Hello there!

I do actually update this. Quite often, in fact. Except most of it is my boring day to day stuff that I cannot imagine interests anyone. But I've had this for going on 9 years. All I can say is that I'm a little bit less of an idiot than I was then. A little less. Comment if the curiousity is just burning you up inside.

Nov. 27th, 2007

I like lists, they give me a false sense of organization.

1. I need to watch it before this place turns me into a closet alcoholic. Its a strange thing, I never drink enough to even achieve a suitable buzz, but somehow drinking tequila for no other good reason than "I'm not on call tonight" just doesn't seem quite right.

2. My date this weekend was a disaster. A disaster. Once he starts talking about his hemorrhoids, the date is essentially over. I am a doctor (tempted to use the finger air quotes), but I am not your doctor. Who thinks I want to hear this stuff? Who thinks that just because I'm a urologist that I want to hear about your childhood experiences with testicular pain? Why do I have to hear all this three or four times over?

I am just a girl who would like to (for once) be treated like one. Where does an imperfect human being go to find other imperfect human beings? From now on I'm just going to tell people that I'm a nurse. Or a Wal-Mart greeter.

3. On the other hand, because I gave up the date as lost, we accidentally ended up at a bar that had salsa dancing lessons. I threw off my coat, jumped in, and shimmied with a Christopher Walken look-a-like. The girls had to rotate around while the guys stayed in one place, so I got to dance with everyone. The partners I enjoyed the most were both fantastically good and awe-inspiringly bad. Their unifying force is that they did it with confidence. Say what you must, but I am a girl, and I do have preconceived (primitive) notions about men and strength.

4. After picking up the dance steps relatively easily, we walked outside and I immediately face planted in the middle of the street. (Damn trolley tracks.) What I lack in grace I make up in gravity.

5. Some days I hate being here with the power of a thousand suns. Why does constant belittlement, stress and guilt have to be an important part of achieving my goals?

6. I think all of this would be better if I knew people here who had absolutely nothing to do with work.

7. Rats. Ran out of tequila.

Escucha

I have this sneaking feeling lately that I'm uninteresting and not very well read. I forget so many things that I'm not even sure what I do know.

Life has gotten a little better at the children's hospital. I've pretty much decided not to care what they think. These people don't scare me. Not one bit.

We went into an antiques shop (lured by the masks in the window). There was an older gentleman with a black beret perched atop a mass of white hair who greeted us as we stepped inside. Music in all ways and all forms is lovely, and there was a particularly haunting piece wafting through the antiquities. It was difficult to tell if the song was being sung in English or some other language I couldn't recognize, so we asked the proprietor. He said it was actually a friend of his who was translating French poetry to music. Interested, I asked him what the song was about. Oh, the usual, he said. Love me or I'll die. I should know, he continued, I'm a philosopher (pointing at his chapeau, apparently the club badge). I wonder if either philosphers are the only ones who can understand that sort of suffering or if they are the only ones who appreciate it.

I actually prayed to St Anthony the other day. Not to find something I've lost, but that perhaps I've found something I've been looking for. Life with uncertainty. I should have a t-shirt made.

It has been a rather rainy, cold, grouchy day. Not me grouchy, but the sky has been swirly and moody. I'm not really sure what to do with it, or how to make it better.

Art


Art, originally uploaded by Espion..

I know this is inappropriate, but every once in awhile I'll take a picture and it will be Love at First Sight. It does exist. Sort of.

Again with the strangest profession ever...

On every single night of the week and weekends, the other junior resident and I "man the phones". We run something akin to a 24 hour genito-urinary hotline for all your scrotal needs. Obviously, since I'm at the Children's, these are all parents with questions that run the entire gamut of valid to awe-inspiringly dumb.

(i.e. Frantic Mom: "My son is SLEEPING!!!"
Me: "Uhhh, yes that's great ma'am!"
Frantic Mom: "But if he's sleeping, I can't give him his pain medication!!"
Me: "Well, it was a three millimeter incision..."
Frantic Mom: "But I can't wake him up to give him the medication. What should I do?!"
Me: "Since he's sleeping, he must be pretty comfortable."
Frantic Mom: "NO HE'S NOT!!!"
Me: *sigh*)


Over the weekend my co-resident got a call from a 15 year old kid who refused to be identified by his real name. He was respectfully calling on a Saturday night because he wanted to request an appointment at the Urology clinic. To be castrated.

