Although I have been on an outpatient rotation, I am still covering the wards and consults for the weekends. It's been a bit more call than I usually do in a month--still not too bad--but seeing everyone on the weekends has allowed me snapshots into their lives.
We have one man who will not stop drinking. He drinks and drinks and drinks and drinks. He has had seizures because his sodium is too low. He is essentially diluting himself, thinning out the concentration of his protoplasm full of saline, which is all of our inner state. He doesn't have a tumor, he doesn't have an imbalance in his kidney, he doesn't have a problem with his sugar. He is just sick.
He is one of "my" people, the mentally ill.
He has no understanding that his drinking is causing him problems, or even that it might be related to him being in the hospital. "I know I had a seizure once, but that was years ago! Why do you have to keep TALKING about it?" On admission, his sodium was 109, when the normal level is around 130. With sodium levels that low, free water flows across membranes to areas of higher concentration--like body tissues. Like the brain. More water means swelling in an organ, and a swollen brain means more pressure inside the head, which means seizure, herniation, death.
I saw him last weekend, carring around a larg, 24 ounce Dunkin Doughnuts cup. "My wife brought it for me!" he bayed. He held onto it and kept wandering into the dayroom to refill it with caffeine free Diet Coke from the machine. He never let it go. The nurses couldn't take it from him.
I checked his sodium. 123. Trending down. I asked the nurses if there was any way for us to steal the cup away. They said they'd try. And they did.
This past weekend, there he was again, standing at the nurses' station, bleating for a doctor. He had been out on a pass the day before, where he had drank the largest bottle of Snapple that he could find. He's not gotten any better in the month that he's been with us. Maybe the meds will eventually gain a foothold. Maybe his irritability and mania will soften, cool down. Maybe he will be able to restrain his thirst.
But somehow, I can't see that happening. His thirst is unending, cannot be quenched. I fear the day he is discharged, and wonder how long it will be before he is brought into the ED, flailing madly, intubated, and scanned...and then gone. His mind destroying his body, in the most essential sense of the phrase.
Meanwhile, he stands at the nurses station, wondering why he is here, posing problems that we cannot solve. And so we wait.
And he drinks.
Monday, January 30, 2006
Wednesday, January 11, 2006
Dena's scarf
Dena's Christmas scarf. It's red. It's short-rowed. It's from MagKnits.
I worked on it while I was at the movies.
It's a knitting doctor's dream. And now, it's the knitted property of another doctor!
I worked on it while I was at the movies.
It's a knitting doctor's dream. And now, it's the knitted property of another doctor!
The Loot
These are the wonderful knitting books I got from my wonderful mom. They are, from left to right: Candy Blankies (crocheted baby blankets, nice color groupings and adorable patterns); Knitter's Book of Finishing Techniques; Ann Budd's Knitter's Handy Book of Patterns; the classic Knitting Without Tears by Elizabeth Zimmerman, Alterknits; and Handknit Holidays.
In medical land, I got a book on behavioral treatments for explosive (irritable, dysregulated, "uncontrollable") kids; and a hand puppet in a white coat named Dr. Moody.
In medical land, I got a book on behavioral treatments for explosive (irritable, dysregulated, "uncontrollable") kids; and a hand puppet in a white coat named Dr. Moody.
Hi
I haven't published here in forever. I could pretend that I've been busy, but mostly I've forgotten about it. I didn't think I had that much to say, either.
However, I found a bunch of medical blogs, and that's inspired me. Our C/L attending sent me the URL of a resident psychiatrist in Seattle. She writes the way I wish I could, a "literary blog," one might say. I have many nights during which I lie in bed, waiting to fall asleep, and imagine the things I'd like to write. There's so many patient stories to tell. In the past six months, I've seen and done things that have made me cry, made me laugh, made me hate everyone, everywhere--and sometimes, it's made me feel like a doctor.
And then I screw up again and can't believe anyone lets me even talk to patients.
I presented a journal club today on the treatment of depression in teenagers. It was an actual controlled, randomized clinical trial, which is hard to find in child psychiatry. It also had real statistics, which was difficult, I am sure, for some of our residents. We seem to be somewhat split between the biologicall-minded, science-background folks and the therapy and psychosocial understanding and treatment kind of folks.
Therapy people don't like statistics.
