We made it to Italy!

Luca also just found out from his job that some of his projects that he was worried about having to work on while he was gone have gotten postponed. He (and I) will still have to do work, but it won't be nearly as bad as it could have been.

Even the flight wasn't so bad this time. We only had a three hour layover (instead of our usual 7) in Frankfort, and we actually found A PLACE TO SIT for 40 minutes. The last time we were there we found the airport hotel, which has a lovely, *clean* bathroom with nobody in it in the lobby, so this time we went back and washed our faces and brushed our teeth. It's amazing how much that helps.

I just woke up from a 3 hour nap, and now we're getting ready to go to dinner. Not sure where we'll be going, but my father-in-law uses his son's presence as an excuse to go out and eat way too much. I know, poor us! I'm sure it will be tasty.

We still have to make plans for the rest of the trip and see all kinds of relatives... but we're here!! Now all I have to do is turn my Italian brain back on. Fortunately, my in-laws are very patient with me about this.

Yay!

readmit

I just flew back from my first Orthodox wedding. It was really fun. The ceremony itself was short and sweet (I hear that the bride is worth 6 goats?) and the bridesmaids were very kind to explain the meaning of the various traditions to the three non-Jewish people in attendance. :-)

The dancing was especially fun. It was great to see the couple again, and I know they will be very happy. They are perfect for each other.

I'd had to fly out a day early because of the hurricane, so the bride's father asked a family friend who does not observe the sabbath to put me up. They were so nice! And the wife does quality consulting for hospitals, which is something I'm really interested in, and I got to ask her questions about her work! So, even though I (still) didn't get to work on my manuscript it was a productive weekend from that standpoint.

She took me to get my nails done. Would you believe I'm 34 years old and have never had a manicure/ pedicure? It was very pleasant. The manicure I'm sure I will ruin relatively quickly, and honestly, if I was a little more diligent about my cuticles I could do it myself. The toes however, look fantastic. It made a big difference to their appearance. I may have to do this again sometime.

They were very kind to open their home up to me.

In any case, now I'm back. So far I've.... eaten lunch and taken a nap. Woo! Productive. I'll try to get an hour of work in on my paper. Maybe attempting small chunks will seem less daunting that attempting the whole thing. It really just needs to be reframed. Over the weekend I had the opportunity to talk about hospital readmissions (my paper is about ICU readmissions) and it gave me some thoughts about how I want to spin it. Now all I have to do is actually DO IT.

I find out about Italy tonight. Honestly, I'm a bit on the fence. I'd like to go, but also I HATE the flight over there. HATE HATE HATE. I wouldn't have to board the Boo, and then I'd be able to get some work done. Less guilt = win win. Plus my parents have had to cancel their vacation, and have invited us up for labor day weekend if we don't go to Italy, which would be really pleasant actually. I haven't seen them since Christmas, and the weather in CT is really nice this time of year. The only thing I *wouldn't* be looking forward to is the negotiation with the airline about changing the flights. :-P

Anyway.... mustering up the drive to break out the computer.

Hard Work

One of the things I really tried to not to do in medical school was to be jealous of other peoples' free time. I have to say it was really hard to contain myself sometimes. Particularly when you'd hear a friend with a 9-5 job and no commute who just took a two week vacation to some place lovely and expensive, complain about how much work she had. Or even better! When a friend who was a SAHM (who also had an au pair) would complain about how hard her life was, and then you'd see 30 crafting projects that were all completed in the last month along with recent vacation pictures make it on to her blog.

I have to be honest, it made me not like them very much.

When times are easier, for instance when I've had a day off in recent memory, it's a lot easier to contain my animosity. And yes I realize jealousy like this is really unattractive, and also that other people besides doctors CAN work hard and that being a mommy is a lot of work, and oh, that my hours will be worse during residency, and obviously I must not be that busy because I have time to blog, blah blah blah.

Anyway. I bring this up because yesterday I had two such conversations that made me want to throttle the respective people. The first was with a professor at school. He was worried about the hurricane and his new beach house, where it turns out, he's been spending every weekend -- THURSDAY THROUGH MONDAY THE ENTIRE SUMMER. I asked him if he did work out there, and his response was, "Sometimes I do on Fridays."

Grrrr.

And then I was talking to one of my neighbors who is a PhD student, who took 3 weeks to go to Italy this winter, took a 2 week vacation to the Caribbean this spring and again two weeks ago and ALSO went to Canada to go camping for a week. He just got back literally a week ago, and he was saying how tired he was and how hard it was to make himself to any work. It was 2PM and he'd spent the day napping he told me. Oh and then when I suggested dog school for his new puppy that he was complaining about, he told me he didn't have time to take her.

Are you kidding me????

Normally innocuous bitching like this I'm able to let roll off my back. I know it doesn't mean anything and that people just like to complain, and it's totally possible to feel exhausted and overwhelmed for no good reason. However, since I've not had a day off for the past two months, have had exactly one week of vacation since December where I worked every day that I was there, and I just finished my qualifying exams, and oh! Might not be able to go to Italy because of Luca's work?? My tolerance for it was really low yesterday. I was already in a bad mood, and hearing this was NOT helping. I was able to contain myself from saying something sarcastic, but just barely.

