sick

I am so sick of working on this paper.

I have been working on it for almost 12 months.

Six months ago my statistician and I decided that we would divide our outcome into ICU readmissions that occurred less than 48 hours after discharge, and those that occurred between 48-120 hours after discharge. This is so we can have non-overlapping categories. I actually pushed back on this for a while, but gave in. My mentor was on board with this as well.

We also decided to to a sub analysis looking at 48 hour readmission because that's where all the interesting effects appeared to be happening.

So, at last week's meeting, my mentor asked, "Why are you looking at your outcome in those categories? It makes no sense! You should be looking at 48h or less and 120h or less."

So now I now have to repeat all my sub analyses for these 120 or less readmissions, whose effects will be mixed with the interesting 48 hour or less admissions. Those results will mean NOTHING.

The moral of the story is, when you have a research project, finish it AS FAST AS YOU CAN, before your mentor can decide that the project really needs to be about something else and basically makes you start from scratch.

Three times.

Sometimes I just love research.

spoiler alert

I know it's been over for several years, but Luca and I are one episode shy of finishing Six Feet Under, and I just want to say one thing.

*****If you don't want the series to be spoiled, please stop reading now******





























I AM SO GLAD THEY FINALLY KILLED OFF NATE. What a selfish motherfucker. Everyone else on the show had their flaws, but everyone else grew over the course of the show. He, by contrast, was completely and totally irredeemable.

And that is all I have to say about that!

On judging

Hi all you non-doctors out there. I have news for you: your doctor is judging you. If they're any good, you won't know that this is happening, but it is true. They are human, and well, patients sometimes do ridiculously dumb things that deserve judgement.

I know some of you are thinking how evil I am for saying that. How if you were my patient you would never tell me ANYTHING. How I must be a terrible doctor. (I'm not actually. A doctor. Yet.) But guys, this is a BLOG, not real life, and if you think my judgements are bad, you should see some of the other guys.

In the class we have in medical school on how not to be an asshole to our patients, we learn how make the patients feel like we think that they are intelligent thoughtful consumers of healthcare by listening to them, even if we think that you are totally clueless and endangering yourselves. We do this because we know that if you think we respect your views, you are more likely to follow our advice.

But say you tell us that you just slept with 15 people over the weekend. Or that you refuse to consider quitting smoking. Or that you dilute the formula you feed your baby so that the baby doesn't get fat. Or that you take mega doses of herbs via enema that you shoot up your ass every other day to get the evil spirits out. Or that you think that medical interventions are the work of the devil, and therefore you don't want to give your child chemotherapy.

We are very very happy you told us these things so that we can address them, but we will probably at very least think you're a little weird, and possibly that you're a freaking idiot. And dangerous.

And if we are good at what we do, we will be able to address these issues without making you FEEL stupid or judged. Learning to communicate well as a doctor is kind of like learning how to be a good actor.

In the end, it's still possible to be respectful to patients and even to like them as people, even if they sometimes make bad decisions about their health.

Just remember that the next time you get angry because your doctor tells you something you didn't want to hear.

h.o.t.t.

I am very displeased with the 96 degree weather we're supposed to get tomorrow and Tuesday. Do you hear me? VERY DISPLEASED.

It usually takes a little while for me to acclimate to the heat, but this year's been especially bad. All I want to do is lie around the house in my underwear sipping on a cold drink half awake / half asleep.

Moving makes me nauseous. On Friday, my skin hurt when air blew over it and I was all achy and stiff. I took my temperature and it was 100.6!

(Even by dr. standards that is usually a "real" fever.)

I thought I was coming down with something, but.... nope! I felt better as soon as I could lie in my room in the air conditioning. So yes boys and girls, I was suffering from heat exhaustion, and it wasn't even 90 degrees yet. I'm totally going to be one of those little old ladies that someone finds dead from heat stroke in her house sitting in front of her open refrigerator trying to cool off.

Aw well, maybe I'll read another article for class and then go to the pool at 6 or so. How pathetic am I that I have to go in the evening so I don't roast. Damn Caucasian skin.

quals

This has been my day:
7AM -- Get up, check email, play with my models
8AM -- Go for run + doggy park-y
9:20 -- return to house, procrastinate on email
9:50 -- read baby Rothman, almost doze off
10:20 -- decide I need gatorade water, drink water
10:25 -- read more baby Rothman, take three breaks to pee
11:05 -- shower
11:15 -- realize self is ravenous, make lunch, get dressed
11:30 -- watch episode of scrubs while eating lunch
11:55 -- read more baby Rothman
12:30 -- become very very sleepy and doze off completely
1:15 -- wake up, check email
1:20 -- receive phone call from Luca about swim club
1:30 -- talk to father on phone about news
2:15 -- write blog post
2:25 -- do some reading for the love of God!!!