Yes, you read that right. To be castrated. And not because he's some crazy manic/bipolar/psych disorder du jour kid, but because he wants to become a female. Right now he's in the throes of puberty and its scaring him. He actually called two years ago requesting the same thing, but that time he called in with his aunt as his guardian.

Of course there's the comedy option you could go for, but Kid With No Name, you break my heart. Its already serious, sad business to be a human being in this world, but how could you possibly manage if you felt like a stranger to yourself?

Espera

And if thinking of first lines was tough enough, consider waking up in a warm bed on a cold Saturday. A Saturday where you have to go to work.

A first line would be easier, I think. It helps that I love mornings. And this was the very first 45 degree, cold, crisp fall morning. So clear it was like little sharp stabby bits to your mind. So blue you could see from here to tomorrow.

I went to a bookstore today (makes me feel a little alive, they have their own special energy, I think) and bought a book (based on its cover). Its about a woman who is convinced that she is the last person on the planet. I wonder what it is really about.

I was trying to resist buying a book, because I need to study. My inservice exam is in the middle of November, and I desperately need to load my synapses with urologically centered information. But for the past week (and then some) I've neither been here nor there. I am always in such a hurry to leave work every day. But as soon as I do, I regret it. I don't know what to do with myself. I don't want to go home, I don't want to study. Its so strange. I just don't + fill in the blank. I've never suffered such an utter lack of...ideas.

Talking to a friend today, we compared our inertia. Sitting on the couch waiting with absolutely no idea in the world of what we are waiting for. My unoriginal theory is that stasis = fear and fear = stasis. In the bookstore there was a book with either a title or a quote that was something like, "I have the right to destroy myself". Well, I have neither the courage nor the motivation. And I don't mean taking a dive six feet under. I mean change.

But today I walked (and froze) instead of drove. I went to the bookstore and bought a book. I ate outside. I talked with a frustrated doc in New Jersey who is trying to get someone to take care of his patient. I gave out my phone number. I talked with friends. And now, I'm sitting on the couch. Waiting.

Day #7

This morning I walked outside. And that was it, really. I walked outside then everything flowed as it usually does. Down South Street. Left on 8th. Left on Spruce. Left on 7th.


I saw everyone I needed to see this morning just in the nick of time. Patients always want to tell me in detail about their constipation problems, heartburn problems, foot pain problems. This morning I couldn't stop myself from being honest. Maybe its because I'm a little tired.


"Doc, is it okay to tell the attending that I'm dying?"
"Sir, you're not dying. For heaven's sake, I'll get you something for your gas."


"Doc, this hernia is bulging out. You have to do something about it now!"
"Sir, we couldn't take out your kidney mass because you showed up to the OR drunk. First things first, let's take care of your cancer. Then we'll think about the hernia."


"Doc, the nurses took 15 fucking minutes to come see me and I had to clean myself in the bathroom. You took out my catheter too fast this morning (he wanted me to do it slow?!) and now I'm getting dressed and going home."
"Sir, we have to make sure you are able to pee before we send you home. You've taken a lot of narcotics, and you may not be able to go to the bathroom."
"You people take too fucking long, you don't know shit, I can go to the bathroom. So I'm going, no matter what!"
"Fine, I'll see you in the ER later."


Yesterday I got paged once every 10 minutes between 2pm and 7pm. I don't exaggerate and I have to tell you, I nearly cracked. A full third of those pages were from various members of two medical teams concerning one patient. They seem to think I'm an internal medicine doctor. Which is funny because between all three members of that medicine team, plus the entire slew of infectious disease residents, I'm the only one who knows how to manage diabetes. They were trying to force my hand in taking a patient to the OR. I told them all, in various ways, LIKE HELL. Never in my life would I take a patient to surgery if I knew that it would only hurt him. What that man needed was a doctor to take care of him. He did not need a surgeon to cut him.


I walked outside the hospital and it was pouring rain. I drove across town to the other hospital I cover on the weekends to see a couple patients there. By the time I pulled into the parking lot it was a slight drizzle, not quite enough for an umbrella, but I took it anyway.


