Some people have way too much time on their hands

Too hard

I was talking with a friend the other day who has been doing the post-bacc thing for a couple of years now to go to medical school. She's now having second thoughts about it, mostly because of the time commitment required.

She wants to get married now, and have a family. I told her that plenty of people do this in med school and residency, and that she shouldn't let it deter her, if she still really wants to be a doctor.

But.

She is concerned that she won't have the life she wants. That 7 years (minimum) of 80 hour weeks is more than she wants to sacrifice. That she wants to have a life outside of medicine. Not in 10 years when she's finally an attending, but now.

And you know? She's right. Medical school and residency are an F-Load of time.

I didn't really know what to tell her besides, "Try not to think about this until you take the MCAT!!!" and, "You really need to discuss this with your significant other," and , "Your concerns are completely legitimate." I do worry that she's just getting cold feet because she's getting scared of the big test and the application process. That she's preparing to give up on med school out of fear of failure.

I also really don't want to push her down a path that she'll end up hating.

You know? Not everybody is like me, and it's perfectly ok not to have a high powered career as a doctor, or to decide that you want to do something else with your life. Better now than $200,000 (or more) in debt when you're halfway done with school or residency.

Sometimes I look at my friends who go to their 9-5 jobs every day and have hobbies and traditional families and I think about what my life would have been like had I chosen that path.

But you know, I really want to be the PI. The boss. Not just the person who carries out the research, but the person who designs it. Who gets the grant. Whose research agenda I'm studying. Not somebody else's idea.

There's nothing wrong with being the 9-5 person, but it just wasn't me. That's why I had to do this.

(Or so I keep telling myself.)

Ha.

The hounds

The best part about Christmas (other than seeing my lovely parents of course!) is watching Miss Boo and my parents' dog William play vicious dog with each other. Here they are taking a short reprieve from their activities. Luca is compulsively checking his email, as usual.



Miss Boo is such a lap doggie! She was a complete cuddle bug this weekend, probably because she wanted to keep William away from me. At all times.



And finally, we have a new outfit for the Boo. It's a winter coat (with hood and everything!) that my parents got for William, who of course hates it and won't wear it. Fortunately, William is a very furry poodle and does not actually need a winter jacket, so Boo inherited it.



She is so tolerant!

Xmas Miracle

This Christmas, for the first time ever, I received not one, but TWO bars of cell phone reception at my parents house. I had reception that was good enough to notify me of a message (but not strong enough to make my phone ring) AND to dial into voice mail (on the fourth try) and to listen to my lone message.

And no, it wasn't an important message even. The reception alone was miracle enough.

Where do my parents live, you might wonder, that we get no cell reception? Drum roll please!

Connecticut.

Yes, I am serious.

The reception has been so poor in the past, that AT&T never even bothered to lie about one's ability to receive it. The map has historically shown that our town is uncovered. At the rate NW CT was progressing technologically, my family was beginning to wonder whether it would ever happen. (And it still hasn't really, since you have to go up to the attic to use the phone.)

It's like living in the 1990's up there when we go to visit.

Subliminal Messages

For Christmas, my mother gave me about new (fancy) 5 bra and panty sets.

She also gave me a turkey baster.*

I wonder if she's trying to tell me something.

Maybe the turkey baster is in case the underwear fails to accomplish it's mission?




*In all fairness, she did give me a roasting pan as well.

Wiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii

My dad and I procured a Wii for my mom for Christmas.

A few years back, she had two craniotomies and a coil procedure for three aneurysms, a gamma knife procedure to ablate an AVM. We're thrilled with her outcome (i.e. that she can walk, talk, do most self care, etc.), but since they went through her frontal lobe for one of the procedures, we've noticed that she has trouble with "process" and motivation.

She has always liked video games, and we thought perhaps she might build more synapses playing Super Mario Brothers than by watching Law and Order. We also thought that she might be inspired to get off the couch to do balance exercises by the Wii fit.

These are hopes, of course. Yesterday she did one yoga exercise. The one where you breathe deeply. Once.

Yay?

However Luca and I played extensively. (I suppose if her selfish daughter and son-in-law hadn't hogged the Nintendo so much, she might have been able to play more.... or so I suspect she will argue.)