So you get my point. I have not been productive today. I guess interspersed in there is also about an hour of data management and poster writing, but yeah, you get my point.

I'm scheduled to take my PhD qualifying exams sometime in mid August. Needless to say I have done exactly zero studying until now for them, which is probably ok, since I probably wouldn't remember anything anyway.

One thing I have to say is this: Do you know how much I hate reading Epi methods? Things with names like "risk set sampling" or "1 minus sensitivity." There truly is no better sleeping pill than to open up baby Rothman or Gordis before going to bed. Gordis isn't as bad as Rothman, but it's not much fun either.

The problem is I actually have to acquire some mastery of the material by the end of the summer, so I've been willing myself to stay awake as I read.

I have not been terribly successful. Today I've read 23 pages of baby Rothman so far. I've also done some stats for my papers, and finished my poster. But really? 23 pages? I feel like my limit is about 5 before I lose the ability to actually pay attention to what I'm reading. It's so painful!!!!

By the middle of June, I'd like to get through the following:
baby Rothman
Gordis
stats notes
stats assignments
categorical stats notes
categorical stats assignments
measurement notes

On the plus side, I'm taking an advanced epi class that has so far been a fantastic review of some of the material that I'm supposed to know. It is forcing me to actually think about these issues instead of lazily skimming over them saying yeah yeah yeah I know this, without really absorbing anything. Hopefully the class will be a big help.

In other news, Luca and I found out today that we got into the community swim club! We can go and pay and sign up officially tomorrow! It is literally one block from our house, and we really like the people who are currently members. And IT IS OPEN UNTIL 10PM EVERY NIGHT!! Which means that Luca may be able to forgo his 6AM swims at the Y in Landsdale for a couple of months and get to swim in the evenings.

They have grills and a basketball court and 4 pools.

God willing, this will not be the summer that I give myself skin cancer. Haha....

I AM SO EXCITED!!!!

Adding to this excitement is the fact that the University pool is closed for repairs until mid June, and the substitute pool they give us passes to use is inconvenient, small, and crowded. So, basically, even though this is one of the least productive days of the last several months, I am still very happy.

Yay!

droop

Question for you:

If you saw a friend who you hadn't seen in a couple of days or so, and she had a new right facial droop and slurred speech, would you mention it to her? This happened to me recently, and I did mention it because I was really concerned that she was having a stroke.

She got really offended. I still don't know what was going on, since I haven't seen or heard anything about her since. I hope if it was a stroke, she got to the ER and that everything turned out ok.

I don't feel I did anything wrong, even if she was mad at me. I actually wonder if I should have called her husband to tell him I was concerned.

I hope she's ok, and that I was wrong about what I saw.

Would you have said or done anything differently?

To do for this week:

1. Finish poster #2, get it printed
2. Write discussion section for paper #1
3. Once done with 2, revise paper
4. Finish baby Rothman
5. Understand misclassification bias
6. Figure out how to do ROC curves for mixed effects logistic regression model
7. Resolve missing data issues for paper #1
8. Readings for class on Thursday

Fun stuff. Hopefully I can get paper #1 out reasonably soon so that I can focus on paper #2 and on studying for my quals, which are going to be in August.

rat herder

Luca was reading about the origin of Pit Bulls yesterday. I'm not sure where Luca found this information, otherwise I'd give you a citation, but I thought it was interesting anyway.

So, apparently in Victorian era Britain, the dogs were used for bull baiting (where you tie the bull up and have dogs attack it). This was eventually deemed animal cruelty, the sport was banned, and animal cruelty legislation was passed.

However, this legislation excluded rats. So after people couldn't use their dogs to attack bulls, they used them to attack rats. It happens that the best way to kill the most rats in a small amount of time is to have the dog herd them into a corner, and then attack them.

Awesome.

Well, now I know where Miss. Boo's herding behavior comes from. Her ancestors were rat herders! Such classy origins, don't you think?

Oh! I forgot to mention, these "sports" are where the name "pit bull" originates from -- the bull part from bull baiting, the "pit" part from when the dogs were thrown into the pit full-o-rats.

Away

Before I left for my conference this past week, I gave Luca strict instructions about the Boo. I told him he had to arrange for the dog walker/doggy daycare while I was gone, and to make sure he took her for a 30 minute walk before he left in the morning, since she's not used to being left for 12 hours in a day. And then another serious walk when he got home.

And you know what? He did great. Boo is not a morning doggy, and he still dragged her groggy butt on a walk at 5AM each day before he left for work. She went to daycare on Tuesday, which she enjoyed immensely (the staff asked him if she EVER got tired. Answer: no). And on the other days he took her to the dog park to run around when he got home from work.