After talking to him I spent the rest of the afternoon watching tv and feeling pissy. So there. I not only got no work done, but I also had a shitty afternoon as well and got to feel like a lazy-ass.

I could really use a day off's all I have to say.

So yesterday I downloaded some books from Amazon onto Luca's kindle. Do you realize I haven't read anything for pleasure in over a year? I told myself they're for the plane, but I read for about an hour last night anyway. I think maybe if I relax a little and try to do something non-work related for a few hours, it will make buckling down to finish this paper a little easier. At least I can hope.

Night

There was a really big problem at my husband's work recently, and my husband has basically taken over the work of another person's job in addition to his own. It's resulted in him bringing home more work, and it's possible we won't be able to go to Italy. His boss has been swamped too.

Over the weekend, he and his boss were preparing an important document, and it turned out that the boss was up until 3AM preparing this thing, and then his son got sick, so he just didn't go to bed that night.

Luca was relaying this story to me, and how awful it sounded. He shut up when I said, "Yeah, that sounds like it does suck. Now imagine doing that on purpose every fourth night for the next 3-7 years. Because that's what I'm looking at."

With work hours reform part deux, maybe it will be a little better, but I'm really not so sure. In any event it does suck. Luca muttered something about how that sounded completely insane, and then went back to work.

Yep insane. Pretty much.

Well, that was anticlimatic

I turned in my grant at 11:30 this morning. It was pretty anti-climatic, I have to say. After working on tightening up my language and being more concise this AM, I discovered that I was a whole page shorter than I had to be.

So I increased the font to Arial 11.5, which had been what was recommended anyway.

Then I sent that puppy in.

You know how I blogged about how awesome it was to finish my core clerkships? How it was every bit as amazing a feeling as I imagined it would be? Well, this was more like when I finished step 1. I'm more like.... meh.

I took the Boo to the dog park for a little while. There was nobody there, and hence NO DRAMA. I filled in the tub o' water for her to wallow around in, and she enjoyed chasing the orange ball and running through the tunnel. Then we came back home. Now she is sacked out. It's nice having a dog who is less fit than last year!

This afternoon I have an appointment with the hematologist. This is for mild and completely asymptomatic thrombocytopenia. It turns out I'm also a carrier for hemoglobin D. I'll let you medical professionals look that one up to figure out what it is and why it matters at all. If we ever learned about this during our heme block, I definitely didn't remember it..... It never even came up during my heme-onc rotation either, but that's probably because the rotation was annoyingly onc heavy. I will never be a breast cancer doctor, that's for sure.

Then I plan to swing by Chipotle for dinner (mmmmm..... vegetarian soft tacos....), maybe have a swim at the pool, and come home and try to remember where I left off with all of my other work.

Off the top of my head I KNOW that I have revisions to make on a manuscript, which I am *hoping* to submit before we go to Italy. But am not counting on. I also have to write an IRB amendment, start thinking about my next dissertation project(s), learn about survival analysis on my own, and start skimming the book for the class I'm TAing this fall.

ACK!

I have a lot to do.

Did you feel the earthquake??

My first earthquake in PENNSYLVANIA of all places!

I thought that some kids were jumping on my roof. Miss Boo was totally unfazed.

Maybe now I'll be able to get Luca to consider SF as an option for residency....

Ah well, back to work.

New Aim. New Focus. New Grant.

Yesterday I re-looked back over the RFA, and decided that the powers that be *really* wanted an intervention study. As it stood, my grant was more in the gather information that could be used in an intervention study vein. And, as much as I really don't want to make my career into intervention studies, I would like to pass this exam.

So yesterday I created a new Aim 3 which is an RCT of an intervention based off of findings in Aims 1 and 2. Which led to a refocusing of my patient population and modification of Aim 1 and Aim 2 as well.

Sigh.

Well, at least I had an extra day to fix things.

Today:
1. Human Subjects Protections
2. Modify conceptual model
3. FINISH THIS F-ING THING

It's due at 2PM tomorrow. My hope is that I can spend the morning leisurely reading over a final draft and then submit it. Haha. We'll see if that actually happens.

So, we have a grant

All three aims are written, along with the specific aims page. It's about 1/2 a page over, and I need to edit it to make sure that I didn't say anything utterly stupid, and it's definitely not perfect, but it's there.

I do still need to write the human subjects section, which will be a big pain in my butt, but the hard part is done.

So now I have two days to fret over it and edit and hopefully breathe.

You'll all be happy to hear that the library's server came back up at around noon on Saturday. It was a nice surprise since I was expecting it to be down for the whole weekend.

This time next week I'll be in Saint Louis at my friend's wedding! I am so excited!

And also

"[My Institution] Libraries Downtime: 6pm, Fri., 8/19 - 10am, Sat., 8/20"

Really, library? Why???

At least they should be (allegedly) up and running again in an hour.