We particularly liked the tennis and swordfighting games. Well, I especially liked the sword game. It was freaking awesome.

I'm a bit sore today though... Oops.

Luca and I toyed with the idea of eventually getting a Wii for ourselves. It's definitely a time suck though, and I worry that I REALLY would never graduate if I got one. On the other hand, I like that the Wii fit tracks your progress and teaches you how to do yoga poses and strength exercises that use your own body weight.

The running game was kind of lame though. Penalizing you for passing your pacer? Lame. We need to find a racing program so I can go head to head with Luca and kick his ass.

Shoplifting

Salespeople really aggravate me. I don't want to be bothered when I go shopping, I want to get in and out as fast as possible, and usually I don't need their help.

But, they are paid to ask, so I can't really fault them for it.

I think what I dislike even more than overzealous salespeople, though, is being followed around and helicoptered over by a salesperson. You know, they kind that follow you as you go to a different room of the store, ask if you need help, and then busy themselves "dusting" or "rearranging" some items on a shelf 2 feet away from you after you tell then that you don't need them. Such a salesperson does not care about you or making a sale: he/she is more interested in whether you are going to try to steal something.

I suppose I should be flattered. I look young enough to be a shoplifter! Or at least I don't look *OLD* enough (or rich enough??) to be shopping at a particular kitchen supply store I went to this morning. In any case, I probably shouldn't complain. And let's face it, if I were any sort of minority, the overbearing not-helpful attention of the salespeople would probably suck way more.

Gah. This is why I buy most of my stuff online! Am I the only one who is bothered by this sort of thing?

Happy Birthday to Boo

Well, I don't actually know when Boo's birthday is, but today (or was it two days ago???) marks the anniversary of the day we adopted Miss Boo.

One of the best decisions I've made in a long time.

We love you Miss Boo!

F30

Remember that grant that I submitted in April? No, not the application for the T32 that I did in May, and then received shortly thereafter. This is the F30.

I got my score several months ago, and it was very good. We were all pretty sure I was going to get the grant. However, since I am superstitious, I didn't want to make a big thing out of it.

So today I heard officially -- I got the grant!! Woohoo!!!!!!!!!

I'm especially excited because this grant will allow me to do research in a field that my department does, but doesn't actually have any funding to provide students. So now I get to do what I want!

Yay!

Now, on with my paper.

So embarassing

Last night when Luca came home, one of our neighbors who lives on an adjacent street was sweeping up the leaves in front of my neighbors' houses. You know, the house of the business school professor, and the house of the brats next door whose mother bought them a house.

They haven't raked their leaves once since Fall started and they were completely covering the entire sidewalk 1 ft deep.

Luca and I had done our own leaves this past weekend, but still we were completely mortified -- as representatives of the new "rich" white neighbors on the street -- that our neighbor on an adjacent street would think that the way in which we maintained our block was so deplorable that he would take it upon himself to sweep the leaves for us. We started gathering rakes and garbage cans to dispose of the leaves in. I gathered clippers so I could trim the ivy from my neighbor's garden that had begun to grow across the sidewalk.

Of course, everyone was home, totally oblivious to what this man was doing for them. I knocked on their doors so they could at least thank him, if not help sweep the leaves themselves.

To her credit, the girl next door came out and helped rake. The business school professor shrugged and said, "Oh yeah, my handyman is sick, that's why they haven't been raked (FOR THE ENTIRE MONTH)," and went back inside. I hope he at least writes the man a thank you note.

It was humiliating. No wonder the neighbors hate the white gentrifiers.

Barf

I study ICU bouncebacks, and as part of the curriculum for my PhD, it was decided that I should take a class on operations research -- queuing theory -- in order to learn more about how inventory moves through a company.

