers? If that ends up happening, remember you heard it here first.
Anyway, I bring all this up because while everybody is yammering on about how awful the insurance companies are for stripping them of their lack of choice, and how the plans will force them to leave their doctors for the quack in the ghetto (which..... they might, actually), the REAL way you are going to get F-ed by these plans is because you are not going to be able to get an appointment in the first place.
How is this going to happen? The networks of providers covered will not be large enough to see you quickly, so you will wait. It will be more *subtle* rationing, if you will. Not that I oppose rationing per se -- it already is a common occurrence -- it's just we're better off if it's out in the open (see dissertation topic for more details). And THAT friends, is how the insurance companies REALLY will save money. They don't ever have to pay if you never even get to see the doctor.***
Anyway, I'm not trying to give away my bias here. Who cares what my political opinions are anyway! You make new laws, companies change their business models in order to get around the new laws. It's just life.****
Just make sure you're upset about the right things.
*Not the ACTUAL address. It was around there though.
**Interestingly, as the Slate article points out, it isn't known whether cheaper docs have worse outcomes.
***It's not actually known to what degree delays in care cause increased morbidity and mortality.
****Plus all these changes ensure that I -- as an epidemiologist -- will have ample fodder to study over the coming decades. Perhaps I should have titled this piece, "How health care reform assured me of a job."
Slate ran an article on this as well.
People are very upset about this. If there is one thing Americans don't like, it's when you restrict their choices. And I can't say I blame them. A good friend of mine ended up switching from the HMO to the PPO at her job years back because the ONLY doctor that was covered and accepting new patients in the HMO was a boarded up clinic in the ghetto (43rd and MLK* or some such in Chicago), and the only hospital that any of the docs could admit to was one of this shittiest in Chicago. I think that hospital may be closed now.**
Of course it will be the PPO plans or the equivalent that will end up being the "Cadillac" plans that get taxed out the butt. PPOs are pretty standard these days, they just give you a wider network and more coverage if you go outside it.
What, that hadn't occurred to you, dear readers? If that ends up happening, remember you heard it here first.
Anyway, I bring all this up because while everybody is yammering on about how awful the insurance companies are for stripping them of their lack of choice, and how the plans will force them to leave their doctors for the quack in the ghetto (which..... they might, actually), the REAL way you are going to get F-ed by these plans is because you are not going to be able to get an appointment in the first place.
How is this going to happen? The networks of providers covered will not be large enough to see you quickly, so you will wait. It will be more *subtle* rationing, if you will. Not that I oppose rationing per se -- it already is a common occurrence -- it's just we're better off if it's out in the open (see dissertation topic for more details). And THAT friends, is how the insurance companies REALLY will save money. They don't ever have to pay if you never even get to see the doctor.***
Anyway, I'm not trying to give away my bias here. Who cares what my political opinions are anyway! You make new laws, companies change their business models in order to get around the new laws. It's just life.****
Just make sure you're upset about the right things.
*Not the ACTUAL address. It was around there though.
**Interestingly, as the Slate article points out, it isn't known whether cheaper docs have worse outcomes.
***It's not actually known to what degree delays in care cause increased morbidity and mortality.
****Plus all these changes ensure that I -- as an epidemiologist -- will have ample fodder to study over the coming decades. Perhaps I should have titled this piece, "How health care reform assured me of a job."
Monday, July 19, 2010
Boomarine
The dog park where we take the Boo sometimes is an amazing place. It is about the size of 1/2 a city block, with grass, balls, chuck-its, agility toys, comfortable chairs, shade, water, and a big black tub that we fill up when it gets hot that the dogs can jump/lie in.
The black tub is very popular with the retrievers and the spaniels who frequent the park, however Miss Boo had shown only limited interest in the tub. She preferred to follow other dogs to the edge and then to watch them as they went for their wallow.
The only issue is that it's hot. So we've been resorting to hosing the Boo off with cold water at the dog park so she can run around like a crazy loon in relative comfort. It's a bit of a pain, actually.
So this Sunday, I went to hose the Boo off, and she was standing on the edge of the black tub. I wanted to see if she'd consider getting in the water, so I put one front paw in. No resistance. Then a second front paw in. Then one back paw and then another.
Then I moved a front paw to the deeper water where the water came up to her chest. Still no resistance.
Then I told her to sit. Which she did. And then slowly she lay down on her own volition, submerging her entire body (including her head) into the cool (muddy) water.
No, the dog was not drowning, though I was concerned about this for about 5 seconds. She was blowing bubbles through her nose. I think she learned this last winter when I taught her to fetch treats off the bottom of her water bowl. See, there is a method to my madness!
Eventually she stood up. Shook. And then started walking around in circles in the black tub submerging her entire head and blowing bubbles and splashing. She did this for about 5 minutes, when I decided it was time to teach her how to get OUT of the tub. I think she would have stayed in the tub for longer if I hadn't wanted to sit down myself.
Today we went back to the dog park, and Boo looked very disappointed when she saw there was no water in the tub, and I had to hose her down again. Maybe tomorrow, Miss Boo!