I was really impressed.

I decided I needed to up my game. Miss Boo always gets her AM walk with me, but often we don't get a long one in the afternoon also because I start feeling guilty about my procrastination throughout the day and decide that I don't have time to take her. I really need to get over this -- both the guilt AND the procrastination. My internet addiction has been out of control lately, and it really needs to stop.

So yesterday in between thunderstorms, I walked her over to the park. There weren't that many people there. Eventually a man showed up with his dog "Mr. Pushy*" as well as his two year old.

Mr. Pushy proceeded to try and mount all of the other male dogs in the park, and threw his body solidly against all the other dogs. He kept trying to get between me and the Boo, shoving her out of the way, which did not please her. And a game of keep away turned sour when Boo had this glow in the dark ball, and he decided to push her away from it. Nastiness ensued. Sure, Boo shouldn't have growled at him, but he needs to accept that some dogs don't like being body blocked and not escalate when that happens.

To make matters worse, the man really didn't want to hold his toddler who just had to be running around on the ground on the same level as the dogs. Therefore, when Boo wasn't playing keep away from the other dogs, she was trying to entice the toddler to play with her by circling/herding her, play bowing, and gently tugging on her sleeve, which the toddler, quite understandably, found terrifying.

I think the man was angry at me for not "disciplining" or "controlling" my dog. I'm really not sure what else I could have done though. Each time Boo started paying attention to his daughter, I lured away with treats or with the promise of a dip in "the tub." Did he expect me to hit her or yell at her? Those types of things tend to make situations worse, not better. I think he really wanted me to leave the park, which irritated me.

Really, what kind of moron brings his 2 year old to the dog park to let her run around with the chaos? Even if a dog ignored her completely, she could EASILY have been trampled by a dog that was careening around the park unawares. I get run into or jumped on every single time I go to the park by either my dog or someone else's. I did the best I could with the Boo, but it's a freaking DOG PARK, not a playground.

When I got home, I asked Luca how he was able to not get so irritated by these things. He told me that it was because he considered most people idiots, and therefore this type of behavior didn't surprise him, and he didn't care what they thought unless they got in his face about it.

I do wonder whether part of it is that since I'm a young looking female, different standards of "behavior" are applied to me than are to him as a slightly older looking 6'5" man. Oh well. I suppose it doesn't matter. I think it would probably good practice to try thinking about these situations the way he does, even if they do happen to me more often. At very least I'd probably be less pissed off.



*Not his real name

Why oh why do they make airplane seats so damn uncomfortable!

So I finally got in at 3AM. I have a drs appt at 10:30, so here I am, bright eyed and bushy tailed up at 8. It would have been really nice to have gotten more than 5 hours of sleep. But who am I to complain? I'm a med student, I should be used to not getting sleep.

Ha. Ha.

I closed my eyes on the flight and tried to sleep then too. But why is it that the seats have to be so uncomfortable. I actually had a window, so I could wedge my head between the seat and the wall, but the window was so cold it wasn't worth it since the shivering kept me awake. I think I must have slept a little anyway because I did one of these looks at my watch and discovered that 90 minutes had elapsed somewhere. Still, way more unpleasant than it needed to be.

Hopefully this will be an uneventful appointment.

The Boo was very groggy but happy to see me. She is now lying on my in my computer chair saying, "Mommy, I own you. You are not going anywhere." She is really cute. And stinky. It's funny how used to her smell I'd gotten, as well as used to sleeping in a sandbox. I can't wait until I get back home this afternoon and can sack out in my sandy blankets again!

Airport

So, Southwest wanted to charge me $200 for the privilege of flying standby 2 hours early, so I decided to make it an afternoon in the airport.

First I got my McDonalds (I love quarter pounders with cheese), and then I found a desk(!) with an outlet(!) and free internet access(!) and settled in to do some work. The only annoying part is that I can't just go pee whenever I want because that would mean I'd have to put the computer away -- a giant pain -- and relinquish my spot.

On the positive side, maybe I'll be able to get part of my results section done. That would be really nice. It definitely beats sitting in the deserted convention center all afternoon. I mean, there was no McDonalds there, come on!

Only 3 more hours to go until my flight.....

Update: Oh just kidding, we've already been delayed by 20 minutes, and Denver is expecting torrential rains, hail, and possibly tornadoes starting now and lasting until tomorrow morning. Perhaps I won't be getting home tonight after all.

Research

It's not much of a secret: I hated my heme-onc elective.

There were many things that contributed to my hatred of this rotation.