So I found the following course:

Applications of Operations Research in Systems Engineering.
This course will present a survey of various areas from Operations Research and the methods used to solve problems in these areas. Some of these topics include: Transportation and Transshipment Problems, Introduction to Graphs and Trees, The LINGO Computer Package, The Transportation Simplex Method, Sensitivity Analysis, and Assignment Problems. The course also will discuss: Network Models, Shortest-Path Problems, Maximum-Flow Problems, and Minimum-Cost Network Flow. Integer Programming as applied to Knapsack Problems, Machine Scheduling Problems, and the Traveling Salesperson Problems is also discussed. Other topics include: Decision Making under Uncertainty, Utility Theory, Decision Trees, Decision Making with Multiple Objectives and Analytic Hierarchy Analysis. Some Game Theory involving Two-Person and n-Person Games is also included in the course. Other topics include: Deterministic and Probabilistic Inventory Models, Holding Cost and Lead Times, the Economic Order Quantity (EOQ), The Continuous Rate EOQ Model and Backorders, The News Vendor Problem, The Economic Order Quantity (EOQ) Model with Uncertain Demands. Other possible topics may include: Finite Regular and Finite Absorbing Markov Chains, Random Walks, and Queuing Models.

I was a little worried about the level of math involved, since I haven't had the pre-req in linear programming, but the professor told me that he thought it should be ok.

So I emailed my mentor. Who suggested a slightly different course from the business school.

Operations Management II: Supply Chain Management:
Matching supply with demand is an important challenge for firms: excess supply can lead to costly inventory write offs, while inadequate supply irritates customers and results in lost revenue. In this course we will explore how firms can organize their operations so that they more effectively align their supply with the demand for their products and services. Our aim is to provide both tactical knowledge and high-level insights needed by general managers and management consultants. We will describe how companies have used the principles from this course to significantly enhance their competitiveness. Our emphasis is on managing uncertain demand, both within the firm and across the supply chain. We demonstrate that matching supply to demand is easiest when a firm has a flexible supply process, but flexibility is generally expensive. In this course we will learn (1) how to assess the appropriate level of supply flexibility for a given industry and (2) explore strategies for economically increasing a firm’s supply flexibility. When supply is not flexible, we will learn how to manage demand to better match it to our fixed supply.

Which might be more appropriate in the sense that since it is a business school class there is probably very little math/analytical work. However, since the point (I thought) was to learn quantitative methods, then maybe the engineering class is more appropriate. Also, in order to get to Operations Research: Supply Chain Managemetn at the business school, I must pass through Operations Research: Quality and Productivity first.

But what really got me was this one bit in the syllabus for the business school class where they were talking about class participation. Apparently, the professor does not grade you on this -- YOUR CLASSMATES DO. I.e. They vote for people they like who are in the class with them. It's like a mini departmentally sanctioned/mandated popularity contest right in the middle of class. In fact, 15% of your final grade is determined by voting by your peers.

F-ing business school.

See, I understand that it is important that your work colleagues like you, but to be graded on what a bunch of douchey business people think of you? No thanks. Blegh.

I stopped reading at that point. I didn't want to get to a section where I would be told that I would be graded on my clothes and how I applied my makeup and did my hair as well.

You have no idea how happy I am not to be in the business world anymore. And I intend NEVER to go back if that is in any way possible.

Sleepy

The poor ferocious pit bull stayed up until midnight last night, and had an extended play with the Ridgeback next door, and is STILL sacked out this morning. I asked if she wanted to go pee-pee and the eyes barely opened.

My poor princess Boo likes her 9 hours of sleep, it seems!

Meeting

So I know everyone wants to know how the meeting went.

And I have to say, it went pretty well, all things considered. Not perfectly. But pretty damn well.

I basically told him that he needed to take more interest in me as a person, and that we needed to have some small talk at the beginning of meetings so try to do that. Not 20 minutes of it, but 5. I needed to feel that I wasn't walking on eggshells around him.

He told me that he is going to "try to set boundaries better." Whatever that means.

And most importantly, I felt better when I left the meeting. Cautiously. I didn't feel like crying even once. I didn't shake with rage or frustration. I felt most of what was said was fair. I kept my shit together, and it wasn't even a challenge to do so.

Maybe I'm being overly optimistic.

But to that point, yesterday I went to my mentor's monthly conference for his division. One of the junior faculty was presenting her project to try to get feedback about her specific aims. She's going to be using the same database, and she's about where I was oh.... 8 months ago in the design phase of it. She's struggling with many of the same issues that I struggled with.