My ferocious little Boomarine!
Who'd have thunk my pit would like the water? Maybe she does have some retriever in her after all.
The black tub is very popular with the retrievers and the spaniels who frequent the park, however Miss Boo had shown only limited interest in the tub. She preferred to follow other dogs to the edge and then to watch them as they went for their wallow.
The only issue is that it's hot. So we've been resorting to hosing the Boo off with cold water at the dog park so she can run around like a crazy loon in relative comfort. It's a bit of a pain, actually.
So this Sunday, I went to hose the Boo off, and she was standing on the edge of the black tub. I wanted to see if she'd consider getting in the water, so I put one front paw in. No resistance. Then a second front paw in. Then one back paw and then another.
Then I moved a front paw to the deeper water where the water came up to her chest. Still no resistance.
Then I told her to sit. Which she did. And then slowly she lay down on her own volition, submerging her entire body (including her head) into the cool (muddy) water.
No, the dog was not drowning, though I was concerned about this for about 5 seconds. She was blowing bubbles through her nose. I think she learned this last winter when I taught her to fetch treats off the bottom of her water bowl. See, there is a method to my madness!
Eventually she stood up. Shook. And then started walking around in circles in the black tub submerging her entire head and blowing bubbles and splashing. She did this for about 5 minutes, when I decided it was time to teach her how to get OUT of the tub. I think she would have stayed in the tub for longer if I hadn't wanted to sit down myself.
Today we went back to the dog park, and Boo looked very disappointed when she saw there was no water in the tub, and I had to hose her down again. Maybe tomorrow, Miss Boo!
My ferocious little Boomarine!
Who'd have thunk my pit would like the water? Maybe she does have some retriever in her after all.
Sunday, July 18, 2010
Maybe I've been doing this med school thing too long
Luca and I have been spending the better part of our free time over the past month watching the first three seasons of Friday Night Lights. And I have one word:
LOVE.
We love the show. Ok, maybe only I love it, since Luca was complaining the other day about the lack of football and the preponderance of soap opera. But during season 3 there was a lot more football, so maybe the show redeemed itself to him slightly.
And now season 3 is over, and we are sad since we will have to wait until season 4 comes out on DVD to see it! :-(
Anyway, one thing I've noticed about the show is how much I love the fact that the teenagers all say "Yes ma'am," and "Yes sir." It's completely adorable, actually. I never thought I would say such a thing, since I have this longstanding history of having a problem with authority..... but I was finding that I loved how easy it was to show deference and respect to someone merely by some good eye contact and a heartfelt "Yes sir!"
Up here in the northeast, we think that expecting children to ma'am and sir adults is authoritarian. Bad parenting. Perhaps a sign that the parents spank their children? (Gasp!)
But in a way, ma'am-ing or sir-ing someone is easier than what we expect kids to do here. If you can't show an authority figure you respect them by calling them ma'am or sir, how do you do it instead? You have to go through some sort of unspoken ritual of SHOWING the authority figure that you respect them. And since this ritual is unspoken, and also inconsistent between authority figures, it's a lot more difficult to figure out what you need to do in order to show someone that you respect them. You have to be a fantastic ass-kisser as a teenager to be able to consistently pull this off.
And think about how easy it would be to show deference as a medical student if all you had to do on a rotation to show respect was to "Yes ma'am," the attending. Instead however, you have to laugh at her jokes, bring in cookies, and think of things to say that are simultaneously deferential but also intelligent (but not too intelligent -- you don't want to look like you think you're smarter than everyone else, now do you?).
Gah! It can be downright impossible to please some of them.
Does anyone else have any thoughts on the use of ma'am and sir?
LOVE.
We love the show. Ok, maybe only I love it, since Luca was complaining the other day about the lack of football and the preponderance of soap opera. But during season 3 there was a lot more football, so maybe the show redeemed itself to him slightly.
And now season 3 is over, and we are sad since we will have to wait until season 4 comes out on DVD to see it! :-(
Anyway, one thing I've noticed about the show is how much I love the fact that the teenagers all say "Yes ma'am," and "Yes sir." It's completely adorable, actually. I never thought I would say such a thing, since I have this longstanding history of having a problem with authority..... but I was finding that I loved how easy it was to show deference and respect to someone merely by some good eye contact and a heartfelt "Yes sir!"
Up here in the northeast, we think that expecting children to ma'am and sir adults is authoritarian. Bad parenting. Perhaps a sign that the parents spank their children? (Gasp!)
But in a way, ma'am-ing or sir-ing someone is easier than what we expect kids to do here. If you can't show an authority figure you respect them by calling them ma'am or sir, how do you do it instead? You have to go through some sort of unspoken ritual of SHOWING the authority figure that you respect them. And since this ritual is unspoken, and also inconsistent between authority figures, it's a lot more difficult to figure out what you need to do in order to show someone that you respect them. You have to be a fantastic ass-kisser as a teenager to be able to consistently pull this off.