I like statistics. Or, at least, the kind of studies that you need statistics for. I like the idea that there's some evidence to support what I'm about to do. Otherwise, why did I go to medical school? I can say things to people because "it seemed like the right thing to do," but who knows if I'm helping them? Of course, I know very little about therapy, so I'm not familiar with the literature and the supports for doing certain things. I'll learn.
I've been knitting some. I got spoiled with a bunch of knitting books for Christmas, so I'm trying to rush and finish the current projects so I can start on some new ones. I also got a bag of yarn odd-balls from my grandmother. Maybe I'll knit a stethoscope cozy. Or I'll get some tinfoil and knit my patients some protective hats.
The possibilites are endless.
However, I found a bunch of medical blogs, and that's inspired me. Our C/L attending sent me the URL of a resident psychiatrist in Seattle. She writes the way I wish I could, a "literary blog," one might say. I have many nights during which I lie in bed, waiting to fall asleep, and imagine the things I'd like to write. There's so many patient stories to tell. In the past six months, I've seen and done things that have made me cry, made me laugh, made me hate everyone, everywhere--and sometimes, it's made me feel like a doctor.
And then I screw up again and can't believe anyone lets me even talk to patients.
I presented a journal club today on the treatment of depression in teenagers. It was an actual controlled, randomized clinical trial, which is hard to find in child psychiatry. It also had real statistics, which was difficult, I am sure, for some of our residents. We seem to be somewhat split between the biologicall-minded, science-background folks and the therapy and psychosocial understanding and treatment kind of folks.
Therapy people don't like statistics.
I like statistics. Or, at least, the kind of studies that you need statistics for. I like the idea that there's some evidence to support what I'm about to do. Otherwise, why did I go to medical school? I can say things to people because "it seemed like the right thing to do," but who knows if I'm helping them? Of course, I know very little about therapy, so I'm not familiar with the literature and the supports for doing certain things. I'll learn.
I've been knitting some. I got spoiled with a bunch of knitting books for Christmas, so I'm trying to rush and finish the current projects so I can start on some new ones. I also got a bag of yarn odd-balls from my grandmother. Maybe I'll knit a stethoscope cozy. Or I'll get some tinfoil and knit my patients some protective hats.
The possibilites are endless.
Sunday, October 30, 2005
The Afghan with No Name
Also known as, "Wow, Kate, that's impressive!" (no, not really.)
This is the tan afghan from the textured knits book that I bought for cheap in Minnesota. It's fun to work on because it flows pretty quickly and looks really neat when I show people. I'm making it in an acrylic yarn--I just can't justify using expensive yarn on large projects like this. Maybe when I am a rich doctor I will be able to make cashmere blankets, but not quite yet.
This is the tan afghan from the textured knits book that I bought for cheap in Minnesota. It's fun to work on because it flows pretty quickly and looks really neat when I show people. I'm making it in an acrylic yarn--I just can't justify using expensive yarn on large projects like this. Maybe when I am a rich doctor I will be able to make cashmere blankets, but not quite yet.
Clapotis
This is the very popular Clapotis pattern from knitty.com. I did it in a green wool with flecks of yellow in it, so it's not as soft and it doesn't curl up as nicely as the sample one in the pattern. However, it's interesting and super-warm. The cool thing is that I worked on it all though the new resident orientation weeks at the end of June, and it certainly helped me to stand out as a different kind of resident. (As if I needed more help to stand out.)
Anyhow, it's known at our house as the "residency scarf" and actually prompted the development of some friends, as well as helping to keep me awake.
Yet another example of how knitting can make you smarter AND give you more friends.
Anyhow, it's known at our house as the "residency scarf" and actually prompted the development of some friends, as well as helping to keep me awake.
Yet another example of how knitting can make you smarter AND give you more friends.
Wednesday, October 26, 2005
Rainy Days
We're in the middle of a big storm right now--everyone is calling it the first Nor'easter of the season. I like to think of it as the weather trying to mess up everyone's lives and remind us that it's bigger than we are. As if the hurricaines were not enough, in New England, we have to suffer....rain! Wind! And, in some parts of the state, Snow! At least I finally had the sense to start bringing my umbrella with me as I leave the house.