1. The attendings expected me to shadow them in their outpatient clinic for the entire month. Not only that, they said it was "weird" when I introduced myself to their patients (which I'd been taught to always do), so really they expected me to stand there in rapt silence hanging on their every word. Pain. Ful.

2. They never conveyed their other expectations of what I was supposed to do to me. Apparently, one student before me somehow got a hold of the list of hospitalized patients for the entire practice and got there at 5AM every day to pre-round on every single one of them. I (by contrast) selected the patients I had done the initial consult on, and the handful that I met tagging along with the attendings every day. Rounding on patients who aren't your responsibility and whom you don't know is just weird, IMO. I don't know if they actually wanted me to do this, since when I did, they never gave me any feedback on my notes. Ultimately, I only followed the patients of the one attending I had a bit of a rapport with, and that seemed to work out.

3. Once someone doesn't die from their cancer, oncology basically turns into primary care for cancer patients. Not my cup of tea.

4. There was exactly zero teaching. Oh I take it back. Occasionally one of the attendings would launch into a 5 minute rapid fire monologue of everything there was to know about DCIS or whatever. Somehow I was expected to retain all of this information even though I could barely understand what he was saying.

4. The attendings there had nothing but complete and utter disdain for research. I made the critical mistake of mentioning early on that I was an MD-PhD student, and I did Epidemiology. They took great pains to tell me what a waste of time all these new guidelines were, and that they followed them only loosely. Fair enough, but the sneer they said it with, and the disparaging comments they made about people who did research after that kind of gave me a bad taste in my mouth. Nevermind that I wasn't planning on doing clinical trials (I'm much more into palliative care, for instance), they thought it was all a great big waste of time and took great pains to tell me so.

Which brings me to the point of this post: If you're an MD-PhD student, or if you're just really into research, should you tell people that this is an interest of yours on your clinical rotations?

My answer to this is N.O. At least not until you've pubmedded your teammates and ascertained that you want to do what they do for research and determined that they will be receptive about talking about their own research with you.

See the thing is, most clinicians suck at research. They don't really understand the papers they read, and they think a lot of it is a waste of time. They just want the bottom line on what the findings of the studies mean to their daily lives. They really just aren't interested most of the time, and many of them have PTSD from that summer they spent pipetting in some lab in order to beef up their CV for med school.

Further, and possibly more importantly, many clinicians believe that you are selfish and that you don't care about patients if you plan to devote anything other than 100% of your life to clinical medicine.

Also, there is a common perception that MD-PhD students lack social skills. Perhaps this is often true. You don't want to introduce yourself as an MD-PhD student and have everybody just assume that you have Aspergers syndrome, just because they worked with a student in the past who was like this.

And finally, it is highly likely that nobody will speak to you at all for the first couple of days of your rotation. Bringing up random facts about yourself out of context is going to be seen as weird, and possibly as bragging. And nobody cares about you, your opinion, or your research interests in the hospital anyway. Get over it.

When I was on my clinical rotations, I more or less tried to hide the fact that I was MD-PhD until I knew for a fact that whomever I was talking to would be interested. The exception was that heme-onc rotation, and you can see how well that worked out for me. Some people ultimately were interested in the fact that I wanted to do clinical research, but most were not.

So my advice would be to focus on the clinical medicine on your clinical rotations and keep your mouth shut about your research aspirations -- UNLESS you find someone you want to be the slave of work for. Then and only then can you bring up research. Except it will be THEIR research your bring up, not yours.

Conferences

Can someone please explain to me why these conferences are so incredibly exhausting? I got 9 hours of sleep last night, and still it was all I could do to drag myself to the hotel shuttle by 3:30. I sacked out in my hotel room for an hour when I finally got back, and I could barely muster the energy to get back up to do more work.

Maybe it's because I'm getting old....

Haha!! That was a joke, people.

Tomorrow is the last day, and then I get to go home to the Boo (and Luca). I miss my family! It will be nice to see them.

Quote of the day

I kind of lost my voice today, probably as a side effect of talking too much yesterday + a cold + Nyquil withdrawal induced insomnia, so it was probably good that I had to present yesterday. I came back to the hotel early today to work on my paper/take a nap since I got basically 4 hours of sleep last night as a result.

Today at least three people said to me, "You look like you could be old enough to be a resident." I decided to take this as a compliment, since I am *actually* old enough to be an attending.

I still have to come up with a good response. The few times I responded with, "Well, that's probably because I am old enough to be a resident," because, well it's true, and would be true even if I was a regular old straight through from college MD-only student. I kind of got funny looks from that, but since they're really starting off by telling me they think I look old, I figured it was a fair response.

Any suggestions?