And think about how easy it would be to show deference as a medical student if all you had to do on a rotation to show respect was to "Yes ma'am," the attending. Instead however, you have to laugh at her jokes, bring in cookies, and think of things to say that are simultaneously deferential but also intelligent (but not too intelligent -- you don't want to look like you think you're smarter than everyone else, now do you?).
Gah! It can be downright impossible to please some of them.
Does anyone else have any thoughts on the use of ma'am and sir?
Friday, July 16, 2010
Suspense
I know the suspense is killing you, dear readers, about how my meeting with my mentor went today.
It went well. Not perfectly, but well. It went as I expected it would.
First the bad: I'm going to be 2nd author.
Now the good: My mentor agreed that the kid had acted unprofessionally, and was glad I had told him about how much of a pain in the bum he'd been to work with. How I didn't feel he respected my contributions, or that he understood how the process of working on a research team with a group of collaborators worked. He said he'd speak to him about that.
AND! I get to send the kid my draft, which I more or less finished working on yesterday, and my mentor and he will primarily work on it from here on out. My opinion will be solicited for the final drafts when we're getting to the point where we can submit. This is fantastic because this frees up a bunch of time to work on other projects, and to learn some epidemiology and statistics. I don't have to put up with the disrespect anymore! Well, not for at least a few weeks anyway.
So, that's it.
It would have been nice to share first authorship, and I feel like I rolled over a bit. But my mentor seemed to really want this for the kid, and I would have had to raise a big stink to get that too. It just didn't seem worth it.
Part of me wonders if I gave up too easily.
But at the same time, I managed to not lose my sh*t during the meeting, which relieved me, let me tell you. And I felt like the resolution we came to was fair. With a career ahead of me, where I'm going to have to work with my mentor for a LOOOOONNNNGGGGG time in the future, it didn't seem worth it to fight this fight.
So readers: Do you think I gave up too easily?
It went well. Not perfectly, but well. It went as I expected it would.
First the bad: I'm going to be 2nd author.
Now the good: My mentor agreed that the kid had acted unprofessionally, and was glad I had told him about how much of a pain in the bum he'd been to work with. How I didn't feel he respected my contributions, or that he understood how the process of working on a research team with a group of collaborators worked. He said he'd speak to him about that.
AND! I get to send the kid my draft, which I more or less finished working on yesterday, and my mentor and he will primarily work on it from here on out. My opinion will be solicited for the final drafts when we're getting to the point where we can submit. This is fantastic because this frees up a bunch of time to work on other projects, and to learn some epidemiology and statistics. I don't have to put up with the disrespect anymore! Well, not for at least a few weeks anyway.
So, that's it.
It would have been nice to share first authorship, and I feel like I rolled over a bit. But my mentor seemed to really want this for the kid, and I would have had to raise a big stink to get that too. It just didn't seem worth it.
Part of me wonders if I gave up too easily.
But at the same time, I managed to not lose my sh*t during the meeting, which relieved me, let me tell you. And I felt like the resolution we came to was fair. With a career ahead of me, where I'm going to have to work with my mentor for a LOOOOONNNNGGGGG time in the future, it didn't seem worth it to fight this fight.
So readers: Do you think I gave up too easily?
Thursday, July 15, 2010
Wednesday, July 14, 2010
The kid (continued)
Just as I was starting to feel a bit guilty about my blog tirade regarding the kid, and that maybe I'd been overreacting, he gives me more fodder.
So we had a meeting with my mentor today about the paper. It was very productive. And at the end we started talking about authorship. Originally the kid and I were to be co-first authors, since our contributions had been roughly equivalent.
And I repeated that today. I told my mentor how helpful he'd been for the philosophical angle on the paper, but that we had made equal contributions to the content and the writing.
And then:
The kid told my mentor that he felt that he had ALL the original thoughts contained in the paper. There was only one thought that he considered to be mine. And therefore I should not be a co-PI with him.
Look guys, I'm not trying to be a greedy little paper hogger here, taking credit for something I didn't do. But let's be clear here. I provided the initial framework for the paper. I wrote half the first draft from scratch. I have provided ALL the clinical context. I have adjusted the style and tone to be palatable for a medical audience -- which was met with much resistance, I might add. Several major concepts: trust, gaming the system, the political downside to disclosure, anticipatory guidance (this was more my mentor's thought, but it certainly wasn't the kid's), as well as the reasons physicians might or might not benefit from disclosure, in that paper were mine. Not just one. I also brought in almost all the relevant literature that people before us have written on the subject.
I was really pissed.
And I'm sorry, you don't throw someone under the bus like that in a meeting with the PI. Not cool. Really. Not cool.
This isn't over.
So we had a meeting with my mentor today about the paper. It was very productive. And at the end we started talking about authorship. Originally the kid and I were to be co-first authors, since our contributions had been roughly equivalent.
And I repeated that today. I told my mentor how helpful he'd been for the philosophical angle on the paper, but that we had made equal contributions to the content and the writing.