However, the crappy weather has been helping me to get more knitting done. I am working on a new afghan for the back of our couch. The cats threw up on the slipcover when we first got it (nice kitty) and so there's a spot on the back that we have to keep covered. The old afghan is navy blue, and while that was fine in the old house, where there were navy blue curtains in the windows, it's less good now. So I am making a tan one--knitting it, instead of crocheting. I found a really cool pattern from a book I picked up in Minnesota. The book purchase was funny because I was at a knitting store with my aunt and was looking through the discount section--as is my wont--when I found this book. It's all beat up, but hey, sale! Woo-hoo!!! I can't remember the name off the top of my head, but it's a bunch of patterns that are very much my style of knitting: all one color, with interesting stitch patterns or textures. I still haven't been able to bring myself to try intarsia, or multiple color knitting. (Though I'd better hop to it: the heirloom Christmas stocking that Grandma makes has about 15 colors in it, and the patterns has been passed on to me and another cousin for the future.)
Anyhow, the afghan is turning out very nicely. I'm proud of myself that I have been able to follow the pattern chart...they can be very intimidating when you first look at them, but with work and effort and reading the directions, success is achievable! Plus, it impresses the novice knitters when they come over to practice.
I'm finishing up my pair of red and black socks and will post photos of them soon. I just have to tear the computer from my husband's clutches...he has been playing World of Warcraft religiously, so I'll have to sneak in and use the computer while he's sleeping or something.
More soon!!!
However, the crappy weather has been helping me to get more knitting done. I am working on a new afghan for the back of our couch. The cats threw up on the slipcover when we first got it (nice kitty) and so there's a spot on the back that we have to keep covered. The old afghan is navy blue, and while that was fine in the old house, where there were navy blue curtains in the windows, it's less good now. So I am making a tan one--knitting it, instead of crocheting. I found a really cool pattern from a book I picked up in Minnesota. The book purchase was funny because I was at a knitting store with my aunt and was looking through the discount section--as is my wont--when I found this book. It's all beat up, but hey, sale! Woo-hoo!!! I can't remember the name off the top of my head, but it's a bunch of patterns that are very much my style of knitting: all one color, with interesting stitch patterns or textures. I still haven't been able to bring myself to try intarsia, or multiple color knitting. (Though I'd better hop to it: the heirloom Christmas stocking that Grandma makes has about 15 colors in it, and the patterns has been passed on to me and another cousin for the future.)
Anyhow, the afghan is turning out very nicely. I'm proud of myself that I have been able to follow the pattern chart...they can be very intimidating when you first look at them, but with work and effort and reading the directions, success is achievable! Plus, it impresses the novice knitters when they come over to practice.
I'm finishing up my pair of red and black socks and will post photos of them soon. I just have to tear the computer from my husband's clutches...he has been playing World of Warcraft religiously, so I'll have to sneak in and use the computer while he's sleeping or something.
More soon!!!
Saturday, October 08, 2005
Dear Overnight Charge Nurse;
Was it something I said?
Do you hate me? Is that it? It can't be, because I know you do this to other residents too.
But did you REALLY have to page me at 4 am (right after I had fallen asleep, 1/2 hour after the LAST page) to tell me that the patient has had blood in his urine for the last TWO DAYS!?!?! I mean, I agree that it is something we need to look into . . . but as you said, it's not getting worse (and at 5 am, when I was up again and working on another admission, the medicine resident who's been seeing him said the bleeding was BETTER, and besides, he'd had a traumatic catheter self-removal so actually he did it HIMSELF) so . . . anyhow, why, again, did you need to page me?
Let's talk about this, because if it's like this every time I am on call, I wil be brought to a massive incoherent rage and might be forced to . . . you know . . . say something not nice.
And, you know, you don't want to see me being not nice.
Love, Kate
PS--dear patient whom I admitted involuntarily: 6 am, as I am walking back to the call room to sleep for another hour or so, is really NOT the time to argue with me about whether I am going to let you out. No, really. I'm not kidding.
Do you hate me? Is that it? It can't be, because I know you do this to other residents too.
But did you REALLY have to page me at 4 am (right after I had fallen asleep, 1/2 hour after the LAST page) to tell me that the patient has had blood in his urine for the last TWO DAYS!?!?! I mean, I agree that it is something we need to look into . . . but as you said, it's not getting worse (and at 5 am, when I was up again and working on another admission, the medicine resident who's been seeing him said the bleeding was BETTER, and besides, he'd had a traumatic catheter self-removal so actually he did it HIMSELF) so . . . anyhow, why, again, did you need to page me?