As a side note, I think I might punch the next 26 year old who complains that she is "old" in the face. I did NOT do that when I was that age, and my complaints of my age now have more to to with me feeling behind my peers than with actually feeling "old." I feel the same as I did when I was 25, and I'm also more knowledgeable about the world and more thoughtful. So far there has been no downside to being 30+.

Also, why is it always the "shes" who complain about this? It is very unattractive.

Oh, other things I don't want to ever hear again include:

"I can't believe my 10 year college reunion is this year! I am so old." I think it would be ok to say the first sentence if the second one didn't go along with it.

and

"Medical training is a hard way to spend your 20s." Yeah? It's a hard way to spend your 30s also.

All y'all can go right ahead and bite me.

Lame

The first day of the conference was awesome. My poster was well received, and I got some really great feedback from several people, in particular from one who gave me a potential idea for my methods paper.....

It was a really good suggestion, actually.

And I met one of my mud-phud compatriots who is also here presenting her basic science research. It was also well received. REALLY well received. So well received, in fact, that the head of the pulm critical care dept at my institution came up to her at a mixer we had tonight and tried to convince her to do internal medicine at [here].

I was really proud of her. She rarely toots her own horn, and she really got to look good. I was kinda jealous, but not in a bad way.

I mingled. A lot. I found I am actually ok at mingling in fact, with this group anyway. It'd been a while since I had the occasion to do it, but I met a WHOLE BUNCH of people from my institution, and they were all really really nice. It was good.

I got asked to go bowling.... but decided not to go. My feet hurt, my hotel is far away, and I am recovering from a cold. All I wanted to do was go to sleep. Of course, now I sit here blogging about it instead of doing it. Call me Cinderella.

I don't know. Maybe it would have been fun. But maybe we just would have sat waiting forever for a lane. Anyway, I'm sure there will be other opportunities to mix and mingle, though my formerly socially awkward self freaks out internally whenever I turn down an invite. WHAT IF I NEVER GET ASKED AGAIN!!!!! (wail)

See dear readers, how lame I am.

On the positive side, my cold is getting better. Yay! Just some advice though -- stay away from the cold medicines that have replaced the pseudoephedrine with phenylephrine. Totally gives (me, anyway) balloon head.

TTFN

Denver

Well actually, Stapleton, seems ok. There's a large shopping complex across the divided highway if I find I need anything from Petsmart (for instance), and a shuttle which will take me to the conference.

It's been almost 2 years since the last time I flew, and that was to Italy. So.... I think it's been 4 since I flew domestically. Whoa. I used to fly all the time. The airplane was my bus.

I flew Southwest (as usual). I hate hate HATE US Air, which of course has a hub in Philly. Fortunately Southwest has a direct flight from Philly to Denver. While in the security line, I succeeded in forgetting to remove my liquids from my bag, although funnily enough nobody said anything to me. Oh, I also dropped my computer on the ground.

I. Am awesome.

Then I read an entire book on the plane. I haven't read a book for fun in almost 2 years. Sad, isn't it? I read The Good Earth. I'm not sure what I'm supposed to think of it, but I'm having a really really hard time getting past just how badly women are treated, and how little girls are valued. I think there's supposed to be this profound lesson about how things just repeat themselves generation after generation, but I'm sitting there reading it thinking, "THANK GOD I wasn't born 100 years ago in China." And also, lots of things DON'T repeat themselves.

First off, famine isn't so much a problem here and now in the U.S.. Second, doctors can actually fix things with treatments that work. Third, I'm so glad I wasn't born for the sole purpose of being a slave to some man, my value based solely on how many MALE children I could provide for him.

Yes some things repeat themselves. But we really have made progress in a lot of ways these past 100 years.

I know, profound, right?

I have exactly 19 pages to finish before bed.

As a completely separate issue, as I was sitting on the shuttle from the airport to the hotel, I was listening to this conversation between a junior attending from Pittsburgh chat with a former mentor of her's (I'm assuming) at U Washington. She was talking about this K award that she had won, and how her department is supplying her with all these tablet PCs and providing database support for her so that she can administer a survey for her research. I sat there thinking, this is what I used to DO for a LIVING. Provide this support for people like you. And you don't even know enough about it to use the right language to describe what you're doing.

It sort of made me feel like my technical skills (and I have lots of them) are kind of a waste since if I really do this academics thing I'll have technical backup at my disposal. I don't know, maybe it's not true. But I do wonder sometimes. Then I listened to her mentor tell her about how back in the early 80s he used to spend hours writing computer programs that would do a t-test for him so he didn't have to do it by hand. That made me feel better. So I'm not the only one!

She seemed nice otherwise though, albeit via eavesdropping only.

Also, Pittsburgh sounded really cheap to live in! (Note made to self.)