And then:
The kid told my mentor that he felt that he had ALL the original thoughts contained in the paper. There was only one thought that he considered to be mine. And therefore I should not be a co-PI with him.
Look guys, I'm not trying to be a greedy little paper hogger here, taking credit for something I didn't do. But let's be clear here. I provided the initial framework for the paper. I wrote half the first draft from scratch. I have provided ALL the clinical context. I have adjusted the style and tone to be palatable for a medical audience -- which was met with much resistance, I might add. Several major concepts: trust, gaming the system, the political downside to disclosure, anticipatory guidance (this was more my mentor's thought, but it certainly wasn't the kid's), as well as the reasons physicians might or might not benefit from disclosure, in that paper were mine. Not just one. I also brought in almost all the relevant literature that people before us have written on the subject.
I was really pissed.
And I'm sorry, you don't throw someone under the bus like that in a meeting with the PI. Not cool. Really. Not cool.
This isn't over.
Chair
Fizzy had a post a little while back about, um, seating arrangements in the hospital. And how.... er, the medical student is the always the one who must give up his/her seat if they run out.
And they always run out, guys. As a med student, your safest bet is to just stand in the back until you're SURE that nobody else is coming, and even then you can only lose points by sitting down.
I'd like to think that I picked up on the hierarchy of the seating arrangement early on so I pissed as few people off as possible. Scratch that. I KNOW I picked up on it.
How do I know I'm not just remembering myself in an unrealisticly fond light? Haha. You'll see.
It was back 2.5 years ago on my Ob/Gyn rotation. Now, while seating hierarchy exists on all rotations, it is especially pronounced on this one. (Everything hierarchical is pronounced on Ob.) I was on nightfloat for labor and delivery, and I had arrived 30 minutes early to get organized and go over the board before my shift started.
So I went into theroom closet where the team rounded every day. Usually it was so crowded that the med student had to actually stand OUTSIDE the room, since often there was no room on the floor, hence the reason for my early arrival. But since it was currently 30 minutes before rounds started, the room was EMPTY.
Did you hear that guys? EMPTY. This is important.
Anyway, I go in to read over the board and try to figure out what patients are likely to deliver over the next 12 hours, and my co-med student, Henry*, pops in. Says hi. Starts telling me about his shift and the patients on the board. Noting that the room was empty and would continue to be empty for at least another 30 minutes, we sat in two chairs to facilitate our view of the board.
About 5 minutes later, well before rounds are going to start, Psycho-resident pops her head in and demands to know what we are doing. So Henry tells her.
She was visibly irritated (in retrospect, she was always visibly irritated), "Old MD Girl, MED STUDENTS MUST SIT ON THE FLOOR." She barked. She stares at me. Hard.
At me. Not at Henry, who was also occupying one of the 15 empty chairs in the room. (Did I mention that rounds weren't for another 25 minutes?)
So I moved to the floor, and looked back to the board. "You were telling me about Miss. Iminlabor, Henry? She's how many cm now?"
Anyway, I relate this story because I truly believe that when I am a resident I will also find myself irritated by the errant med student who sits at the table during conference forcing someone else to stand.
However, I am also sure that I will never take it to the level that Psycho here did, and if I do, I hope someone has the mercy to put me out of my misery.
*Not his real name
And they always run out, guys. As a med student, your safest bet is to just stand in the back until you're SURE that nobody else is coming, and even then you can only lose points by sitting down.
I'd like to think that I picked up on the hierarchy of the seating arrangement early on so I pissed as few people off as possible. Scratch that. I KNOW I picked up on it.
How do I know I'm not just remembering myself in an unrealisticly fond light? Haha. You'll see.
It was back 2.5 years ago on my Ob/Gyn rotation. Now, while seating hierarchy exists on all rotations, it is especially pronounced on this one. (Everything hierarchical is pronounced on Ob.) I was on nightfloat for labor and delivery, and I had arrived 30 minutes early to get organized and go over the board before my shift started.
So I went into the
Did you hear that guys? EMPTY. This is important.
Anyway, I go in to read over the board and try to figure out what patients are likely to deliver over the next 12 hours, and my co-med student, Henry*, pops in. Says hi. Starts telling me about his shift and the patients on the board. Noting that the room was empty and would continue to be empty for at least another 30 minutes, we sat in two chairs to facilitate our view of the board.
About 5 minutes later, well before rounds are going to start, Psycho-resident pops her head in and demands to know what we are doing. So Henry tells her.
She was visibly irritated (in retrospect, she was always visibly irritated), "Old MD Girl, MED STUDENTS MUST SIT ON THE FLOOR." She barked. She stares at me. Hard.
At me. Not at Henry, who was also occupying one of the 15 empty chairs in the room. (Did I mention that rounds weren't for another 25 minutes?)
So I moved to the floor, and looked back to the board. "You were telling me about Miss. Iminlabor, Henry? She's how many cm now?"
Anyway, I relate this story because I truly believe that when I am a resident I will also find myself irritated by the errant med student who sits at the table during conference forcing someone else to stand.