Walking through the halls of the VA, I had this irresistable urge to repeatedly rap the business end of the umbrella into my fist like a thug looking for a few heads to knock around. Luckily no blood products to infuse. It would have been easier to set myself up next to the patient, put in an IV and transfer my blood directly to him, than what I went through last weekend.


After that I came home and fell asleep on the couch. Mr. "I'm going home right now" is barfing, and another patient who wanted to go home, would rather stay in the hospital until she gets tired of the food.


Oh, my reality. Sometimes I'm beating myself over the head with the umbrella. I'm okay with the fact that for the most part, the patients I see are frustrated, angry, ungrateful, and have twisted priorities. Sickness just does that to people. You can tell the strength of a man's character in how they deal with adversity. And not everyone is strong.


And that's okay.


Kant buy me looooove

Driving home today I saw one of the many Philadelphia dog owners walking with her dog on the sidewalk. It was a large Weimaraner-ish dog, but with a brindle coat. He was trotting alongside his owner carrying a huge stick in his mouth, looking like he had just won the lottery. My mutt used to do nothing but carry her rawhide bone from room to room on certain days. (Tuesdays.)

Today one of my patients tried to get me to tell his wife that he wouldn't be allowed to have sex for two weeks. The dude has a kidney stone. Heh.

We had a lot of intra-operative foley consults today. They were all justified consults, too. Every single one of them required our usual bag of tricks to get the catheter past a stricture. Today was supposed to be a slow day.

My chief resident, whom I like and respect immensely, decided that he's going to teach me philosophy, which is great, because I've always enjoyed a smattering of philosophy. Here's what I got:

1. Laura, it is all mind over matter. If you don't mind, it doesn't matter.

Now Rakesh can say most anything and it will sound as though a centuries aged maharishi has never spoken truer words. (Unless you are into ripping off S.L. Clemens.) He always speaks in an unassuming, meditative manner so it doesn't really matter what he says. Its all philosophy. (Tabes dorsalis...its the best!)

2. True happiness comes from finding joy in suffering.

"So, Rakesh, the path to true happiness is continual suffering?" (This had already started to sound suspiciously like an attempt to make residency seem like a pleasant diversion than a 5 to 10 tour in the pen.)

[In the pen. HAHAHA! In the Penn. *wipes a tear* Oooh, Nelly, doesn't that just work?]

He paused for a moment, took a deep breath, thought for a few moments, then put his hand on my shoulder. "Laura, if you don't mind, it doesn't matter."

"Rakesh. We have to suffer to find happiness? That makes no sense."

"Well, it just does."

"But why should we have to suffer?"

"Uhhhh, because."

"Rakesh?"

"Yeah?"

"You're a good philosopher."

"I know."

Aug. 21st, 2007

I finished 100 Years of Solitude. Straingley enough, I'm consumed by the desire to read it all over again, just to soak in every lyrical turn of phrase until it becomes committed to memory. So many places that I want to go back and read and re-read. How does anyone manage to write in such a penetrating way? You'd have to read it from cover to cover, make good use of the genealogy printed in the front and be the right sort of sentiment to understand. I will read it again sometime soon, but first I'll start The Wind-up Bird Chronicles.

(from boingboing)

These are amazing...a collection of mostly Polish movie posters. My favorites so far are Wherever You Are, The Conformist, Amadeus, and 12 Angry Men.

A typical, daily, conversation.

Me: "Hi, this is Urology, I was paged?


Nurse/Resident/Student: "Neurology?"


Me: "No, urology."


Nurse/Resident/Student (heard calling out): "Did anyone page neurology?"


Me: "Noooo, U-rology."


Nurse/Resident/Student: "Nope, no one paged neurology."


Me: "AUUUGHHH! PENIS!!!"

Moving...

Boxes are starting to pile up.

So...how about the weather?

Growing up in the middle of nowhere has its benefits; however, I have a crippling inability to schmooze. Small talk, witty banter, and polite conversation. I'll admit, it is difficult. Saying nothing at all is a much better alternative, but then I berate myself for being a lump with nothing intelligent to say. Heh, you can only lose a fight against yourself.

After that aforementioned call, I slept to about 6pm the following day. I woke up with this sudden desire to walk outside, so I threw on some jeans and decided to go to my local chain bookstore down near the harbor. I had been reading (finished actually) a book that had described a point in time when the main character was going through hell because he didn't know his own reality. I figured what I really needed was a book with a version of reality, and another with a version of life.