And I was the resident expert on the database. Of all the fellows and attendings sitting in that room, I was the one who knew about what was available in the data, and how you could actually use it. What were the appropriate models to ask the question. My mentor was there, providing more (very very useful) big picture advice, but when people asked technical questions about the data, I was the one who knew the answer.

For the first time in the past year I felt a sense of collegiality with my mentor and with the group.

Tentatively.

So, here's crossing my fingers and hoping that things really are going to be better. That he is actually trying to improve, and that we won't have the problems we were having before. I doubt that it will be 100% smooth sailing from here on out, but maybe it will be less choppy?

Anyway.

Happy end of semester to my peeps still in school!

Diet

I haven't been exercising much lately. After my swim partner moved away this spring, it just wasn't fun anymore. And it's been too cold to run + go to the dog park, and I don't have time to do both separately, so it's just been the dog park.

So I started worrying that I might be getting.... fatter. But my scale had been broken for 2 months so I had no idea.

Last weekend I asked Luca to pick up a new scale at Target. And it turned out I weigh the same as I did before. Yay!

However.

The Boo now weighs 55 lbs. I knew she was getting fatter due to comments made by her foster mom last week. However now we have empiric evidence in addition to extra "skin" folds and lack of rib. She should be ~50 lbs.

Luca is 5 lbs heavier too.

Boo was getting 3+ cups of food per day, so I decided to cut back to 2.5 cups per day. I know it's significantly less because she makes less poo now. But my question is, is this a reasonable amount to cut her to for slow weight loss, or should I cut her back more, like to 2 cups. I guess I wonder whether 2.5 cups/day is a maintenance amount, and she'll just stop gaining weight, and not actually lose any.

Any advice from the vets/other dog owners in the room?


(Luca started working out again this week.)

Meeting

I probably shouldn't be blogging about this.... but I will anyway because I need your advice.

So, today my mentor and I are going to have a meeting about how to make our relationship work better. And I've been trying to figure out what to say to him that doesn't sound utterly lame and pathetic.

What I really want to say is, "I feel like you view me as a paper-producing machine, who wants me to deposit finished papers upon your desk with no need for input from yourself, and that you're not invested in my development as an investigator. I feel like you don't care about me as a person."

See, it's not that I want my mentor to be my new best bud, but I do think that in the most successful mentor - mentee relationships, the mentor is at least a little invested, a little interested in the mentee as a person. It often seems to me that my mentor views me as a paper-dispenser, and becomes impatient and irritated, resulting in various insults to be directed my way, when I am not able to produce papers with a snap of the fingers.

Now, I'm sure he would say that I'm difficult to work with too, needy, weird, too demanding, manic. Actually, he has said these things. But I have tried so many things to try to accommodate his style.

Let me list them for you:

1) I've tried speaking more slowly and deliberately, because that's how he talks, and he seems to equate the two with competence. I know he thinks I have too much energy.
2) I've tried meeting with him less, which has led to micromanage-y emails.
3) I've tried meeting with him more, which has led to complaints that I'm too needy.
4) I've stopped making jokes of any kind because he just doesn't seem to get them.
5) I've stopped asking about his baby/wife/family/etc. because he has rebuffed all attempts to relate to him on an interpersonal level.
6) When he complained that I was being condescending for telling him my research plan in an email (that Luca wrote precisely because I was afraid of coming off badly -- and Luca writes delicate emails for a living), I tried asking rather than telling. And then he complained that I was too needy again.

Nothing seems to work. I can't seem to win no matter what I do. And some of the things, like speaking slowly and calmly at all times (no matter what), and asking always rather than telling, are really hard for me to maintain 100% of the time.

Basically, I think the problem is that he just doesn't get me, and has some unrealistic expectations about how I'm supposed to be progressing. And I don't know how to convey this without sounding like a whiny brat.

Do you have any suggestions?

The pink ghetto

Less than 25% of the faculty in my department are women. That's f-ing pathetic. You want to know what's more pathetic? The most famous of them do behavioral research. How to get people to change what they eat or to get them to exercise. Or how get them to be less sad and have better body images.