However, I am also sure that I will never take it to the level that Psycho here did, and if I do, I hope someone has the mercy to put me out of my misery.
*Not his real name
Sunday, July 11, 2010
The kid
I'm working with a college student this summer on a thought piece we're hoping to submit to a journal sometime this Fall. It's been interesting. On one hand, I've found his perspective very helpful. I got to relearn all about the categorical imperative. I can't say that I even remotely enjoyed learning about it the FIRST time back in college, but it was a lot more palatable this time. Probably since at least this time, I didn't have to read that godforsaken book.
Blegh. I hated Kant.
On the other hand, as we were meeting last week to talk about some changes I had made to his draft, I found myself feeling really irritated by him. The kid wanted to go line by line and dispute EVERY. SINGLE. CHANGE. I had proposed. He had these long and elaborate reasons for why he had structured his sentences the way he had. Sentences like:
If critical care medicine is to remain a moral enterprise, physicians must reevaluate their common communicative practices in the ICU.
Which to me sound pompous and verbose. NOT stylistically appropriate for a medical journal. But NO!!! He wouldn't even think about changing them! He told me that I didn't know what I was talking about.
I told him that the style wasn't appropriate for a medical journal, and that we needed to keep the piece under 2500-3000 words. I told him that I was sure what he'd written would be great for a philosophy paper, and his ideas were really interesting, but that we needed to change some of the language to make it more accessible for a medical audience.
And you know what happened? The kid insulted my writing. Told me that I had "no original thought" because I had brought in citations from the literature! That it was "choppy and disjointed."
I have to say, by the end there it was getting really hard for me to restrain myself from saying, "Listen kiddo. I know you think you're smarter than me, but I've been doing this for 7 years now, and I know what I'm talking about. AND you're being a disrespectful little snot. And by the way, your writing is pompous, and you NEED to cite the literature because frankly, nobody cares what you think if you can't show them you know what's come before you."
But I didn't.
Part of me is afraid that he is going to tattle on me to my mentor. Tell my mentor that I'm "being mean." I wish I had a better relationship with my mentor and felt like he would back me up, but I just don't. What if my mentor actually thinks this pompous style is desirable? My mentor already told me that he thinks the kid writes well. I find it hard to believe that this style was what he was referring to, but you never know with him.
I hate to say it, it made me feel a little grateful for the hospital hierarchy. Most med students wouldn't dare to talk to a resident or attending like that for fear of death. And the ones who do? Sound really really snotty, and don't do very well academically. Or with the nurses, patients, residents, or anyone else, actually.
I just feel incredibly disrespected and insulted, and I'm not sure how to handle this in a way that is diplomatic, allows me to fix the paper so it is presentable, and shows the kid that he can't act like this.
Part of becoming better is learning to accept criticism. You just can't actively insult the people you work with or for if you want to get ahead in this world.
Blegh. I hated Kant.
On the other hand, as we were meeting last week to talk about some changes I had made to his draft, I found myself feeling really irritated by him. The kid wanted to go line by line and dispute EVERY. SINGLE. CHANGE. I had proposed. He had these long and elaborate reasons for why he had structured his sentences the way he had. Sentences like:
If critical care medicine is to remain a moral enterprise, physicians must reevaluate their common communicative practices in the ICU.
Which to me sound pompous and verbose. NOT stylistically appropriate for a medical journal. But NO!!! He wouldn't even think about changing them! He told me that I didn't know what I was talking about.
I told him that the style wasn't appropriate for a medical journal, and that we needed to keep the piece under 2500-3000 words. I told him that I was sure what he'd written would be great for a philosophy paper, and his ideas were really interesting, but that we needed to change some of the language to make it more accessible for a medical audience.
And you know what happened? The kid insulted my writing. Told me that I had "no original thought" because I had brought in citations from the literature! That it was "choppy and disjointed."
I have to say, by the end there it was getting really hard for me to restrain myself from saying, "Listen kiddo. I know you think you're smarter than me, but I've been doing this for 7 years now, and I know what I'm talking about. AND you're being a disrespectful little snot. And by the way, your writing is pompous, and you NEED to cite the literature because frankly, nobody cares what you think if you can't show them you know what's come before you."
But I didn't.
Part of me is afraid that he is going to tattle on me to my mentor. Tell my mentor that I'm "being mean." I wish I had a better relationship with my mentor and felt like he would back me up, but I just don't. What if my mentor actually thinks this pompous style is desirable? My mentor already told me that he thinks the kid writes well. I find it hard to believe that this style was what he was referring to, but you never know with him.
I hate to say it, it made me feel a little grateful for the hospital hierarchy. Most med students wouldn't dare to talk to a resident or attending like that for fear of death. And the ones who do? Sound really really snotty, and don't do very well academically. Or with the nurses, patients, residents, or anyone else, actually.
I just feel incredibly disrespected and insulted, and I'm not sure how to handle this in a way that is diplomatic, allows me to fix the paper so it is presentable, and shows the kid that he can't act like this.