Oh in case you're curious, I'm at ATS (American Thoracic Society). Apparently it is THE lung disease conference and also the conference for critical care. I am presenting my poster tomorrow. If you're here (and you can figure out who I am haha) stop by!

And now, I'm going to review what my poster is actually *about* since I made it a month ago.

Snot head

I'm feeling really really whiny today.

Luca and I got back from vacation last night, and I fly out to my conference in Denver this afternoon, so I'm going to be running around all day.

Luca thought he was having "allergies" during the first part of the trip. Ha. It turns out he had a cold.

Now I have a cold. Since I inevitably get 10x sicker from what he had than he was, since Wednesday night I have been feverish and snotty with a nasty sore throat. I am most displeased. Bring on the decongestants!

Also, one of the locals was in my garden again. This time they stole my lone herbaceous peony flower. I never even got to see this one bloom. And my rose bush got some powdery mildew. So last night when we got home I was frantically trimming the bush and sprinkling it with poison in the hope that it would be healthy enough to actually bloom this year.

And then I lost my favorite earring down the drain.

Did I mention I have a cold? My head feels completely disconnected from the rest of my body. Ugh.

The vacation was nice. We spent a lot of time walking on the beach, and the Boo was even well behaved enough to be off leash as long as there weren't other dogs or small children around. She splashed around in the water and chased crabs.

We also ate a lot of food. Mainly shrimp, crab, and (raw and cooked) oyster, which I love. I suppose the good news is that I only gained two pounds, which should come off pretty quickly since everything I put in my mouth tastes like snot.

And we stayed up late sitting in the Jacuzzi and watching Criminal Minds.

Too bad it's over and I'm sick now.

Yay.

I think I just figured out why a lot of my elementary school teachers disliked me

I got a pedometer about a week ago. A friend who is on my project team got one, and talked about how it had made her a lot more aware of how little she moved. I thought it sounded like a fantastic idea.

I figured out that on an "easy" day, when I take the Boo for a walk in the morning, and then walk to school and back, I do a little over 10,000 steps. If I go for a run, I add about 4000 steps to that (I don't run that far). In fact, taking an extra walk to the dog park adds about the same number of steps to my day as a run does.

What was most interesting, though, was how many "steps" I took while I was sitting at my computer doing work. My friend has the same pedometer that I have, and she said on days when she doesn't walk to work, she will take 1200 steps.

I got 1200 "steps" sitting at my computer (going to the bathroom repeatedly, getting something to eat, going upstairs to get a highlighter, playing vicious dog with Boo) for just a couple of hours.

It appears that I am completely incapable of sitting still. It occurred to me that this is probably why I have always been skinny. It also occurred to me that this is probably why my teachers thought I wasn't paying attention. It must be very distracting to be teaching a classroom full of students while watching them wiggle around in their seats. Fortunately, I've never had any problems *actually* paying attention or staying on task.

All I have to say is: thank god I'm not a kid in elementary school anymore. And also, good thing I've found a vocation that will allow me to move around. THANK GOD.

toot toot?

Just received this email from the PR department of my institution:

Dear Old MD Girl -

I have just learned that you will be presenting a poster at the upcoming [Denver] meeting title “The first part of your dissertation.”

I believe this may be of some interest to the news media and I was hoping to get a copy of your paper or abstract? We may consider issuing a news brief on the research.

Please let me know if you have any questions.

On one hand... cool?

On the other, way to give a girl a heart attack on her vacation!

I guess I know what I'm going to be working on this evening.... after we get back from dinner anyway.

Our House in Duck

Luca and I are FINALLY on vacation!!! This year we went to Duck in the Outer Banks.

Duck is the bougie town on the outer banks, and so far has been totally worth the extra $300/ week. Our house is a little farther from the beach (i.e. 300 ft instead of 50), but it is bigger and better maintained. Once I figure out how to make video files smaller, I will post one of the house (did I mention? Luca got himself me a video camera for my birthday!) Most importantly, dogs are allowed OFF LEASH on the beach.

We still don't really trust the Boo off leash, despite out recent success in Control Unleashed school, so I don't know how much we'll really take advantage of this. She's completely transfixed by the crabs, and seems to care less about the retrievers running after balls into the ocean. It's still a really REALLY nice beach, though. Even nicer than the one in South Nags Head where we stayed last Spring.

Miss Boo has already had a great vacation. There's a screened in porch and when we arrived, there were two birds trapped inside. When we opened the door to let them out, the Boo raced in and promptly dispatched one of the birds, depositing it at our feet.

On one hand we were very impressed with Miss Boo's hunting prowess. On the other hand, we felt a little bad for the bird. No so bad though. Birds are stupid. Birdie, why oh why didn't you fly UP rather than into the mouth of the Boo?