Let's talk about this, because if it's like this every time I am on call, I wil be brought to a massive incoherent rage and might be forced to . . . you know . . . say something not nice.
And, you know, you don't want to see me being not nice.
Love, Kate
PS--dear patient whom I admitted involuntarily: 6 am, as I am walking back to the call room to sleep for another hour or so, is really NOT the time to argue with me about whether I am going to let you out. No, really. I'm not kidding.
Thursday, October 06, 2005
Balance
We knitted only a little last night...mostly we talked. One of the things that we talked about was knitting (of course). Two of the girls, psych residents both, said they were starting to learn how to knit and were frustrated by how hard it was to learn. One of them said, "I just want this to be perfect, like yours is."
So the first thing I did was show her all the mistakes that I have made in my current pair of socks.
Then I told her what I had heard the Amish do in their quilts: they often intentionally make a mistake in the quilt. They feel it opens a space to let God into their work.
Some of my projects have more God in them than others.
But it's something important, especially for med residents to think about. We are so focused on being perfect and working hard all the time...and at the same time, we aren't really MAKING anything. We're labeling people, and we're trying to change their chemistries or their ways of relating to others, but it's a long slow process and sometimes more destructive than productive. At the end of the day, I want to feel like I am making something, besides money and headaches for my attendings.
So I knit. See? There's a med-knitting link. You just have to, you know, stretch.
So the first thing I did was show her all the mistakes that I have made in my current pair of socks.
Then I told her what I had heard the Amish do in their quilts: they often intentionally make a mistake in the quilt. They feel it opens a space to let God into their work.
Some of my projects have more God in them than others.
But it's something important, especially for med residents to think about. We are so focused on being perfect and working hard all the time...and at the same time, we aren't really MAKING anything. We're labeling people, and we're trying to change their chemistries or their ways of relating to others, but it's a long slow process and sometimes more destructive than productive. At the end of the day, I want to feel like I am making something, besides money and headaches for my attendings.
So I knit. See? There's a med-knitting link. You just have to, you know, stretch.
Wednesday, October 05, 2005
Knitting Party
Also, we are having a knitting party tonight. The cats are excited because they will have more people to pet them. Should be a good time...plus, there's going to be cookies, and everyone loves cookies.
New and improved, with knitting content!
Thank you Sara for your nice comment! (that would be my first non-family member comment... how special!) Sara has a good point: WHERE THE HECK IS ALL THIS TALK ABOUT KNITTING? Well, she said it nicer than that. But she is right. Where is the knitting content?
Well, here are the first pair of socks that I made. They are self-patterning yarn, made using the toe-up design from Knitty. I wear them on call. Last week, when I was on call and wearing them, my attending doctor asked me, "hey, did you make those?" "Yes," I replied, "do you like them?" And, because he is a jerk, he said "No." (grrr.) But he was kidding, and *I* like them! I am currently working on sock #2 from the pattern in the Winter 2004 Interweave Knits, Retro-Rib Socks. They are so handy to carry to lectures and Grand Rounds.
I am also working on a pretty afghan, and a basic garter-stitch scarf and hat set for one of the other interns. He is from Nepal and for some reason has no winter clothes.
Once the husband comes back from vacation (he has the digital camera), I'll take some more photos of Finished Objects. Keep tuning in!!!
Well, here are the first pair of socks that I made. They are self-patterning yarn, made using the toe-up design from Knitty. I wear them on call. Last week, when I was on call and wearing them, my attending doctor asked me, "hey, did you make those?" "Yes," I replied, "do you like them?" And, because he is a jerk, he said "No." (grrr.) But he was kidding, and *I* like them! I am currently working on sock #2 from the pattern in the Winter 2004 Interweave Knits, Retro-Rib Socks. They are so handy to carry to lectures and Grand Rounds.
I am also working on a pretty afghan, and a basic garter-stitch scarf and hat set for one of the other interns. He is from Nepal and for some reason has no winter clothes.
Once the husband comes back from vacation (he has the digital camera), I'll take some more photos of Finished Objects. Keep tuning in!!!
Tuesday, October 04, 2005
My First (wearable) Sweater
So, I finally did something with the HUGE spools of yarn that I've had for over a year. I made a sweater! I started with the "Hourglass Sweater" pattern from Last Minute Knitted Gifts and then put on the sleeves and hood from Debbie Bliss' Simply Living book. I also fudged around with the number of stitches because my gague was a little off. But look how cute I am!!!