Part of becoming better is learning to accept criticism. You just can't actively insult the people you work with or for if you want to get ahead in this world.
Friday, July 09, 2010
Nothing
Today is going to be one of those days where I get nothing done. I am resigned to this. Therefore if I get ANYTHING accomplished I will feel very happy. And if I get nothing done I will not be frustrated.
Right.
So, I have to take my SAS cds back to the software lady who doesn't answer the phone or return emails. Ever. Will she be there? Who knows! But her office is a 15 minute walk across campus from mine, effectively killing at least an hour of my day any time I try to go over there. Which (since she never answers her phone or returns emails) must happen multiple times to get one thing done.
Love it!
Second on the agenda will be learning what I need to do to encrypt my laptop (suggestions from fellow readers welcome here -- will encrypting the whole disk necessitate me wiping my entire heard drive? Thanks.). The predicted sequence of the conversation will go something like this:
Me: Hello, my program director told me I should ask you guys about what I need to do to encrypt my laptop.
Tech Guy: Is it your personal laptop?
Me: Yes, but...
Tech Guy: We can only provide support for UNIVERSITY laptops.
Me: I'm not asking you for support, I'm asking you a data security question.
Tech Guy: I am still going to try to avoid helping you.
Me: Well, it's an incredibly large federal violation for me to walk around campus with patient data on my non-encryted computer.
Tech Guy: La la la!! Not my problem!
Me: My program director told me that you would be able to help me.
Tech Guy: Rant about how nobody understands what my job requirements are.
Me: What software do you recommend.
Tech Guy: Passive aggressive response about how nobody takes his suggestions anyway, but I should use X software, but really I need to talk to this other person who never returns email or answers his phone, and also is out of the country for 2 weeks.
Me: Thanks for all your help!
Tech Guy: Blow it out your ass!
Not that the conversation would LITERALLY take place like that, but you catch my drift.
Anyway, as I was saying, I will be ecstatic if I'm actually able to get anything done today.
Suggestions about encryption welcome.
Right.
So, I have to take my SAS cds back to the software lady who doesn't answer the phone or return emails. Ever. Will she be there? Who knows! But her office is a 15 minute walk across campus from mine, effectively killing at least an hour of my day any time I try to go over there. Which (since she never answers her phone or returns emails) must happen multiple times to get one thing done.
Love it!
Second on the agenda will be learning what I need to do to encrypt my laptop (suggestions from fellow readers welcome here -- will encrypting the whole disk necessitate me wiping my entire heard drive? Thanks.). The predicted sequence of the conversation will go something like this:
Me: Hello, my program director told me I should ask you guys about what I need to do to encrypt my laptop.
Tech Guy: Is it your personal laptop?
Me: Yes, but...
Tech Guy: We can only provide support for UNIVERSITY laptops.
Me: I'm not asking you for support, I'm asking you a data security question.
Tech Guy: I am still going to try to avoid helping you.
Me: Well, it's an incredibly large federal violation for me to walk around campus with patient data on my non-encryted computer.
Tech Guy: La la la!! Not my problem!
Me: My program director told me that you would be able to help me.
Tech Guy: Rant about how nobody understands what my job requirements are.
Me: What software do you recommend.
Tech Guy: Passive aggressive response about how nobody takes his suggestions anyway, but I should use X software, but really I need to talk to this other person who never returns email or answers his phone, and also is out of the country for 2 weeks.
Me: Thanks for all your help!
Tech Guy: Blow it out your ass!
Not that the conversation would LITERALLY take place like that, but you catch my drift.
Anyway, as I was saying, I will be ecstatic if I'm actually able to get anything done today.
Suggestions about encryption welcome.
Wednesday, July 07, 2010
Neighbors
So originally, our new neighbors told us that their daughter would be off doing Semester at Sea over the summer, and the house would be vacant.
Then it turns out she is actually babysitting for faculty children on Semester at Sea (which still seems like a pretty sweet gig, if you ask me).
And then it turns out that there will be people staying in the house after all. Plus a squatter or two.
This is all fine and good, but sometimes it is nice to let the neighbors know who the new strangers will be. On the plus side, I introduced myself to them yesterday, and they seemed nice enough. On the minus side, they said they'd been told that nobody was ever home in the house next door (!).
Sigh.
Luca and I saw the neighbors last weekend and said, "Good Morning!" and they actually walked right by us without saying hi. We turned to each other and started laughing. Familial aspergers perhaps?
Anyhow.
In other news, although it was 90 degrees at the dog park this AM, it felt cooler than yesterday. I think I may be getting used to the heat. I know Miss Boo is. She used to pass out when she came home from the dog park, but today -- even with the heat -- she was still asking me to throw the ball after we got home.
She's so cute!
And I got a bunch of things on my to do list crossed off! Yay!
Ok, back to work.
Then it turns out she is actually babysitting for faculty children on Semester at Sea (which still seems like a pretty sweet gig, if you ask me).
And then it turns out that there will be people staying in the house after all. Plus a squatter or two.