I'm not poo-pooing the value of the research. But it is comparatively "female" research -- compared to studying drugs and side effects and diseases. And "female" research is thought inferior to male research. Sorry! That's how it is. Because male research is about science and is more "serious." I can think of one woman in my department who does "male" research. ONE.

Pathetic.

*****

I decided to do Epi because I wanted to learn QUANTITATIVE methods. Statistics. Math. Earlier this year, my mentor decided that I should do more QUALITATIVE research. Focus groups, interviews, ethnography. I have no idea what made him think this was a good idea. Fact is that qualitative research is still viewed widely as "not-science." And who does most of the qualitative research?

Women.

Qualitative research is only just beginning to be taken seriously. It's still borderline impossible to get a qualitative study published in many of the leading journals. It's not that I think qualitative research isn't valuable. It is. It's a) that my mentor never asked me what *I* wanted to study, and b) he somehow decided that I should do qualitative research despite the fact that I'm in an Epidemiology & Biostatistics department. Why did he decide this? I dunno. And, when I started learning more advanced stats methods this fall, he became really really snippy with me, saying things like, "Well, there are plenty of methodologists out there. It doesn't matter how good you are at the methods. It's more important to have a nice personality." And he's still trying to steer me away from taking more stats classes. I can't understand why.

No doubt being liked is important. But if you're an idiot who doesn't know what she's doing, my thought is that nobody will want to work with you either. Just saying.

*****

Other things about my department also make me sad.

There is one man PhD student in the department. He speaks up in class. And you know what all the girls say? "X is so smart. I'm not nearly as smart as he is. I could never think that quickly on my feet," and they rarely if ever participate in class. What's sad about that? It's not that X isn't smart, he is very smart. It's that they think they're less smart. And less valuable. And less likely to succeed. And are so afraid of being wrong that they don't try at all.

I want to shake them by the shoulders and tell them they're shooting themselves in the foot. But these same people think I'm too loud. Too outspoken. Too controversial. They wouldn't listen to me if I told them to start speaking up themselves. And I can't make them believe in their own value.

*****

Before medical school, it never even occurred to me that my gender would be such a big impediment to my future success in academic medicine. Nowadays, I feel like my female-ness is being shoved in my face daily. There are people who tell me in concerned tones if I have children, "It will be so much harder -- as a woman -- to have a career in academic medicine." Who ask me why women "fail" so often in my field. Who try to channel me into more "female" areas of research. There are the people who tell me I should sit silently in class and not ask questions. Who tell me I will never succeed unless I can make them like me. And the only people they like are the ones who know the secret handshake.

I'm tired of being told I'm going to fail because I don't conform to some stereotype about what a good woman student should be. And that I'm also going to fail because I do conform in other ways.

I hate it.

*****

Isn't this 2010? Shouldn't we be past this by now?

The test

A friend told me that when her husband meets someone knew, he will usually say something outlandish just to see how they will react. If they act all uptight and comment on his inappropriateness, he knows that he probably won't want to hang out with them.

Personally, I thought it was rather brilliant.

My own strategy when I'm out and about with Luca is to see whether people are willing to try to understand his accent. It really isn't that hard to speak Luca, you just need to give it a minute or two to get used to it. Most people do just fine, but there is a non-insignificant portion of the population that will make a quick attempt, but then beat a hasty retreat once they have to expend any effort at all to understand him.

IMO, if you're not willing to at least TRY to do this, you're probably not worth our time. Maybe this is unfair, but it's very very pragmatic. And of course if people come back and try again and are more successful the second time, they get a pass.

Do you have any weeding out strategies when you meet new people to see if they are compatible with you?

Mentors

I was talking with some friends the other day about their mentors. And you know what? We all have problems with our mentors, but none of us has the same problem.

- One of us has a micromanager mentor who shoots down all of her ideas and tells her specifically what analysis he wants run, giving her little leeway to develop her ability to think scientifically
- One of us has a mentor who is TOO hands off. Who lets her design and conduct whatever analysis she wants with little to no input from him. Which would be great if she were on the right track. But right now she feels like she is flailing.
- And finally one of us a mentor who constantly critiques her personality. Who makes cutting insults about her intellect and productivity (which by all other accounts are doing great), and who tells her that she will never succeed because she has a difficult personality.