UPDATE:

Ah, a more detailed message now:

"The XXX Libraries web site and all online library resources and services will be unavailable while PECO performs electrical work."

And it's now 10:20 and service is not back up yet.

Since it's PECO, my guess is that it won't be back up until Monday.

Push ups

Not so much time to exercise since I'm working on my quals, and running isn't really an option for me at the moment. But! I've still been doing the push-ups.

I haven't progressed at quite the rate that the program recommends, mostly because I sometimes "forget" to do them for 4-5 days, but I've still gotten better. I'm currently on week 4, and two days ago I did:

14
16
12
12
18

Which is 72 push-ups! Crazy. I do sometimes cheat a little by not going down the whole way, but it's still a lot better than I was able to do at the start of this program.

Moral of the story is stick with is, be as consistent as you can manage, and don't let the fact that you missed a couple of days throw you off the bandwagon entirely, and you WILL IMPROVE.

Implicit vs. Explicit

The powers that be on my dissertation committee decided last year that I would do an implicit review of medical records as one of my three (count them) dissertation projects.

At the time I had no idea what they were talking about. I'd never heard of the method, and was a bit baffled about how to go about doing such a review.

Fast forward 8 months, one outcomes research class, and now at least I knew that implicit review was a validated method that people actually used(!) to do QI assessments using medical charts.

But I still didn't know the details. The pros and cons. The alternatives (mainly explicit review), or about the fact that you can (apparently) do a "structured" implicit review, in order to make those mentally lazy doctors focus on actual processes of care and not just the overall picture. Haha.

Well, for this (fake) grant, I've decided to do an implicit / explicit review of medical records. Both because of the process checkbox nature of certain aspects of my topic, but also the more gestalt-y subjective nature of other aspects of my topic. So, this (fake) grant is at very least forcing me to become familiar with these competing methods that I will -- allegedly -- ACTUALLY be using in the near future.

So maybe this process is useful afterall.

Intervention

I think what annoys me most about the grant part of my quals is that I have to write about doing an intervention study. I can't stand intervention studies. And yes, I realize I am maligning the work of 50% of the people in my department.

Here's the thing about intervention studies: I think of them all like weight loss fads. They all work! (If you're motivated and there is some sort of accountability and social support.) Yet they all fail! (If there is not.) In the end, it doesn't matter which one you do as long as you have buy in from management and the team members.

Don't get me started about measuring the benefits of intervention programs. The fact that unmotivated organizations tend not to participate is a HUGE irreconcilable confounder.

Anyway, so I get to write a protocol for a series of studies I don't believe in for this grant. Woo. To say that this is physically painful is an understatement.

Piece of crap

At least I have a topic for my grant now.

Now all I have to do is get my computer to actually be able to display pdfs from the library. My other 2 computers can do it, but using them would necessitate that I move all my crap from this computer over there.

I really want to take a hammer to this piece of crap. If it's not one thing, it's another.

Part 3

Finished part 2 of my quals yesterday. It went fine, though for some reason they thought it would be a great idea to give us SAS output to interpret, even though all of our coursework is taught using STATA. It's actually kind of difficult to get a SAS license in my department.

Got part 3 this morning. They were really nice, and are letting me start 3 hours early. Woo for getting to get up at 5:30 to start working. On the other hand, I'm glad I asked. Let this be a lesson to you: If you ask, sometimes you receive!

Though -- NOT excited about my topic. I do policy research on how patients flow through the hospital. ICU readmissions. Transitions of care. Very few people do what I do now (relatively speaking). It's pretty novel.

My topic, that I have to write a fake grant on, is on Hospital Acquired Infections. Now, this was something I'd *considered* maybe doing in the future, but the problem is that if you do this with your career, you end up being the safety police at your hospital. Not a particularly interesting or intriguing job, IMO. It's not the same as being a researcher. I do like ID, but blegh.

Plus, it's not at all related to what I study. I'm going to have to spend a few days wading through the rafts of literature on how we cause so many infections, all the while I'm thinking, "Sure we cause some of them, but sometimes sick people just get sick, and there ain't much we can do about it." This is not a popular viewpoint, but it is true.

(Not saying we shouldn't TRY, but yeah, sometimes sick people are predisposed to get sicker, and there isn't much you can do about it. Of course what you remember is the resident you saw lick the catheter before putting it in the patient's neck, and you decide that this happens all the time and that we need an intervention.)

ANYWAY.

Not excited about this topic. Maybe it will get better as I read about it. But maybe it will be a week crap and an utter waste of my time instead. Mostly because there is little chance that I will actually use anything I find again for any project I am currently working on. At least not for a long time. I think though, fundamentally, my issue with this topic is that I just don't find it all that interesting. The literature bores the crap out of me.

Oh, and none of the links on the CDC webpage on the topic actually work. I'm off to a great start, don't you think?

Part 1

I got up at 6:30, my usual time this morning. But since Luca took Boo to daycare so I wouldn't be distracted while I took my exam, I had nothing to do. So I sat, and read the news, and then I went for a long walk. It started to drizzle at the end, but it was nice and cool, and very pleasant.

