Tuesday, March 10, 2009

Mommy and Parker, self-portrait

Not the MOST attractive photo, but the most up-to-the moment photo!

Looking at the rocks

Looking at the rocks
Originally uploaded by emtkatydid
Here is my little boy, Mr. P, on a sunny day at the beach. The cold, cold, cold-watered beach. Did that stop him from going in the water? No, sir!

Late. Late. Late late Kate.

I haven't posted in forever and no one is listening. But I had a baby! He's a big boy now! I am getting close to being done with my residency! I just did my taxes!

Pictures to follow.


Sunday, April 29, 2007

My next big project

Fetus 12 weeks
Originally uploaded by emtkatydid.
I've been sort of busy lately, with work and all, but Chris and I found time to work on another project that I think you're all really going to like. It's set to go live on November 7th, although there are a lot of us here at FetusHQ who are hopeful that we might be set to go a little earlier than that, although not too early, of course. We have found that if editions premiere too soon they can have a lot of bugs and well, it's just the best for all end-users if the project is seen through to completion.

So here's photographic (ultrasonographic) evidence of how the project is proceeding so far. We're happy to report that fingers were visualized, as was a heartbeat and lots of cute little fetal movements. Head to the right, hand above the head, and stomach to the left. Though we ARE hopeful that the final color scheme might be a little less monochromatic....

Anyhow, I'm feeling lots better now, and apparently (according to our midwife) the next 3 months will be the best I EVER feel, maybe in the rest of my life? So I'm looking forward to that.

So, yeah. Surprise!

Tuesday, April 24, 2007

Old knitting

Mom sweater
Originally uploaded by DrEtak.
I finished this last summer. It's a tunic sweater pattern from the Summer 06 issue of Vogue Knitting. Originally it was done in white, but Mom is much more of a green person. I had to alter the neck to add more length at the shoulder, but it ended up fitting Mom perfectly.

The best part? Grandma, the goddess of knitting, ASKED MOM WHERE SHE BOUGHT IT. Whoo!!!

On Call...

So, I didn't actually die, just abandoned my blog for a while. A long, long while. It just wasn't fitting into life for a while.

I don't know if it will keep fitting in or not. I've started work on a new project...with any luck, we'll be finished by early November or so. But there will be more info to come in future weeks.

Tonight I am on call. We have a night float system at our program, and we do nights for two weeks. Additionally, we have a PA come in from midnight to 8 am, so we end up doing only 8 hours a night (from 4 to midnight). This resulted from some RRC issues about too much service and not enough teaching...golly, those crazy RRC people. (RRC = Residency Review Committee, the folks in charge of credentialing residency programs and making sure they do everything they are supposed to, including teaching us lots of stuff AND not abusing us too much.) So most night float stretches are pretty good, and even if it's super busy, you usually get to go home at a reasonable hour.

However, when the PA goes on vacation, another resident comes in from 4-10 pm, and then the night float person comes in from 10 pm-8 am. And...the PA was on vacation on Wednesday, and Thursday, and Sunday! And currently, overnights have not been good for me. It's been much better for me to be IN BED rather than roaming around the unit tucking the elderly into bed, or sitting in the ER listening to the next story of tragedy and horror. This has all resulted in my sleep-wake schedule becoming very altered, which caused me to have insomnia when I got home at midnight last night and could FINALLY sleep. There I was, with a cat under each arm and a husband next to me and....nope. Nothing. At all. *sigh*

I'm not quite sure what to say about the Virginia Tech thing. My brother went to school at Richmond, and one of my friends is in med school in Richmond, so I've probably at least BEEN to Virginia a few more times than some people. And being a budding shrink, it seems like the kind of issue I'd be thinking about. I did end up seeing a few patients the night after it happened who'd been destabilized by it. One had an intensification of his psychosis and ended up lying on the floor of his parents' living room, sobbing hysterically in front of CNN. Another approached staff at the homeless shelter and told them they needed to send him to the hospital, because he couldn't see what was stopping him from taking a cop's gun and doing the same thing as Cho. So it did affect our community.

But I've been intrigued to see the number of forensic social workers and psychologists willing to discuss the man's issues on TV. Without examining the person, but by what small history we have, and by the evidence of his disturbing behavior in classes, people are willing to offer all kinds of diagnoses. Psychosis, schizophrenia, depression, paranoid personality disorder, antisocial personality disorder...we're trying to label this, to put it in a box, to make it "other." This makes the case safe. In effect, we're labeling and extruding him from the community. By labeling him with some kind of named illness (although he is clearly very broken), we both feel we've explained the unexplainable, and insulated ourselves from the possibility that it could ever happen to someone "normal." It is possible that a person could make a horrible choice. People do this all the time. They lie, steal, murder, cheat, sleep around, hurt themselves, and hurt others--all without having a diagnosis of mental illness. In fact, there are people in Iraq who are planning the injury and murder of many more people than died in the VTech assault, and we don't call them mentally ill...but we call them radicals, or extremists, and we ignore the numbers of innocent people who die there every day. But people have their reasons for doing things, even inexplicable things.