There is one area along the way where I walk particularly fast, because for reasons completely beyond me, I'll get a few "hey baby's", "daaaamn" or a whistle or two. My theory is that they see boobs first and ask questions later. Or maybe they just enjoy making me crazy uncomfortable. Nobody catcalls in West Texas unless they see a twelve point buck. And that's only after they've shot it.

So I pass Construction Worker/Homeless Dude Boulevarde and start enjoying my walk a little more. There are almost always banners flying above South Pratt Street advertising the latest convention or festival. The newest proclaimed a meeting of the "Baltimore Society of Foresight". For a brief moment, I thought, "Holy crap, that's awesome! Its like damage control before the damage! Preventative medicine! Thinking before we act!" My brain filled with the possibilities of an entire organization pondering Future. Then I actually read it and realized it said: "Baltimore Society for Sight". (Well, that's cool too.)

The harbor was filled with people, as per usual. I finally walked up to the book store and was faced with the usual conundrum of having arrived, yet without the slightest idea of what I needed or what I was after. Sometimes I find it, sometimes I don't.

This time I found two books that I think will fit the bill quite nicely, and this is without knowing anything about either. I needed a version of reality (The Razor's Edge by Maugham) and a version of life (One Hundred Years of Solitude by Marquez). They both jumped out at me and told me that I would find a little piece of myself in their pages. And who hasn't found themselves in a book? Its the very most about what I love about art. The dynamic back and forth interplay between the artist and the patron. There is nothing static about a painting, or words, or a photograph.

Walking home, it was just between dusk and complete dark. I wasn't really thinking about the walk home as much as the half a million things I needed to be doing. My own little world is refreshing to me, unfortunately, no one else lives there. Heh. Then right in front of me on the path a lightning bug flashed briefly.

(Hey baby.)

A dramatic tale...

Last night I met a human being who set out to define and embody the full meaning of "histrionic". And over-achiever that she was, she attained success on a grand scale. Encased in the body of a slightly obese 10 year old girl was the most over-the-top pediatric surgical consult I've ever received from the Peds ED. After carefully reviewing her plain films and confirming that at least there was no overt radiological evidence of badness in her abdomen (other than being nigh on extremely constipated) I performed my first assessment.

I peeked into the window.



This is a very, very important first step. In many ways, children are more difficult to examine than adults. An unfortunate (and perhaps fortunate) consequence is that we have to take everything much more seriously than in adults. Over in the main ED, we have more freedom to roll our eyes and look the other way. However, in the pediatric side, a child that cries wolf may buy themselves a few scars more than when they first came in--all in the name of "being on the safe side". So it is very important to separate the wheat from the chaff whenever possible, and there are a few tricks of the trade that I've picked up from the pediatricians.


Taking a glance inside the exam room before you enter can elicit volumes of information. The child was resting, watching cartoons and laughing quietly. Mom was at bedside watching TV as well, and Dad was staring off into space in the corner. "Okay, good," I think. "No one's sick."


I step into the room and straight into a three ring circus.


"OWWWWWWWWWWWWWWWWWWAHHHHHHHHHHHHHHHHHHHHHHHHHHHHOWWWWWWWWWWWWWWWWWWWWWW!"

The kid instantly starts writhing and twisting on the bed in pain as soon as she lays eyes on my white coat. With no hope of dimming the volume on our background music, I sit down and attempt to talk with the mom about what has been going on. Turns out the child had a laparoscopic appendectomy quite awhile ago, and has had pain for the last 2 days. I try to tease out the information and find that she has been taking pepcid and zantac for the past 5 months, but had stopped taking MiraLAX about 4 days ago.

About this time, the kid realized that I wasn't really paying attention to her, and stepped up the screaming and writhing to about the level of standing in front of a jet engine. So I asked the girl to describe the pain. This is where it really started to get good.

"OOOOWWWWWWWWWWWWW! I'M IN SO MUCH PAIN, OWWWWWWWWWWWWW! IT'S...IT'S.......INDESCRIBABLE!!!! AHHHHHHHHHHHHHHH!!!"