The exam was 4 hours straight. I was impressed that I was able to focus for that long. In some ways I felt like my focus actually got better as the exam progressed, which I was a little surprised at. I'd prepared a sandwich to eat in the middle of it, along with a piece of fruit. That helped a lot I think.

When it was over I lay on the couch for an hour and watched an episode of Mad Men. Hopefully this rain will stop and I'll be able to take another walk.

Overall I think it was ok. There was one question that I got just as I had to send it in, which I know I missed. But it was one part of one question. Not the end of the world. Oh well.

I am so fried!

I love the Philly curfew

Ever since it was implemented, there are no longer groups of teenagers hanging out in the park next to our house late at night. We can take the dog to pee at 10PM and not have to smell pot smoke and listen to comments directed towards us and our dog.

Thank you mayor Nutter.

Maybe if they keep the curfew active, next spring the juvenile delinquents won't be able to steal my flowers.

Adventures in Cinematography

I'm posting a video of the house we stayed at in Duck this Spring. We only just figured out how to compress it sufficiently for the internet now. What can I say, technology is not my strength. I don't even have a smart phone yet.



I know some people are going to ask, "Why did you rent a whole house for just you and Luca?" And the answer to that question is:

1) In the off season houses are reasonably cheap,

2) We wanted to stay in Duck because dogs are allowed OFF LEASH on the beach, even though most of the dogs here are labs and golden retrievers rather than ferocious pit bulls

3) the only hotel in Duck doesn't take dogs (to our knowledge) and it very expensive,

4) we like space,

5) we don't like talking to people such as hotel concierge staff, housekeepers, and other guests, and staying in a house allows us to indulge in our misanthropy,

6) this is pretty small for a rental house -- if you go much smaller you run the risk of getting a dump.

Anyway, enjoy!

Annoying

This article really annoyed me. Basically it is about how the state of Missouri has to pay doctors to take overnight call at one of their rural psychiatric facilities.

Of course the author spins it as, "Doctors are paid to sleep."

Hi jerk-face: it's called moonlighting. Would you prefer that there was no doctor on call at night at all in this facility? Because that is the alternative, because nobody would work there. It's the same reason people who work ANY undesirable job get paid a lot.

Oh I know, why don't we get "the government" to "force" doctors to work there for free. What a great alternative! Those greedy doctors who are on call 24 hours a day definitely don't deserve to be compensated more than I am at my 40 hour a week job.

At least most of the people who commented (including the governor) said essentially what I did. But sheesh. Taking the doctor-hate to a new level.

If you don't ask, you will not receive

Last night Luca and I dropped by the house of a friend of ours to pick up the keys to her house. She'd asked whether I could let her three dogs out to pee while she was out of town Friday night. She had someone else for the rest of the weekend, she just needed the one walk.

When we got there, it turned out that a) the dogs had to be let out 1 at a time, b) one dog had just had surgery THAT DAY, and would we mind making sure her incision looked ok, and c) hey, one of my other people backed out -- would you mind doing 5 additional walks and also feed my dogs and my 4 cats, and administer complex medication regimens to them?

Bearing in mind that my quals are on Monday, and I still have an ass-ton of studying I want to accomplish beforehand, I don't really have the time to spend 6+ hours of my time taking care of her pets. Not this weekend. Which I told her.

Then she offered to pay me $90, which frankly is a laughable sum compared to what a pet sitter/dog walker would charge for 7 animals over two days.

So I said no, sorry I couldn't do it this weekend. I could still do Friday, however.

But this post isn't about saying no. Though it could have been. I almost said yes until Luca talked some sense into me.

It's about asking for what you want.

As we were leaving, Luca said to me, "Can you believe her? That was incredible what she asked for. That girl is nuts."

And I said, "Yes it was pretty incredible. That girl has an enormous set of balls. I'm actually kind of impressed. And she almost got what she wanted."

Moral of the story is: If you don't ask, you DEFINITELY won't get what you want. If you ask, you might. Worst case is people talk about how presumptuous you are behind your back when you leave.

Why do I bring this up? Well, today I found out that part 1 of my exam is 9-1 on Monday, part 2 is 9-1 on Tuesday, and part 3, which was supposed to be SEVEN days long is 9AM on Wednesday - 5PM the following Wednesday. The seven days is to write a grant.

How many days is that? That is not seven days, kids. That's 8 days.

Now, normally I would not mind having the extra time. However in this case, since I assumed seven days actually meant seven days (how crazy of me, I know), I scheduled a doctor's appointment at 3PM on the final Wednesday.

My first instinct was to suck it up and just deal with having three hours less than everyone else to do that section (since I'd have to leave my house at 2PM to get to the dr on time).

But the more I thought about it, the more I thought, well why SHOULDN'T I ask for an extra three hours to do this? Would it really be so horrible for them to send my my exam at 6AM on Wednesday instead of 9AM? REALLY??? Is that so demanding and bratty of me?