Hearing these stories made me feel relieved. Relieved that I am not the only one who has these kinds of problems.

Hearing these stories has also made me think about the fact that I need to get my mentorship from multiple people. Not just one. Also, I think I may really need a woman mentor to help me navigate some of these issues. Issues like the politics in my department, which is really just a giant fraternity.

Any suggestions on how to go about this?

Nipples

I'm not sure exactly why, but something about the fact that the top of my mentor's head is about the height of my husband's nipples pleases me greatly.

I know this song was written just for me and the Boo

No matter what I do,
All I think about is you,
Even when I'm with my Boo
Boy, ya know I'm crazy over you.

See Luca, even though I pay more attention to the dog than to you, I really do like you better than the dog. Or as much. Almost. Or.... whatever. I swear.

;-)

Multi-tasking

The only problem with remote desktop is that, though it enhances my ability to run multiple models at the same time, I have also started having the problem of forgetting what I was doing on one computer while the other models are running on the other computer.

Multitasking will be the end of me.

Frustration

I had a meeting with my MSTP director the other day. He made the rather memorable comment that he knew of many PIs with a bad temper. With a low frustration threshold. Indeed, he knew many who threw tantrums and had seemed to do just fine. In both life and in their careers.

Fantastic.

You apparently don't have to have a perfectly evenly keeled personality to have a successful academic career. I suppose to those who are familiar with academics, this isn't a terribly surprising revelation. Ha.

I mention this because I can -- on occasion -- be a little bit.... volatile?? If nothing else, outspoken. And I definitely have a low frustration threshold. It's good to know that these things won't stand in the way of my career, though. Haha.

Of course, I AM a woman, so perhaps the rules are probably a little different for me. And I don't really want to be known as the PI who pitches a fit every time something doesn't go my way. Also, at the same time, I continuously try to improve upon the ways in which I relate to others. It's a work in progress, but still I am hopeful that I can be more poised when I finally get my first faculty job (ahem. 10 years from now. ahem.). Somehow I doubt the tantrum throwing PIs are doing this, but who really knows.

And I still do like the fact that I have a strong personality. Even if I can be a little abrasive at times. Even if not everyone else likes it too.

Because without it, I'd never have gotten where I am now.

Curbside

Last night we had Boo's foster mom over for a beer to talk about some jobs that are open at Luca's company, that she wanted more information on. It turns out that all that extra "fur" that Boo has developed in the last month or two? Is fat. Oops. I *thought* I could still feel her ribs, but apparently I have to press harder than one should to do this.

Anyway, I was grateful for the advice. We will be cutting back from 4 cups of food/day to 3. Poor Miss. Boo!! Fortunately, it hasn't gotten out of hand.

But me? Personally? As a student doctor? I hate it when people ask me medical advice. Or when people tell me how their loved wrong has been wronged by the medical establishment and how they're going to sue. The whole thing makes me incredibly uncomfortable. And when those people are the same person?

*Shudder*

I usually just tell them if they're really concerned, they should go see their doctor. Usually this works, but with one friend in particular, it NEVER does. She always persists with more questions. And then maybe she'll go to the doctor and use the, "He gave me antibiotics so SEE I really WAS sick."

Oh God.

Does being a doctor mean that you have to humor people like this? How do you deflect the curbside consults from your friends and relatives?

Dec 7th

I remember growing up, every year when December 7th rolled around, we would hear that THIS was Pearl Harbor day. The day the United States declared war on Japan in 1941.

I can't remember hearing about this for several years now. Is this because most WWII veterans are dead now? Is our memory for history that short?

Is so, that's really depressing. That was only 69 years ago! That's not even that long! Gah! What else have we forgotten?

On kissing ass

I am not good at this. I do very well at expressing interest and enthusiasm when actually interested, but when I find someone boring or repugnant I have a really hard time pretending that I think they are God's gift to everything.

Sigh.

Unfortunately, being able to do this is important to having a happy life and a successful career. Therefore I present a list of things you can do to try to schmooze it up with the people around you. I found this list of tips here.

1) Frame flattery as advice-seeking. For example, you can ask, “How were you able to close that deal so successfully?”