Otherwise, everything is fine. Chris is on a little vacation for the week, visiting some friends of his in the Pennsylvania-Maryland area...and for anyone watching The Amazing Race this season, yes, Pennsylvania IS a state. My aunt and I would know that...we continue to insist that we would kick ass on TAR. And we are sooooo right, until of course I got all worn out and started to cry a lot. As I do.
I'm working on a cabled afghan for the back of the couch now, and I'm also finishing up a pair of socks at work. I've ALSO been named the Webmistress of our residency program's website (along with Important Major Consultant, My Husband) so I've gotta get cracking on that as well. Hope everyone on the internets is doing well.
Thursday, September 29, 2005
Emergency Room
So I made it through the month of August, doing pediatrics ward work--or, as I like to call it, "sticking needles into babies." It was fun and interesting and I will talk about it sometime soon. I have been spending this month on emergency psychiatry. We have our own part of the emergency room, to keep those bad crazy people away from the "legitimately sick" people. Actually, it is nice to have our own space. Believe it or not, sometimes the people who we have come in are upset or agitated. (Can you believe it?) And so, it's a nice thing to be able to have a place where they can be that has locked entrance and exit doors, and no monitors or oxygen nozzles on the walls for them to break or injure themselves with.
Aside from the near-constant threat of physical violence (just kidding mom!) it's been fun. It's so interesting to see how people get to the point that they need to come to the emergency room, and the stories they tell when they are here. Some of the biggest shockers have been people telling me about all the drugs they do ("I do as much cocaine as I can." "How do you get the money for that?" "Food stamps.") and the fact that people lie. To doctors! They lie! I'm shocked and horrified. ("I don't drink that much." "But your alcohol level was .460 when you came in last night. I'd be dead!" "Well, I just had a few drinks.") Meanwhile, I've been working with very talented social workers and nurses who have been helping me a LOT. The nice thing about having the social workers there, ASIDE from the fact that THEY can evaluate patients, write up the eval and SEND THEM SOMEWHERE (i.e. to a hospital) is that they know a lot of the "frequent fliers." They have specific plans for when Ms. BR comes in saying she is suicidal but realls just wants a sandwich. They know when the patients are looking for attention and when they are really sick. So that helps a lot.
But it's kind of scary. I'm seeing people here at their lowest. They want to die. Alcohol or drugs have taken control of their lives. The voices in their head just won't go away. The voices are telling them to kill themselves. The television is telling them they've already killed someone. The radio and X-box are talking to them, but the X-box speaks a different language so no one knows what it's saying. Their partner just died. Their cat just died. Their television just died. Their dad brought them into the emergency room to hospitalize them to "teach them a lesson." They want to die. They want to die. They want to die.
And you sit across the room and look at them. You listen to them. You try to help. You try to give hope. Things can get better, you say. There are a lot of treatment programs. I can see that you're a smart person, you're a survivor. You have a lot of skills. We want to help you. We want you to get better. We want to send you to the hospital where they can help you. The frequent fliers scoff at that. They don't help me there, and sometimes you believe them. Sometimes you wonder what we can do. Then you send them to the hospital anyway, and they spend a few days there, or a week, or a month, and then they get sent home with follow-up appointments they don't keep, therapists they don't see, and psychiatrists they don't call.
And then a few nights later, they come and see us again.
Anyhow, tomorrow is my last day in the ED. I start the consult service on Monday, where we help out medical and surgical services with the psych issues of their patients. We have an interesting attending so I know I will have some fun stories!
I have some knitting content to put up too. Will happen soon, I promise.
Aside from the near-constant threat of physical violence (just kidding mom!) it's been fun. It's so interesting to see how people get to the point that they need to come to the emergency room, and the stories they tell when they are here. Some of the biggest shockers have been people telling me about all the drugs they do ("I do as much cocaine as I can." "How do you get the money for that?" "Food stamps.") and the fact that people lie. To doctors! They lie! I'm shocked and horrified. ("I don't drink that much." "But your alcohol level was .460 when you came in last night. I'd be dead!" "Well, I just had a few drinks.") Meanwhile, I've been working with very talented social workers and nurses who have been helping me a LOT. The nice thing about having the social workers there, ASIDE from the fact that THEY can evaluate patients, write up the eval and SEND THEM SOMEWHERE (i.e. to a hospital) is that they know a lot of the "frequent fliers." They have specific plans for when Ms. BR comes in saying she is suicidal but realls just wants a sandwich. They know when the patients are looking for attention and when they are really sick. So that helps a lot.