In the back of my mind though, I worried whether they would complain about what a brat I was amongst each other and possibly (even worse) to my mentor. But then I thought: Shit. This isn't a crazy nutso request at all. And if I don't ask I will be bitter about it. All I have to do is write a professional email, and make my request. In reality, worst case they'll just say no.

So I sent the following email:

Here is my issue:

Since I assumed 7 days meant 7 days, I scheduled a drs appointment (which is essentially not movable) for 3PM on the 24th, since I'd assumed the exam would be due by at latest 9AM that day. Everyone who has taken this before me has told me that they worked up until the time the exam was due, so I am concerned that I will get three hours less (3PM minus the time to walk to the dr) than everyone else to work on this.

Would it be possible to get the exam sent to me at 6AM on Weds the 17th to make up for the time? Apologies for any inconvenience this might cause.

Please let me know.

I suppose they could tell me to reschedule the drs appt -- which would force me to move it to a month from now. And I suppose I could, but he is a specialist, and hard to get in to see and I don't feel like I should have to.

I suppose they could tell me to suck it up, that in real life you have deadlines and other conflicts come up and you just have to deal with it. To which I will be tempted to reply, "Well, this isn't real life. It's an exam. And since you brought it up, IN REAL LIFE, I've already written several grants. One of which was funded. So bite me."

I'd probably leave off that last part.

Though I have to admit, I'll be pretty annoyed if they say no.

But anyway I digress. Point is, if you don't ask, you definitely won't receive. So thank you, dear friend with the seven pets and your outlandish request, for giving me the balls to ask.

And I have to say, asking is kind of a rush.

I'll keep you posted, dear readers, about what happens.

2.5

2.5 days of studying left until I actually have to take my quals.

I really don't want to study anymore. I want to move on. To work on my paper. To get the IRB taken care of for this other project I'm doing. To get my next projects underway.

But no. 9 days of exam hell are staring me in the face instead.

Blegh.

Ok through bitching. Now I'm going to look at my Categorical Data Analysis notes from last fall. Wish me luck in not falling asleep!

Miding my own care

Went to get blood drawn on Monday. For some reason, the new drs office I'm going to says I have to get it drawn at a lab across the city, but at the old drs office, they told me I could use the lab downstairs. It turns out *in general* for my insurance company, they want you to go to a specific inconvenient lab, but for *my specific plan* I can go to the one in the building. Nice to know that they were too lazy to look up this information. And it seems that they might have sent me to a lab that actually *wasn't* covered.

Oh joy.

So, the forms. The woman who filled them out? Spelled the dr's name wrong, my street address wrong, AND put in the wrong ethnicity. To top things off, she failed to check off what lab I needed drawn.

I didn't write down all the labs I was supposed to get according to the dr last time, so I'm not actually sure all of the ones on the other form were checked off. Who knew you had to keep track of all this yourself, and then scrutinize the lab ticket before you left the office to make sure things were filled out correctly!

When I got to the lab place, they had to call my dr to get them to tell them what lab needed to be drawn. It took 90 minutes for them to call back. That was actually faster than I thought it would be.

And the new dr charged me $25 for the visit co-pay. I looked at the back of my card the other day (my bad for not checking before), and it looks like it was supposed to be $15. Woo.

Right now I'm wondering whether they're actually going to call me with my results, or if I'm going to have to call them. I'm kind of thinking that it will be the latter since they seem to be the antithesis of competent over there at this new drs. Which scares me. I'm a pretty together patient, but even I don't know all the things I'm supposed to have to do. And who knew that I'd have to double check everything the administrative staff did?

I feel bad for patients who aren't as savvy at navigating the system as I am.

I'm wondering if I should mention these problems to the dr. They'd probably just blame me, though. Or blow me off. Not sure which would be worse.

Mad Men

Season 1 of Mad Men is available to stream on Netflix now! I've watched two episodes so far, since I'm trying to restrain myself and study. Quals are only in 5 days!

Not sure if my perspective is typical, but it definitely made me think about things. In particular, my parents were just a couple of years younger than many of the protagonists were in 1960. Both were young professionals making their careers in Manhattan.

My Dad has told me before about the multiple martini lunches and how everybody smoked, including him. He was working in commercial banking, I think, and from what he tells me it was a considerably more blue collar (less preppy) environment than the one depicted at the ad agency on the show. At that time, it was not uncommon to work your way up from the mail room.

My mom has a slightly different perspective. She was the first woman investment banker at Morgan Guarantee. *NOT* a secretary. A securities analyst.

Watching the show? I think I understand a bit better why she is the way she is. She has told me many times about how she had to fight to be taken seriously. She's told me about how they'd interview a female candidate, and how after she left the men were completely unable to talk about anything other than how hot the candidate was. She also has told me how badly many of her secretaries treated her, and how there were some who refused to do what she asked them to do. She's told me how long it took for the company to be willing to bring her to client meetings.

She also has told me how her family had no appreciation for what she was doing either, and figured she end up an old maid -- a clear failure as a woman in their eyes.