This is all fine and good, but sometimes it is nice to let the neighbors know who the new strangers will be. On the plus side, I introduced myself to them yesterday, and they seemed nice enough. On the minus side, they said they'd been told that nobody was ever home in the house next door (!).
Sigh.
Luca and I saw the neighbors last weekend and said, "Good Morning!" and they actually walked right by us without saying hi. We turned to each other and started laughing. Familial aspergers perhaps?
Anyhow.
In other news, although it was 90 degrees at the dog park this AM, it felt cooler than yesterday. I think I may be getting used to the heat. I know Miss Boo is. She used to pass out when she came home from the dog park, but today -- even with the heat -- she was still asking me to throw the ball after we got home.
She's so cute!
And I got a bunch of things on my to do list crossed off! Yay!
Ok, back to work.
Tuesday, July 06, 2010
On looking young
When I was on my ob rotation, one day I saw a woman who'd had 4 kids who was in her 30's and wanted her tubes tied. This all seemed reasonable to me. I took my history, and then went out to present to the resident.
That day, I had one of the male residents, J. He was actually usually really nice to me, but since I'd been brow-beaten by so many of the other residents (mostly ladies, but also one guy who was a particular ass), I was a little nervous. You never knew when one of the ob residents was going to snap and go all psychotic on you.
Anyway, we go in to see the patient together, and the first words out of her mouth were, "Oh my god, how OLD ARE YOU???" directed towards my resident. (She hadn't asked me. I must have been looking especially geriatric that day, heehee.)
"27," he said. I guess he'd skipped a few grades or something. 27 is pretty young for a 3rd year resident.
Unable to restrain myself (so what else is new), I blurted out, "27? Wow. You ARE really young," and then I turned to the patient and said, "Dr. J is a prodigy. See how lucky you are to be seeing such a smart doctor today?"
And then I froze. I had broken the unbreakable rule of KMS*, which is ESPECIALLY unbreakable on the Ob/Gyn service. I was going to be in so much deep sh*t. I started feeling a little nauseous about the new orifice that was going to be torn in my backside once we left the room. I could feel the cold sweat start to trickle down my back.
The patient and J laughed. He finished my history, and we got her consented to have her procedure a few weeks from then.
J never said anything at all to me about my little comment.
****
I ran into J a few months later at the US Pro Cycling Championships. I was running along the Schulykill river path with my husband, dripping with sweat, and it was about 1000 degrees outside (kind of like today). We stopped to watch the bikes zoom by.
"OMDG!!! Hey!" J came trotting over with his wife. I looked around, "J??? How are you? How is that paper you're working on? I heard you got a [very prestigious fellowship] in [another, even hotter region of the country]. Congratulations!"
We chatted for a few minutes about it. I was completely shocked that he remembered me, and that he'd taken the time to approach me outside the hospital and say hi. I never would have expected that from any of the ob/gyn residents.
It really meant a lot to me.
I guess maybe opening my big fat mouth worked out for me sometimes.
:-)
*KMS=Keep Mouth Shut
That day, I had one of the male residents, J. He was actually usually really nice to me, but since I'd been brow-beaten by so many of the other residents (mostly ladies, but also one guy who was a particular ass), I was a little nervous. You never knew when one of the ob residents was going to snap and go all psychotic on you.
Anyway, we go in to see the patient together, and the first words out of her mouth were, "Oh my god, how OLD ARE YOU???" directed towards my resident. (She hadn't asked me. I must have been looking especially geriatric that day, heehee.)
"27," he said. I guess he'd skipped a few grades or something. 27 is pretty young for a 3rd year resident.
Unable to restrain myself (so what else is new), I blurted out, "27? Wow. You ARE really young," and then I turned to the patient and said, "Dr. J is a prodigy. See how lucky you are to be seeing such a smart doctor today?"
And then I froze. I had broken the unbreakable rule of KMS*, which is ESPECIALLY unbreakable on the Ob/Gyn service. I was going to be in so much deep sh*t. I started feeling a little nauseous about the new orifice that was going to be torn in my backside once we left the room. I could feel the cold sweat start to trickle down my back.
The patient and J laughed. He finished my history, and we got her consented to have her procedure a few weeks from then.
J never said anything at all to me about my little comment.
****
I ran into J a few months later at the US Pro Cycling Championships. I was running along the Schulykill river path with my husband, dripping with sweat, and it was about 1000 degrees outside (kind of like today). We stopped to watch the bikes zoom by.
"OMDG!!! Hey!" J came trotting over with his wife. I looked around, "J??? How are you? How is that paper you're working on? I heard you got a [very prestigious fellowship] in [another, even hotter region of the country]. Congratulations!"
We chatted for a few minutes about it. I was completely shocked that he remembered me, and that he'd taken the time to approach me outside the hospital and say hi. I never would have expected that from any of the ob/gyn residents.
It really meant a lot to me.
I guess maybe opening my big fat mouth worked out for me sometimes.