Today is rainy, so I'm hoping to finish off the last of my motherfing assignments for the semester. The rest of the week should be nice. First I think I will drag Luca for go for a run.

Yay!

Thanks guys!

Thanks for all the happy birthdays, guys!

You'll be happy to know that my meeting with the speaker yesterday went well. I really liked her, actually. She was kind of awesome.

And then I studied for 8 hours. Woo!

***

There was one moment of irony when I received an fb happy birthday from a girl I'd gone to high school with. She said, "I had NO IDEA we shared a birthday!!"

*I* knew. She was much more popular than I was, and I remembered we shared a birthday because every year I'd be walking down the halls on May 5th, and I'd hear 10 people shout, "Happy Birthday Jenny!" My birthday, apparently, was not on their radar. At the time, this was upsetting to me.

:-P

I do have to credit her with my discovery that if you want people to remember your birthday, you have to TELL THEM. Repeatedly. The results are totally worth it.

At any rate, I never really begrudged her of this since she really was a nice person, unlike those people who are popular because they strike fear into the hearts of everyone around them.

So I wished her happy birthday back.

***

And now, off to my exam.

Happy Birthday to ME!!!

Guess what guys? Today is my birthday! I am now officially 34.

To celebrate, I am going to walk the Boo, go to conference, and then meet with the speaker to talk about her career. She's also 34, and is already a junior investigator. I will try to forget that fact as I talk to her.

Hopefully it will go well.....

And THEN I will spend the rest of the day studying for my outcomes research exam tomorrow. At some point I really will have to tell you about this class. I LOVED this class. It was probably the best class I have taken during my PhD (Longitudinal Methods and perhaps Categorical Methods were a close 2nd and 3rd). I had a hard time containing my enthusiasm, which I got the impression irritated the instructor. Hopefully I was reading too much into that, though.....

ANYWAY, then I am coming home and (drumroll, please) studying some more!!

I know you all are jealous of my wild and crazy birthday plans. :-)

I'm really not sad. Work is work and the bad part (exam week) is almost done. Isn't 34 supposed to be too old to care about these sorts of thing anymore? Aren't I supposed to count backwards now or something so that next year I will be "32".

Haha.

Fortunately I get my vacation at the end of this week to make up for it. Yay!

Doggy Day Care

My baby went to daycare for the first time today. Since I'm going to a conference in the middle of May, and Miss Boo would have to be alone for 13-14 hours per day, Luca decided that daycare would be a better choice than one, or even two walks.

So today we finally bit the bullet and sent her.

Luca dropped her off. I think I might have cried if I had gone (not really -- I think). Also, he has the car.

According to him, she sniffed around for a little bit before he left. He did say that she whined when she couldn't see him anymore.

Apparently she got over whatever separation anxiety she had. The noon report was that she had made a new friend with Cleo.

And I noticed that although I wasn't FANTASTICALLY productive, it was nice to be able to get straight to work at 8, rather than having to take the dog for a walk. Miss Boo and her ever present demands for my attention were not here, and I think I was able to focus better than usual. Wow, that dog takes up a lot of my time!

But I missed her anyway. It was very quiet around here. There was no jingling of the tags as she walked up and down the stairs, and no random barking at strangers walking by our house. No soft fur to stroke when I took a study break.

She'll probably be exhausted when she gets home today.

I think we should do this more often. We'll see what Luca says.

A professional presence

I wonder if my attendings found out, if they would think having a blog is unprofessional.

They would probably be concerned that I would write about patients, violating privacy laws, or that I would come across in an unbecoming way as a doctor-to-be.

Sigh.

I do know I make some people angry. I know this from my occasional (mostly unpublished) hate comments.

(You think you're so much better than everyone else.)
(You can't take criticism.)
(You are arrogant.)
(You will be a horrible doctor)
(Your attitude will serve you poorly when you are a clerkship student.)*

I'd like to think that most of these hate comments are either trying to get under my skin, or the person is just having a bad day. Though, maybe there is something to some of them on occasion. I will say, if you think I can't keep my mouth shut when I need to, remember this is a blog and not real life.

I was reading about how one attending thinks doctors *should* blog. She thinks it's ok for doctors to have a social media presence, but that you really have to manage your image. She doesn't think that most med students are mature enough to do this. Maybe this is true for some people, but of course I am the exception. :-)

I decided to read some posts from the very few med student blogs she links, and I have to say, I found them annoyingly pert. There was no personal touch. They were one of two flavors: "how to write a personal statement" or "this anonyfied patient interaction made me realize how profound and deep the experience of being a doctor was. I am so privileged to be here."