Anyway, pretty much everyone else who has told me about this show has had a SAHM for a mom, and often a SAHM who never lived in Manhattan, and who is about 10-15 years younger than my mom is. I really like the show, but I imagine the stories I've grown up with make me see it from a slightly different perspective than they see it from.

Watching the show has made me realize this: My mom was a total ass-kicker.

Sometimes my department makes me want to rip my hair out

I registered for the LAST CLASS I AM EVER GOING TO TAKE* in my department ever again about a month ago. I was going to take Survival Analysis last year, but decided to use the time instead to work on a paper I was writing (that is only now getting finished.... but I digress). Of course as soon as December rolled around, my mentor decided that I should be doing a survival analysis for a piece of my dissertation. Oh joy. So I decided to take it this year instead.

When I registered, I thought it was odd that the time was listed for 12:30-2 Tu F. Usually classes are Tu Th, not Tu F, and the year before it had been on Tu Th. However, it definitely wouldn't have been the first time a) my department had a wacko schedule for a class, or b) that a class might be offered at a different time in consecutive years. Case in point, the year before it had been offered 9-10:30 M W. The same time as Longitudinal or some such.

So anyway, I registered, put it in my calendar, and proceeded to schedule a variety of other things in my available time. Such as TAing, which I am required to do. And TAing happens to fall 1:30-4:30 on Thursday afternoon.

So, I've gotten everything set up, and I take a look at my calendar and! Lo, Survival Analysis is back to Tu Th, overlapping with TAing.

Mother of God.

You know, sometimes my department really makes me want to tear out my hair.

I'm sure it will all work out.... My biostatistician is an expert in this field, and I have a book I can read on the subject, and I could always email the professor and ask if she'd mind if I skipped out 30 min early on Thurs class (though that feels very rude to me). She said no to a similar request last year though -- not that I blame her -- so I'm not terribly optimistic about it.

On the other hand, my friends who took it last year say that the class wasn't nearly as good as Categorical Data Analysis.... which was an incredibly awesome class, so it was rather a high bar to be as good.

I will repeat this mantra: It will all work out. It will all work out. It will all work out.

Maybe this will even be better since that time in my schedule will be freed up to work on my myriad of other projects.


*This truly is cause for celebration.

Miss Boo is a very tolerant doggie

Last year, between running with the dog, and almost daily trips to the doggie-parkie we found that Miss Boo never really needed to have her toenails clipped. She also had limitless energy and drove me a little crazy when I was at home with her.

As we started to grow tired of all the dog park drama, and I discovered that running was so much more pleasant without a dog pulling me along in various directions, Miss Boo has gradually been weaned to a 30 minute walk every morning, plus occasional trips to the dog park/agility center/somewhat longer walk on the weekends. Luca also plays tug with her most nights when he gets home.

We've tried to spend more time learning tricks in the house to compensate, which she seems to enjoy. And I let her sniff as much as she wants (mostly) when we walk in the morning. She has adapted quite nicely. Most of the day she sleeps on the couch next to me while I study, or chews her antler. So far she has learned in addition to what she did before:

Upstairs
Get in the tub
Get in the shower
Target (2 on 2 off at the bottom of the stairs)
Target (touch nose to disk on floor)
Wait and Get it (for food left under her nose)
Heel (we're working on her moving around me to the heel position)
Roll Over
Play Dead
Paw
Beg
Right (spin right)
Left (spin left)
Hoop
Through (go through 4 weave poles)

I think mostly she cues off body motion rather than the words, but whatever. Most of the time she does what we ask her to, and she seems to love it.

(If anyone has any other tricks to suggest PLEASE let me know! We're constantly challenged to come up with new things to teach her.)

But, with this reduced amount of activity we have found that we really need to start trimming her nails. Actually we discovered this because she started slipping on the floor. Oops. Bad mommy.

So I clipped her nails. She is very good with body and paw handling, but it's obvious she does not enjoy this. The first time I did it, I nicked the quick twice and she bled FOREVER. She tracked blood all over the floor and couch. It looked like a murder scene, and Luca started calling her "The Dex-terrier." (Sorry if you don't get the reference, I know we're lame.) We didn't have any Quickstop which made things worse, obviously.

I got better at clipping thereafter, and haven't nicked her since. But I'm always afraid that I will, and plus the quick itself has gotten long so in order to "train it back" I'd have to clip very close to it, very often, and I'd most certainly nick it.

So last week I purchased a Dremmel. Miss Boo is not fond of having her nails filed, but she puts up with it. Especially if I feed her breakfast and praise her extensively as we go. So far we've dremmeled twice: once last week, once this week. And it has gone reasonably well. Fortunately she has some white nails, so it's possible to see where the quick is and know when to stop based on that.

But what I am wondering is: How short do we need to go? How often do we need to file in order to train her nails back? I read someplace that once a week for several months should do the trick.... is that accurate? They really aren't THAT bad, I just want to get on top of this now so that they don't GET bad, and so she stops slipping (which has mostly resolved anyway). I read somewhere that you shouldn't be able to hear the nails clicking on your floors, but that seems very short to me.