2) Argue before accepting a manager’s opinion.

3) Compliment the manager to friends in his or her social network.

4) Act as if you realize that flattery will make the manager uncomfortable. For example, you can say, “I don’t want to embarrass you but your presentation was really top-notch.”

5) Agree with the manager’s values before agreeing with his or her opinions.

6) Tell the manager’s friends how much you agree with his or her values.

7) Bring up affiliations you think you may have in common with the manager, such as a religious group or political party.

I can handle 3, 4 and 6, though I've never actually used the phrase, "I don't mean to embarrass you, but..." Doing #1 never occurred to me, but it sounds feasible, so I might give it a try. It also never occurred to me to do #2. If you agree you agree, right? Why argue about it before hand? I mean, I see *why* but yeah, it never even occurred to me to do this.

But.

The whole part about agreeing with your manager's values is odd though. How do you even figure out what those are? And what do you do if you trip over some hot button issue and your manager assumes that you disagree, even though you say you agree? And what if you rabidly disagree? I mean, obviously you should keep that to yourself, but do you go a step farther and pretend you actually rabidly agree anyway?

And the whole part about religious or political affiliations? People are trained not to discuss these things in the workplace. How do you figure out what your manager's beliefs are so that you can start pretending to agree with them? It's not often that your attending preceptor streams Rush Limbaugh on his computer over lunch while he eats. Usually, political affiliation is more challenging to figure out.

Anyhow, perhaps this next week will be devoted to identifying opportunities to kiss ass. Perhaps once I've identified ass kissing opportunities, then I can move on to actual ass kissing techniques.

Because God knows I need to get better at it.

Remote

OMG I just figured out how to use Remote Desktop from home to my school computer!!! You have NO IDEA how much easier this will make my life!!!

Small victories. That's all there is in PhD-land sometimes.

Doctor time

I just fielded a call from the housecleaning service we use. They're coming to clean tomorrow, and wanted to reschedule.

"What time were you thinking?" I asked.

"As early as possible," the lady said.

"And how early is that," I asked.

"As early as possible," she repeated. I think she was afraid she would piss me off.

"Which would be when?" I repeated.

"8 o'clock? 8:30?" she asked.

"Oh. That's fine," I said. I'll get to school by 7, set up my models, and then run home to meet the cleaners. I should have plenty of time.

I was thinking early for the house cleaner = 7AM? 6AM? But 8? That's normal time.

I remember when dragging myself out of bed in the mornings at 7:30 for work was a daily struggle. Now if I sleep until 8 I feel positively slothful.

I wondered silently to myself at what point I started considering 7AM a time at which any responsible person would already be awake. Was it during my Ob/Gyn rotation with my 4:30 AM wake-up time? Or my medicine rotation with day after day of 5:30-6AM wake-ups? If I were going into surgery, would I have requested a 6AM house cleaning time with the thought that anything later would just be lazy?

Anyway. I wonder when people with "normal" jobs get up. Probably early too. Probably this is another way that doctors think they're special but aren't. Hm. I wonder.

God

About a year ago, I was talking with a friend I was thinking about setting up with another friend. It turned out the two were of different religions, and this was a deal breaker for the woman.

Ok fine.

But then she said something that bothers me to this day:

"Religiosity in a partner is very important to me. I feel that if you don't have a strong faith in a religion you have no moral compass."

I think it bothers me because I feel the opposite way. I feel that if you need a religious authority to provide you with a moral compass, than you have some serious problems. People have brains and hearts and should be able to tell right from wrong without a priest or God or Whoever telling them it's ok to do this, but not ok to do that.

(And if you must know, no I did not say this to her. I know she thinks I'm a heathen, and I don't really care about her opinion regarding these things.)

I recognize that my view probably comes from my protestant upbringing, though. Do other people have thoughts on this?

Yo -- People who say I can't have it all? GFY.