She had the best dramatic pauses. She waited exactly the right amount of time to feel for our anticipation of the response then swooped in to leave the audience breathless. Indescribable. Now that must be pain! Pain of magnificent and epic proportions. Pain unlike any 10 year old girl has ever experienced before. I actually briefly considered asking her if she'd rather play a more stoic heroine, quietly suffering and inconsolable to the pity of all, say, Beth in Little Women, but I decided against it. Instead I waited patiently for the fresh burst of ow's and ah's to blow over. My patience comes at the most inopportune times.

Her coup de grace was a little premature, but just to keep the ball rolling, she started screaming at her mother.

"I HATE YOU! I HATE YOU! OWWWWWWWWWWWWWWWWWWW!!!!THE PAIN IS INDESCRIBABLE! INDESCRIBABLE!!! GIVE ME SOMETHING TO BITE ON! GIVE ME SOMETHING TO BITE ON!!!!"

To the incredulity of at least myself, the kid actually started tearing at the bedclothes with her teeth. Except it wasn't as graceful as that. She couldn't quite reach the sheets, so she had to pick them up to put them in her mouth so she could gnash, grunt and rend at her heart's content. Her father, who had been staring into space with his hands shoved into his pockets, stood up and handed her one of those soft "stress-ball" toys. The kind that you squeeze repeatedly to achieve nirvana in the middle of marathon business meetings.

She grabbed the toy from her father, proceeded to rip a chunk out of it with her teeth, spit it out, and threw it at her mother. I started craving popcorn at this point.

I wish I was good at poker, because at least I would have a well-practiced poker face. Its a very handy tool in a doc's armamentarium. It allows the patient (and patient's mother) to think that you are taking them seriously, when in fact, you want to tell that poor child that she is going to make some man very, very miserable someday. I discovered that the child has a history of constipation, for which she's taken MiraLAX every day for years. And they stopped taking it on Sunday. And she hasn't had a bowel movement since Sunday.

And they failed to see a connection. Absolutely and utterly failed. I actually did believe the kid had pain. Maybe not to the dramatic degree that she would have liked us to believe, but pain nonetheless. It fit with the colicky nature, the slight abdominal fullness, and the crazy amount of narcotics she has been taking a month after having a routine appendectomy with three sub-centimeter incisions. She had no other symptoms to suggest obstruction or even early obstruction. Her films were negative, and her belly was a soft as the Pillsbury Doughboy. The kid just needed to poop.

But the mother refused to believe that something so simple could be the cause of all her daughter's pain. She wanted a real diagnosis. She wanted CANCER! or PERFORATION! or ULCERS BURNING HER FROM THE INSIDE OUT! (quote...unquote.)

Once I realized that the kid received her character in the honest way, I threw a quick glance at Dad (still staring at the floor with his hands shoved so far in his pockets you'd think he was trying to dig a hole to China) and took my leave. I had stayed long enough thoroughly examine the kid, get a history and realize that she was completely non-surgical. I suggested that she continue to take the MiraLAX and I deposited them back into the hands of the Peds ED and walked straight into the next room to see my next consult.

I had the afternoon off...

I've just discovered NPR's Coffee Break Spanish. Two Scots teaching Spanish. I'm hooked.

Tired and grouchy.

Post call again. Someone was sticking consult pins in my voodoo doll because the unholy trifecta of Plastics, Face, and Hand service were slapping me upside the head and calling me Sally.

Whenever some old surgeon squawks about the "good old days" of surgery when the residents worked 120 hour weeks, I say screw you hippies. You worked 120 hours for ONE service which was your OWN. I covered 6 different services last night. You nostalgic tossers can kiss my ass.

Apr. 21st, 2007

The weather is BEAUTIFUL HERE!

*throws her arms out wide and dances a jig. a dadgum jig*

Adventures in ethics...

Earlier this week, I admitted a woman with cholecystitis (inflamed gallbladder) due to a large, impacted gallstone. I evaluated and admitted her from the ER and explained to her then that her gallbladder was inflamed and she would need the sugery with the "cameras" to take it out. But I didn't consent her for the surgery then.

We saw her the next day with the attending and the nurse practitioner stayed behind and explained how the gallbladder is a little bag that sits underneath your liver and helps to digest fats. But we didn't consent her for the surgery then.

I came back a day later when we were ready to take her to the operating room and filled out the consent form in front of her and explained all the medical terms one by one. (Cholelithiasis, cholecystectomy, etc.)