Any thoughts?

Just wanted to add

Today I was all worried because I have to go get blood drawn (on the opposite side of the city OF COURSE) and I have a telephone meeting with a prospective PhD thesis committee member today. And since I have basically no cell reception in my house anymore (I hate you AT&T)* I am walking to campus in order to receive a freaking phone call.

So basically I was thinking my day was shot. Particularly since the morning is my most productive time of the day, work-wise. That I'd get back home at around 2 and then be totally unproductive for the rest of the day.

I decided to go get the blood drawn *after* the phone call to at least give myself the morning to work. And then I woke up magically at 5:45 this morning, wide freaking awake, and decided to just get up and start working.

It is only 9:30 and already I have completed the changes to my manuscript (~2hrs worth of work) taken the dog to the dog park, and am getting ready to start studying stats.

I even got to talk to Luca a little bit before he left for work this morning at 6:30. Usually I just miss him.

Kinda makes me think that 5:45AM should be a more regular thing for me. Haha. We'll see.




*It's so bad that we're going to get a land line when we get back from Italy in September. What is this, 2001?

Too Far

The next time the Boo acts up, and any of y'all think I'm "taking things too far" or "being hypersensitive" by complaining about having my doggy parenting skills criticized by a stranger, please consider this lady.

Yes, you read that correctly. A man on a bus told a lady that he was going to call child protective services after seeing her repeatedly spank her rambunctious child.

So she called her friends to come shoot him.

Ah, Philadelphia.

Want

7 days and counting until day 1 of my quals.

I woke up at 4AM last night in a panic that I didn't know stats. I'd also just had a dream that I was taking the Epi portion of my exam and it was completely based on Harry Potter trivia, which I am definitely not an expert in. And there were spiders.

I should have just gotten up and started studying. Instead, I tossed and turned, and fell back to sleep around 5, and then slept in until 8.

I felt guilty that I'd slept so late. That's how distorted my perspective has become. Thank you, medical school.

So of course this morning, rather than study stats, I have tried in earnest to complete my manuscript. Can someone please tell me why this process takes so freaking long no matter how hard I try to plow through it?

Sigh.

Barriers

What else is there to say but, OF COURSE the library's server that allows you to access Pubmed and online articles is down today. OF COURSE it is. Why on earth should I expect it to work? I only go to a major research university, for goodness sakes!.

All this means is that it will take that much longer to put the changes into my manuscript and get the f-ing thing out the door again.

Library -- I hate you.

Old

Had another opportunity to feel old yesterday as I was talking to one of the incoming MD-PhD students about life in Europe vs. life in the US, and why I could never work in Italy.

I used to get asked all the time why on earth I would have chosen to come to med school rather than move back to Italy with Luca, and I'm always like, "Really? Do you have any idea what life is actually like over there? I would never be able to find a job. Best case I'd be a mommy, 'translator,' or tour guide."

Now, see how Italy is about to default? See what Berlusconi is saying/doing about it?* NOTHING. See how economic growth in Italy has been 0.15% over the past 10 YEARS???? Now do you understand?

Anyway.

So the kid I was talking to was from Poland, and he really understood. His parents were doctors, and he said they'd told him to go to the US to study because the opportunities in science and medicine were so much better over here than there. He said a few things about what they'd told him it was like before the Berlin wall fell.

I came home and talked about this with Luca. Then Luca paused.... "Wait, was he even ALIVE before the wall fell?" I did a quick calculation in my head. If he was 22 now, he would have been born in 1989, which is the year the wall fell. So..... no.

I remember sitting in my 7th grade classroom at Salisbury Central with Mrs. Psorakis my social studies teacher as she told us what a momentous occasion this was. Luca remembers traveling all over eastern Europe as a teenager in the years immediately following the fall of communism.

It boggles our minds that there are "kids" now in my program who were actually born after that.

It's amazing how time flies.



*Perhaps he will feel the need to cut back on his underage hooker habit.... nah.

future dermatologist?

Yesterday at the retreat, the organizers had managed to invite some clinical research people to the lunch. Since often no basic science people will sit with them, I sat with them at the start of the meal so that someone would come and talk with them. I think one was an ID specialist, and the other was a cardiologist?

I did the same thing last year, and had some really great conversations. Learned a LOT. They're always interested in talking about career trajectories post residency, how to pick specialties and get grants, and since that's only 5 or so years out for me (!) it's exactly what I need to be hearing about.

This year about midway through lunch, a basic science student who had worked with both faculty members on her medicine rotation came by to say hi. She seemed pleasant enough. She effused about how great a time she'd had on those rotations and how wonderful the teams she had been on had been (which is exactly what I would have done).

The funny part happened when they asked what specialties she was planning on going into, and she said -- absolutely DEFINITIVELY -- "I'm thinking about cardiology and ID. Definitely internal medicine."

Hahahahahahha!!!!

(I snickered on the inside.)

Anyway, it's possible she wasn't completely full of shit. I personally find those fields really interesting, and am thinking about them too. But I am skeptical. And perhaps a little cynical too.