:-)
*KMS=Keep Mouth Shut
Comments
Like Dr. Grumpy, I am also having problems with comments. When blogger gets its act together I will post them. Thanks for your patience!
Sunday, July 04, 2010
Fotografia
My MIL sent us a picture that she took of me and Luca at the White Dog Cafe the night before she and my FIL flew back to Italy. I thought it turned out cute!
I can't believe it's already been a month since they went back! Crazy how time flies.
I can't believe it's already been a month since they went back! Crazy how time flies.
Saturday, July 03, 2010
Holy mother of god
Philadelphia Pro: Spring arrives in April!
Philadelphia Con: It stays in the high 90's for 2 months during the summer.
Click to enlarge.
Philadelphia Con: It stays in the high 90's for 2 months during the summer.
Click to enlarge.
Can you guess who said this to me?
Yesterday:
Him: Rant about work hours regulations, and what a bad idea they are.
Me: Didn't they come out with a new set of recommendations recently?
Him: Yes. Rant about what a bad idea the NEW recommendations are too.
Me: Well, I don't know.... I'm kind of like a drunk person after being awake for 24 hours straight.
Him: Well, then YOU'RE not going to be able to be a DOCTOR then.
Me: .... ?
Him: Rant about work hours regulations, and what a bad idea they are.
Me: Didn't they come out with a new set of recommendations recently?
Him: Yes. Rant about what a bad idea the NEW recommendations are too.
Me: Well, I don't know.... I'm kind of like a drunk person after being awake for 24 hours straight.
Him: Well, then YOU'RE not going to be able to be a DOCTOR then.
Me: .... ?
Friday, July 02, 2010
My little hippopotomus
We just opened a new bag of dog food, and oops! I discovered that Luca accidentally bought puppy food instead of the adult dog food. I first noticed because it looked different. But it actually smells different too. It's much stinkier.
So I fed her some. OMG, I have never seen dog so interested in her food before.
Ever.
So I looked at the label and noted that there was about twice the fat and protein as there is in adult dog food.
Now, I'm not especially excited about the idea of pitching a whole bag of dog food, but I also don't want Boo to turn into a little hippo. I'm wondering if I can get away with feeding her 2/3 or so of what she usually gets for the duration of this bag and maybe her girth will not expand.
Thoughts?
So I fed her some. OMG, I have never seen dog so interested in her food before.
Ever.
So I looked at the label and noted that there was about twice the fat and protein as there is in adult dog food.
Now, I'm not especially excited about the idea of pitching a whole bag of dog food, but I also don't want Boo to turn into a little hippo. I'm wondering if I can get away with feeding her 2/3 or so of what she usually gets for the duration of this bag and maybe her girth will not expand.
Thoughts?
Thursday, July 01, 2010
To Do List for Self
Sorry about the relative lack of interesting-ness of posts lately. I've been swamped! But I guess that's a good thing.
Below is my to do list for the next week or so. Note, I have to prepare some sort of abstract for the MD-PhD retreat in August. And yes, this is a low priority item. I do want to avoid looking like a total idiot, however. Right now, I have NO IDEA what I am going to present, since my data is not going to be ready for analysis by then, and because all I have are a bunch of protocols. I'll probably just present those if the 15th rolls around and I still don't have data yet.
And yes, I realize that reading my to do list is boring too. At least it might be educational for people thinking about doing an Epi MD-PhD!
Paper describing ICU bounceback epidemiology
-Prepare for Friday’s meeting
- Data processing with new rules
- start doing analysis
IRB documents
- determine what I need to do for IRB submissions
- Work on IRB documents for aim 1 paper
- Work on IRB documents for aim 2 paper
Qualitative Study
- Write protocol for final assignment
Thought piece on rationing
- Work on paper
Reading for self
- Read baby rothman
- Read stats notes from 2nd semester
- Read jewell
- Read big rothman
Abstract/Poster for MD-PhD Retreat
- Abstract due July 16th
Figure out how to encrypt laptop
Do overdue HSR training (40+ modules, at least)
Do med student safety training
Below is my to do list for the next week or so. Note, I have to prepare some sort of abstract for the MD-PhD retreat in August. And yes, this is a low priority item. I do want to avoid looking like a total idiot, however. Right now, I have NO IDEA what I am going to present, since my data is not going to be ready for analysis by then, and because all I have are a bunch of protocols. I'll probably just present those if the 15th rolls around and I still don't have data yet.
And yes, I realize that reading my to do list is boring too. At least it might be educational for people thinking about doing an Epi MD-PhD!
Paper describing ICU bounceback epidemiology
-
- Data processing with new rules
- start doing analysis
IRB documents
- determine what I need to do for IRB submissions
- Work on IRB documents for aim 1 paper
- Work on IRB documents for aim 2 paper
- Write protocol for final assignment
- Work on paper
Reading for self
- Read baby rothman
- Read stats notes from 2nd semester
- Read jewell
- Read big rothman
Abstract/Poster for MD-PhD Retreat
- Abstract due July 16th
Figure out how to encrypt laptop
Do med student safety training
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