And the point of something inexplicable is that you CAN'T explain it. There's no doctor on earth who can really explain why this happened. Trying just seems so...pointless.

Anyhow. This is what happens when a shrink is short of sleep. More info on the project...later.

Monday, July 03, 2006

Keep Me In Your Heart

Dear baby F,

I'm so sorry. I want to start out that way. I know that what happened wasn't my fault, and I hope that wherever you are now, you're beyond blaming anyone, but...I'm sorry. I'm sorry I didn't push harder for a DHHS referral. I'm sorry we sent you home again.

We didn't know what was wrong with you. We didn't know why your mother kept bringing you in to the hospital, and saying that you were choking. When we looked at you, you were a gorgeous baby girl. We did every study we could find, and didn't even find any reflux. We found nothing. We called it reflux anyway and treated you, figuring that at least we were doing something.

You never had a choking spell at the hospital. You never turned gray, or even blue. You never dropped your oxygen saturations on the monitors. You smiled at us, and you loved when we fed you, and held you, and walked around the unit holding you, swaying from side to side and humming softly under our breath.

Everything you owned was pink, and when she brought you in she always brought a bag full of your clothes, before she turned and fled down the hall. The nurses chased her down the hall, shouting questions at a quickly retreating back and thin shoulders. "What does she eat? How much? How often? Do you thicken her formula? Hello?" Then she was gone, and we had to guess.

We stopped having to write new admission notes on you. We called up your last file from medical records and copied the last one, which was only a few days old, and merely added another hospital admission to the list. "Admitted 3 times since 3/06." "4th admission since birth." "Fifth..." "Sixth..."

Finally we started to ask hard questions. We had the abuse specialist see you. We x-rayed your bones and scanned your head. There was nothing pathologic there. We knew the visiting nurses were coming to see you, and we thought it was enough. We thought she cared, and we taught her CPR. Just in case, we said to ourselves. We thought we had done enough. We thought you had time enough.

The seventh admission was the last one. You hadn't been home long, and--it was the morning again--she called the ambulance again. You weren't breathing, she said. She found you like that, she said. She tried CPR, she said.

I don't know how or why, but we brought you back. But we didn't bring you back--not the you that you were. We brought back your brainstem, and your heart beat for us, but that was all. You didn't breathe on your own. You didn't look at us anymore. You were a tiny corpse, kept alive by our persistence, by our unbelief, by our sheer conviction that babies should live, that babies can live, that babies can survive miraculously. You were kept alive by our love.

We didn't believe the first EEG, which lacked the mountainous pulsations or brain activity. We didn't believe the examinations that showed that all of your baby body was limp and lifeless. We barely believed the second EEG, still flat and serene, but the third one visited reality on us. You really were gone.

There were so many of us who knew you. All the nurses loved you, even if they hadn't taken care of you. Most of the residents knew you--most of the residents had admitted you. Your pediatrician had seen you so many times in your short life, and the loss of you broke him. He was kicking things in the ICU, trash cans, cart racks, anything in his way, so angry, so lost.

We were all of us powerless to change the fate that awaited you, rustling in the wings, behind the heavy velvet curtain that hid the things we cannot see. We could not see into her heart, into her fears, into her intent toward you. We could not understand the message she tried to give us. She in turn could not understand we would have taken you. We would have kept you. If she couldn't take care of you, we would have. There were so many of us who loved you, and so many families desperate for a sweet, well-behaved, healthy baby. If she had only known...If we had only said...

We don't know what happened to you. The autopsy showed nothing, and she said nothing. Anything could have happened. Just anything.

There is so little we can do for you, little girl. We can imagine you as a bigger girl...wearing a pink bathing suit, playing in a sprinkler...smiling, your front teeth missing, on your first day of school...blowing out the candles on a birthday cake...lying down to sleep on pink and purple sheets. You sleep somewhere else now, somewhere cold and dark, and our memories and imaginations cannot reach you there.

But we can promise you this. We will remember you. We will carry you with us. We will keep you in our heart. That's all we can do for you now.

And little baby, I am so, so, so sorry.

Sunday, June 11, 2006

MY sockpal socks!!!

Received Sockpal Socks
Originally uploaded by emtkatydid.
I got my sockpal socks! They were such a nice surprise during a loooong week (I started back to peds last week). They were made by a knitter in British Columbia named Ann, and they are just goregous. She picked a lovely hand-dyed yarn and worked them up really, really nicely. They feel great (and I might happen to have them on at exactly this moment). They fit perfectly and I'm happy happy happy.

She also sent an adorable teeny tiny book about knitting, and a pretty card with a woodcut picture of a salmon on the front of it--very Pacific-Northwest-y. Of course the fish reminded me that with all the rain we've been having lately, we may have to develop gills just to survive...

Thanks so much, Ann! Yay for new socks!!!

Friday, May 12, 2006

I am 12. This is my doll.