Perhaps she's really a future dermatologist?

Grumpy

This morning I am grumpy. We have the annual MD-PhD retreat today out at Villanova, and I get to waste a whole day listening to 10 (count them) student basic science presentations. I also get to stand next to one of my posters as basic science people walk by and feign interest. Well, if I'm lucky they will feign interest. If I'm not lucky nobody will stop at all.

Fortunately, they have of late been inviting clinical researchers to the lunch, so at least there will be someone I can talk to about my career trajectory while I eat. Sort of anyway. I've heard both of their spiels before though (well, they ARE in my department guys) and really I'd rather be studying for my quals.

It's better than it was my first couple of years though when only basic science faculty would be invited to these things. Then I'd get asked, "Wait, you think you're going to be TENURE track? I don't know any clinical researchers who do THAT. The best any of them can do is clinician educator. Maybe you'd better rethink your career." They didn't know what they were talking about, and thankfully I did, but unfortunately a second year medical student can't really say that to a faculty member, even if they are stark raving ignorant about what you do.

At least nobody is going to tell me that the NIH doesn't fund clinical research this year.

Ha. Ha. Ha.

Bite me Dr. X.

I'm also grouchy that in order to get there, I have to get up at 5:45 so that my husband can drive me. And he's sleeping IN today -- poor guy.

It will be nice to see some of my classmates, that is the ones who don't skip out half way through. Hm... There's a thought.

Sorry, I'm really whiny. A couple of times they've asked whether we want a two day retreat again like we had back in the old days when there was money.

Hells no.

It's better than it used to be vis a vis the disrespect for clinical research, but it still does have a long way to go.

Honey

We were having brunch with some friends on Sunday, and the conversation turned to vacuum cleaners. You see, last month, Luca and I finally bit the bullet and purchased a fancy vacuum. A miele* in fact.

It sucks.

Really well actually.

I was marveling at the fact that Luca can now vacuum on the second floor while I study downstairs, and I can barely hear it. Contrast that with our old Dirt Devil that sounded like a tornado was ripping through our house.

Luca also commented that he loved the fact that he could now vacuum between the bannister and the wall.

At some point my friend said, "Would you have ever thought 15 years ago that you'd be having a conversation about the new vacuum cleaner you had just bought, and that you'd actually be excited about it?"

Pause.

No, I would not have imagined that.

Our next topics of conversation were: kitchen renovations and how to keep them within a budget and the cost of child care in the Philadelphia area.

I think this means I am officially old.


*Means honey in Italian in case you're curious

update

The hard drive has been successfully replaced. Now all I have to do is reload everything onto that machine. Thanks for the helpful suggestions on how to switch them out! They prevented me from having Dell "walk me through the process" on my phone which gets terrible reception in my house.

Quals studying is going well. I *may* move up my exam date to sometime late next week, depending on how I'm feeling. Maybe the 11th? Not sure I want to go as early as the 10th. I can't do the 12th because I have a midday meeting.

Why are all meetings midday? They seriously f with the rest of my day.

This week we have a brief respite from drs appointments! Yay! Though I'm supposed to get a call from hematology so they can "tell me when my appointment will be." I'm not sure I like that. I'm hoping it's more of a, "These are our openings. Which will work for you?" than a, "You will come in at X time. What, you can't? You have pre-existing life commitments? Don't you care about your health?" though I am not optimistic.

Sigh.

The only people less considerate of your time than doctors are those in the criminal justice system.

computer

The saga continues.

When I called Dell on Wednesday, I was told I would receive a call between 12-1 on Thursday to inform me when a tech would be coming to my house on Friday. I was told if I did *not* receive a call, that meant the part had not arrived yet and the tech would be coming Monday.

Of course there was no call.

On Friday at 9 I received a call from a tech asking me if they could come over in 10 minutes. I was in the bathroom -- AT SCHOOL -- so I told them no, but they could come at 1 instead. Surprisingly, that was ok (apparently Dell is not like Comcast). It was a little annoying that the guy was adamant that the snafu with the phone call wasn't his fault (like I care whose fault it was), but he even showed up on time and fixed my computer.

Well almost.

The hard drive he brought couldn't be read by my computer, so he told me that he would have to come back on Monday. Well, not him necessarily. But *someone* would. And I would receive a call letting me know when.

Fine.

So I received a call last night from the gentleman in the Philippines again informing me that nobody would be coming to my house. That instead FedEx would be delivering the hard drive, and that I would be replacing it. Which is fine by me. At least I'll learn how to replace a hard drive.

On the other hand, he was completely unable to tell me what size screwdriver I needed, which was a little annoying. And, if this doesn't work (Which guys? Let's be honest here. It's not going to.) and the hard drive is still unable to be read, I am going to have to send them my computer and they will have to fix it on site.

Anyone want to place some bets on when this issue is going to get resolved?

My vote is for 2 weeks. Too bad that tech people coming to your house actually makes the time until functional computer status is achieved longer, because that's what it seems like it's doing.