Below is the transcript of a speech Nora Ephron gave at the 1996 Wellesley commencement. I found it over on Michelle Au's blog. I think I like this except the best:

This is the season when a clutch of successful women -- who have it all -- give speeches to women like you and say, to be perfectly honest, you can't have it all. Maybe young women don't wonder whether they can have it all any longer, but in case of you are wondering, of course you can have it all. What are you going to do? Everything, is my guess. It will be a little messy, but embrace the mess. It will be complicated, but rejoice in the complications. It will not be anything like what you think it will be like, but surprises are good for you. And don't be frightened: you can always change your mind.

Then she goes on to talk about the 5 words that best describe her, and how those are different now than they were 10 and 20 years ago.

Which got me to thinking, what are my 5 words?

This was not an easy task.

So,

boat-rocker
doctor-to-be
researcher
perceptive
driven

is what I came up with.

What are your 5 words?

I needed a good laugh this morning, and Jeopardy provided me one.

Shift

I did another EM shift the other night. I had a few observations.

1) This time, my attending wanted to pick out "interesting" patients for me, rather than having me pick up patients on my own like a sub-i, but then he forgot so I sat around a lot not knowing if I should just go and pick one up, or if he would be mad if I did that. All in all I was totally NOT busy enough which is never a good thing for me.

2) I had a patient with headache in an immunosuppressed patient with thromobocytopenia. She was on tacrolimus. All we cared about was whether we'd LP him to rule out infection, and whether we should CT her to rule out brain bleed. However, the differential is a bit broader. RPLS, GVHD, tacrolimus toxicity. In the ED they weren't so interested in those things, and it made me a little sad to think I'd never think about them again either (much) if I went into EM.

3) Something similar happened with a patient who complained of dyspnea on exertion and new shortness of breath. Once we convinced ourselves that this new SOB wasn't life threatening, and wasn't due to infection or a PE, we sent her up to the floor for them to think about. Now, I am not especially interested in heart failure or echo-cardiograms, but it bugged me that I would never really know what was going on with this patient.

4) My attending went on a tirade about how one of our patients was obviously crazy because she had a hand splint for carpal tunnel syndrome. And who knows, maybe she was crazy. But the thing is, she was polite and straightforward when we examined her, and didn't act crazy or difficult at all. As someone who has periodic hand pain myself (bad enough to keep me from sleeping) from time to time associated with excessive computer work, I was a bit put off by the sweeping statement that all patients with carpal tunnel are crazy and lawsuit happy.

So, I am wondering whether neurology may be a better choice for me.

Thoughts?

Sometimes I actually do keep my mouth shut. Really.

And sometimes I should keep my mouth shut, but I don't, and it doesn't matter anyway. Or maybe it makes things better? Maybe?

Like last night, I was doing another ED shift and one of the interns who was rotating from a non-ED specialty had some down time and started doing her med student evaluations while she was sitting at the public computer right next to me. It caught my eye because the template looked exactly like the one we fill out for the residents.

I couldn't read the student's name, or any of the text describing what attributes she was evaluating. However I *could* see that she was giving the med student some shitty-ass grades. Like a 3/7 for some skills, and nothing higher than a 5/7.

Now, I KNOW this is none of my business, but I said anyway, "Wait is that a med student eval? You do realize that a 3/7 is a failing grade for a rotation, and a 5/7 is barely a pass, right?"

"It is?" she asked.

"Yeah.... I mean, maybe that student was terrible, but a 3/7 is harsh! Please leave some sort of comment if you're going to give him or her that kind of grade. I always found that the comments that people gave me to be the most useful part. Even a 5/7 is only a pass, and is bad if there's not even a comment to know how you could do better in the future."

"I probably shouldn't be doing this in front of you," she said.

"Probably not. Sorry, I won't bother you anymore. And I doubt you'll ever have to evaluate me for anything."

(Famous last words -- ha.)

Anyway, I should have probably kept my mouth shut. It was probably inappropriate to say anything at all. But seriously? It's totally inappropriate to give a student a failing grade without a good reason, just because you're too uninformed to realize what you're doing. I'd have thought that since she was recently a med student herself, that she'd remember what it was like to be a clerkship level med-student, but apparently not!

I also don't know if she changed any of her grades. I tried really hard to avert my eyes so that I wouldn't be tempted to say anything else to her.

I hope I remember what it was like to be a clerkship student when I'm in her position 4 years (I hope) from now so at least I can be fair.