She is smaller than most of the patients here, thin, and not as tall. The only concession her body has made to old age, aside from her white hair and wrinkles, is a rather large rear end. When she sits in a chair, she draws her knees up, or slings them over the chair arm. She eschews the hospital garb--except on days that she has ECT--and wears a knit light blue jacket, turtlenecks, and gingham pants. She always wants to wear the jacket, even when it is dirty.

She has lived in psychiatric hospitals most of her life. She has never had a house of her own. She has never had an apartment, paid bills, done the shopping. Yet she insists that she will, and the first day she met me, she pointed angrily. "Rebecca! You're going to take my apartment! Don't do it!" Then she burst into tears.

My name is not Rebecca.

She carries a doll with her most of the time. It is an incredibly realistic baby, about 1 month old, and if you're not paying attention it looks like a dead baby. Having recently worked on the pediatrics floor, this instantly activates "code brain"--take the baby to the treatment room, airway breathing circulation, call respiratory, do we have access, an IV, anything, what's the cause, respiratory failure, are we intubated yet, what's the rhythym--but it's just a doll. Sometimes she puts it in the basket of her walker and takes it around with her. In the middle of the week she left it in the dayroom for a long time. Today she cradles it like a real infant.

Sometimes she says she is not who she is. She says she is 12, or 14, or a boy. Her name is Andrew, or Jessica. She explains her white hair, her wrinkles, so quickly--I dyed my hair, I got too much sun. We are not sure why she does this, if she actually has dissociative identity disorder, or if she is interpreting her reality into what she knows--before she came to us, she was at the state hospital, surrounded by desperately sick teenagers. She was the only geriatric patient left, the only one the state couldn't get rid of.

She kept asking the nurse today how old she was.

"78," said the nurse.

"What YEAR is it?" she asked.

Her mouth opened and closed when she heard the answer, opened and closed with nothing to say.

The past few days she has cried every afternoon, in front of the nurse's station. She begs for $3, for a hot dog. Two days ago my attending took pity and gave her the money. She promptly lost it, and begged for it again the next day. She shrieks. She prefers injections, but will only sometimes allow them. Her right bicep is a hard lump from the years and years of injections. Calming medications, antipsychotic medications, any kind of medications.

Her speech is horribly jumbled and we don't know why. She just can't close her mouth around her words, as though she has a thousand marbles in there, fighting with the words. On days she hates us and wants us to leave, she's more clear, "Get out of here--go away" as she pushes us with her hands. When she feels better, her speech is less clear. Sometimes she will write her conversations with us.

How are you doing today?

I am 12. This is my doll.

He's a very nice doll.

It is a girl.

I'm sorry, my mistake. If you can keep from screaming and do what the nurses tell you today, you can go to the store (i.e. go to the cafeteria and get a hot dog.)

They are not nurses.

OK. Is there anything we can help you with today?

I am alright.

So we leave, move on, as she sits by the nurse's station, cradling the dead baby, and stalking us with her eyes. She will never get better. She will never have that apartment--I might as well have been Rebecca the apartment stealing girl. The state doesn't want her back, but we can't keep her here forever. No one wants her.

But our attending loves her. He sits with her, holds her hand, leans his head towards her. He figures out any way to communicate with her. He gives her the $3, the allowance, the hot dogs. She is thought about, time is taken for her, pleasures are devised for her. He wants her to be happy. He carries her with him, in his heart.

And maybe, for one day at least, that is enough.

Wednesday, April 26, 2006

My new faucet

Faucet Two
Originally uploaded by emtkatydid.
My husband and I are useful. We know how to put new faucets in! This is the "Kate's sink" faucet, the "Chris' sink" faucet is on my flickr pages (www.flickr.com/photos/drkate). It's pretty. Now if only I could make the focus right....I have a lot of work to do with my camera!

The packaged sockpal socks

The socks!
Originally uploaded by emtkatydid.
Here are the socks, all labeled up and ready to go. They have a long journey...I hope they don't get too cold!

Sockpal Socks

Sockpal Socks
Originally uploaded by emtkatydid.
They are finally done! I finished them two nights ago, and didn't get around to photographing them until today. (Allow me to digress briefly about how NICE a LOT of the knitting photography on other peoples' blogs is. And how challenging it's been for me to take partially nice photos. Part of the challence is the built-in flash on my camera. When I am close enough to get the interesting details in my knitting, esp. in macro mode, the flash just washes out all the color. I'm looking at external flashes for my camera now. It's getting to that point where I really notice the performance of the flash. So it results in me feeling inadequate about posting knitting photos. Anyway.)

So the socks are done, and done BEFORE the deadline, which I must say is pretty impressive for a busy intern! Fortunately socks are just the right kind of project for me, they are easy to transport and not too obvious to work on during grand rounds and lectures. Also, people fuss over them, which is nice. I hope my sockpal loves her socks! They have lots of knowledge knitted in.

Now I have to find a few "goodies" to include with the package, and it will be ready to be sent off!