So she signs the form for informed consent, and was wheeled off to surgery for a much needed laparoscopic cholecystectomy.


And the first dadgum question she asks me the next morning is, "How am I gonna pee?"

"Pardon?"

"I've had my bladder removed. How'm I gonna pee?"

"SOMEONE TOOK OUT YOUR BLADDER?!" (I'm thinking, "Whoa Nelly. Need to know information always comes after the fact." This lady had cervical cancer previously with a definitive surgery and that could necessitate taking out the entire contents of the pelvis, including the bladder.)

"You did!"

"No, when did you have your bladder removed?"

"Yesterday!"

"Wha- ... *sigh*"

"No, ma'am, we took out your gallbladder."

"Exactly, HOW'M I GONNA PEE?"

"No, ma'am, the gallbladder. With the gallstones. We had absolutely nothing to do with your bladder."

"Ohhhhhh, you took out my gallstones."

"Uhhhhh, sure."


*pause*


"So I can pee?"

Weekends don't exist...2

4/9/07

"Laura pays. And pays and pays and pays..."

I catapulted myself out of bed motivated by the knowledge that some other poor soul (intern) just spent 24 hours in the hospital and it is up to me and me alone to grant them well deserved reprieve.

I get to the hospital and run around like a half-asleep headless chicken seeing my patients while I'm waiting to round with our fast-talking, mafia-dating, Brooklyn born and raised trauma-surgeon attending. You might find this crazy, but I have never heard a New York accent in real life before. Likewise, I've never met a Jew before I moved to Baltimore (and now I know many). And heroin addicts? Something I've only heard of in books. (Again, and now I know many.) I actually remember the first time I saw a prostitute/pimp combo on a street corner. (Again...kidding.) A city is a dangerous place for a little country mouse.

Based on how cute the nurses are is about how quickly the attending and I get through rounds. Luckily, the B team was on that day. I've learned that New Yorkers are just as fascinated with their accents as everyone else is, because they love to hear themselves talk. Heh. We move through rather sluggishly, because it seems the attending had just as good a time as I did, so we mumble our way through our version of "bloodshot eyes and coffee rounds" and scare the bejeebers out of our patients.

We finish up and I'm blankly staring at one of the computers at the front desk trying to remember exactly why I started staring at the computer in the first place when one of the nurses runs up to me and grabs my shoulder.

I swear I jumped about 6 feet in the air and very nearly wet my pants.

"Doctor! The patient in room 25 is covered in blood!"

I'll admit, my shoulders dropped a little and I had to close my eyes for a second. I knew that this would be no small thing.

I got up and walked briskly toward the patient's room and somewhere along the way a gremlin shoved a dagum magnet up my nose. The smell of iron was so overpowering it was almost palpable. A ran into the room and saw a shivering, emaciated alcoholic lying in a bed full of melena. Not to be overly graphic, but it really is amazing how much poured out of this guy.

My sleep-addled mind heard itself calling out the orders (CBC, coags, type and cross 4 units STAT, slam in 1 liter normal saline to start, stop the tube feeds, throw down an NG tube, get me some current vitals and as soon as we get the blood...run it.)

I called the surgical ICU, gastroenterology and my tired attending. The dadgum SICU fellow was one of the emergency medicine critical care fellows (not to sound arrogant, but...not a surgeon) and I had to run down to the unit and force him to take me seriously. (Later on we found out that my patient bled down to a hematocrit of around 12 or 14. Normal for a man is around 42.) When I ran back up stairs, the nurses had just managed to successfully place a naso-gastric (NG) tube...and he was pouring blood from there as well.

The SICU fellow finally gets up to the floor and starts freaking out. My tired attending rolls through at this point and puts the kibosh on the antics and the end result is my patient gets down to the unit and gets adequately resuscitated. Gastroenterology agrees to scope him (camera down to the stomach/duodenum, and camera up the whazoo to check out the colon) after he has some blood and more fluid on board.

So the day rolls forth with a new page from a different nurse about every 5 minutes (oh, how I wish I exaggerated) until around 5 pm I get paged by the SICU. Before I can say my standard greeting ("Hello, this is surgery. I was paged?") the resident who picked up the line excitedly blurts out, "We can't stop the bleeding!!!" Then he proceeds to tell me at roughly 150 words per minute that my favorite alcoholic is still bleeding and GI can't stop it with their little grab-bag full of tricks. It turned out that the patient had an active arterial bleed from a perforated duodenal ulcer.