And while of course both types of post have their place (pragmatic information for pre-meds is, well, pragmatic, and everyone loves a gut punching story), I still felt that you never really got to see who the person was behind the post.

That's probably what she liked about them. :-P

I wonder if she'd approve of this blog. I I hand-wring about this because deep down I want everyone's approval (esp. superiors!!). Who doesn't? That's not really practical, I know, and probably goes 100x over for blogging. Maybe I am being a little proactively defensive about my blogging under the assumption that people won't approve. Go paranoia!

I guess the reason for my blogging is not the same as theirs. I am not doing it to further my career or to score a book contract. I am doing it to document my life and as a way to process things. I also like my blogging community. I don't especially care if what I feel or write isn't 100% socially perfect. I actually find those people annoying. I wouldn't want to work with them anymore than they'd want to work with me.

So there.

As a side note, I did tell the MD-PhD program administrator about my blog, and guess what? She didn't care.

I do however, intend to make my blog private when I apply to residency. I am not THAT much of an idiot.





*I'm happy to report that wasn't the case. I kicked ass as a clerkship student. So, in your face, anonymous commenter!
**

I am tired of studying

If you don't want to listen to me whine, feel free to skip this post.

So as you know, this OPIM class I've been taking hasn't been going so well. Fortunately, after studying for oh.... 10 hours each on Saturday and Sunday, as well as about 4 hours yesterday and (so far) 5 today, I am beginning to get the hang of it.

It turns out (shocker) I had no idea what I was doing before.

And now? Well, I know the material a bit better. And I'm sort of kicking myself for not working harder this block since my HW grades are abysmal. On the other hand, an investment of 30 or even 20 freaking hours is kind of a lot to ask for on a weekly basis for one class when I have two papers I ought to be working on instead. Or so I am telling myself to assuage my guilt.

At any rate.

Today I got up at 7 and went for a run with the dog, and then the dog park. It was about 70 and sunny, and I only felt like I was going to puke for about 50% of my run (not so smart to run right after breakfast, but really, what choice does one have sometimes?). It nonetheless was a very pleasant way to start off my day. I started studying at 9:30, went to a meeting from 11-12:30, then came home and ate lunch, and have been studying since 1:30.

I will likely keep going until 11 or so tonight.

I know, cry me a river, right? Med school was basically like this every day for the first 1.5 years. At least in the clinics I got to move around and do stuff (or just stand there sometimes as the case may be). That definitely wins out over having my nose in a book for 14 hours today.

The thing is, I am so sick of doing practice problems. SO SICK of it. I have 2 more chapters to go tonight, and then I want to read over my notes again for definitions. I want to throw a hissy fit every time I accidentally look up the loss function instead of the cumulative distribution function because it is so easy to make that mistake! It makes me want to throw my book across the room!

The exam is at 6 tomorrow night, which sucks because, at least for me, the hours leading up to the exam are useless for retention. I have this theory that synapses form while you sleep at night, and if you study and then take the test right after with no sleep in between, you don't get as much out of the studying. I also have this theory that alcohol consumption of any kind screws up the synapse making process. So, no relaxing beverages until AFTER Friday. Ugh.

Even though doing so will be borderline useless given the reasons I just outlined, tomorrow I plan on going over my HWs again -- just the problems I asterixed the last time I went over them. I also want to go over the problems I asterixed today when I was studying. BECAUSE I HAVE TO BECAUSE I CANNOT FAIL THIS CLASS.

Cannot.

(I am not a melodramatic sort, this is for real guys.)

Let's hope there's time for everything I want to go over, plus a little relaxation right before the test.

And then we'll have another session on Thursday so I can prepare for Friday's exam.

Yuck.

And THEN (oh you thought that was it, did you??) I get to complete my final project for the most useless class EVER. Fortunately, no synapses will be required to complete this assignment, so perhaps a lovely beer can be sipped to facilitate that process.

As long as that gets done Friday night, it will be smooth sailing on vacation for 1 week after that. In theory.

Of course, I will probably feel intensely guilty for the whole vacation because I really really wanted to get a draft of one of my papers completed before I went. But alas, I knew a lot less than I thought for my finals, and well, it's important to pass them. So those will have to get done at a slightly later date.

Here's hoping I can resist working on them during vacation!

Tulips and Miss Ferocious

This was what the tulips looked like before the mother-f-ers picked them. There actually eventually even MORE, but I didn't get a chance to take a picture before they were gone.

:-(



This is me attempting to be "artsy."



And this is Miss Boo on her favorite perch where she lies while I am studying.



So ferocious!

Pet CPR

Our Control Unleashed instructor works over at the VHUP and made this video about human (and pet) CPR. I thought it was pretty cute.