So at 6 pm we had to rush him to the OR, split his belly open, filet his duodenum and oversew a spurting artery that was trying its damndest to kill the man.

(I also learned a very important lesson. I would have never made it through my trauma rotation without telling my attending to go fuck himself at least twenty times in fifteen minutes. What a dadgum primadonna.)

We deposited our patient safely in the surgical ICU after a 3 hour flail that somehow succeeded in accomplishing our goal.

Afterward I checked my pager and there were 24 pages (one every 7 and a half minutes) and I had been overhead paged...twice. The overhead page is a hospital-wide intercom for emergencies. Patients dying, fire drills, bomb scares. I was overhead paged because the patient on the 10th floor NEEDED SOMETHING TO SLEEP.

Oh, I seethe. That was the closest I ever came to breathing fire, except that one time I ate lunch in Juarez.


And now, I'm home and its 4:30 in the afternoon. And I'm still awake.

Tags:

Weekends don't exist...

In my continuing efforts to live like I'm still in college, I've managed to get about 5 hours of sleep in the last 48+ hours. Of course I'm not complaining, I take responsibility for my own lack of sleep. Nothing worthwhile comes from playing it safe, but it also means I have to be willing to pay for my transgressions.

So I present this as truth (proof to follow):

Saturday x [Tequila + Live Music] = Sunday x [Massive upper GI bleed^1,000,000 ridiculous pages]

Or, to put it more simply...the more fun Laura has the night before call, the number of patients who decide to unexpectedly crash and burn rises exponentially.


4/8/2007

"Laura has a night out"

My roommate, one of her fellow interns, and I decided to go out for a few hours to catch up on conversations and eat these great nachos at a tequila bar in Fed Hill. Tequila is fairly new to the old scotch and bourbon set, but I'm from Texas. I like good tequila. So I ordered Herradura anejo, neat. The right tequila is very spicy and warm but without the overbearing flavor of bourbon or traditional whiskey. (I would highly recommend at least giving it a try, but don't desecrate this sweet little libation in a margarita.) So I'm enjoying my drink and in doing so simultaneously attract and seriously annoy the only redneck in Federal Hill.

He was already two sheets to the wind gesturing widely and slurring through his flirtation with the bartender. His head was swiveling dangerously, throwing spittle-flecked aphorisms to everybody in particular. His gaze settled on my drink and his eyes literally widened at my measured sips and exclaimed a sudden, "WHATCHOO DOIN'?!"

He was completely aghast, taken aback, offended, seriously put out, and downright horrified that I would not just get it over with and drink the damn thing. Luckily for me, he relayed these important thoughts to the bar for the next half hour or so. He even tried an appeal on behalf of celebrity, "LISTEN GIRL, I DRINK AT DAYTONA. DAYTONA." He furrowed his eyebrows and put a stern little nod in there for effect.

He was entirely successful in convincing me to finish my drink.

My roommate's co-worker suggested another bar in Fed Hill, so we took the bar-hopping route and headed a few blocks down the street. The dive bar was fun, but the craziest thing was spotting one of these:



I don't wear mine much anymore, but Aggies can spot that ring from 500 yards. I would never attempt to make anyone else understand what an Aggie ring is to my alma mater, but let's just say that we are a unique bunch of almuni. It turned out that this guy was class of '99 (I'm class of '01) and was practicing law in D.C. He was up in B-more for a CD release party for his friend's band at another bar down the street. So after talking about all things A&M for awhile, he invites us along. I unceremoniously drag my roommate and her friend with me. I love live music, and the band was amazing (very rockstar with just the right amount of blues). So I'm enjoying music, meeting new people, and have an all around crazy good time. Then I turn around and see a confused Iranian and disgruntled Egyptian.

("Laura...uh, where are all the hot Arab men?"

"Geez, guys, can't you let me embrace my inner uncouth-beer-drinking-American-ness, like a coupla times?")

My awesome roommie said, yes, just this once. The Egyptian one left. Heh.

I stumbled home later and fell into a lovely three hour sleep before I had to be up and at work on Sunday morning.
I've learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.
~Maya Angelou

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