But it's kind of scary. I'm seeing people here at their lowest. They want to die. Alcohol or drugs have taken control of their lives. The voices in their head just won't go away. The voices are telling them to kill themselves. The television is telling them they've already killed someone. The radio and X-box are talking to them, but the X-box speaks a different language so no one knows what it's saying. Their partner just died. Their cat just died. Their television just died. Their dad brought them into the emergency room to hospitalize them to "teach them a lesson." They want to die. They want to die. They want to die.
And you sit across the room and look at them. You listen to them. You try to help. You try to give hope. Things can get better, you say. There are a lot of treatment programs. I can see that you're a smart person, you're a survivor. You have a lot of skills. We want to help you. We want you to get better. We want to send you to the hospital where they can help you. The frequent fliers scoff at that. They don't help me there, and sometimes you believe them. Sometimes you wonder what we can do. Then you send them to the hospital anyway, and they spend a few days there, or a week, or a month, and then they get sent home with follow-up appointments they don't keep, therapists they don't see, and psychiatrists they don't call.
And then a few nights later, they come and see us again.
Anyhow, tomorrow is my last day in the ED. I start the consult service on Monday, where we help out medical and surgical services with the psych issues of their patients. We have an interesting attending so I know I will have some fun stories!
I have some knitting content to put up too. Will happen soon, I promise.
Saturday, July 30, 2005
Indentured Servitude
Also known as, Residency.
Today is my first 24-hour call for psychiatry. And my first weekend call. It's been interesting. I have certainly been learning a lot: we've covered some consult patients (tell other services about their crazy patients), we sent someone to our other psych hospital (tell the patient that she's crazy)--against her will (take away the rights of the crazy person)--and we've answered some calls about outpatients (help soothe crazy people). Meanwhile I have been hanging out with the nurses (we are all crazy people here).
It's been interesting, although I have really started to hate the sound of my pager.
I have spent the last month on our geriatric psych unit, which is actually the only psych floor in the main hospital. It's a unique kind of set-up, different from Vermont: the elderly and medically complicated patients stay here, and any other kind of patient (children, adolescents, and medically stable adults) go to the off-site psych hospital. We rotate there second year of residency. It's almost like we do most of the "medically complicated" stuff our first year: our geri floor, medicine (or pediatrics) floors, and the ED. After that we get to start forgetting everything we know about medicine: antibiotics, chest X-rays, anticoagulation, IV fluid rates, etc. It's kind of sad, in a way, although we start learning more and more specific psych information. I guess we can't know EVERYTHING--it's why we specialize, right? A pulmonologist probably forgets what he knows about renal, too. But it's still kind of weird, and sad. Chris definitely wants me to hang on to my medicine knowledge, and while I am using it, I know I will. And when I am not using it? Well, there's always my palm pilot. And the internet, of course.
So, it's been going okay. I am starting to get to know everyone. I like most of my fellow interns. There is one psych intern whom I do NOT like. I'm working on that and trying to be gracious and understanding and etc, etc, etc, but when my friends who are interns on OTHER services say, "We can't believe how you have to put up with this person," well, then it's harder. One thing that made me upset, though: when she first had her name badge made, she didn't put her last name on it. I have seen nurses do this sometimes on psych, especially if they are rotating in from other services. It's like there is this idea that in some way, putting your last name on your badge makes you vulnerable: that somehow, a "crazy" person (and crazy = bad, of course) will find your last name out and then, like, STALK you. Why is this a problem to me? Well, first of all, there is that stigma thing. As a "mental health professional," I am deeply interested in decreasing the suffering of my patients. This includes the societal and psychic suffering that comes from being judged because of one's illness. And second? For right now, most of my patients are so out-of-their-mind demented that they can't even remember my FIRST NAME, much LESS be interested in my last name. One of my patients has given up and just calls me "Red."
Plus, it's cool to be introduced as "Dr. Brownlowe."
So, life is going pretty well right now, and I am working hard and learning a lot and doing well. Chris and one of the new interns, Amam, have been hanging out today and brought me dinner: Afghan food! No, not made of a blanket, but actually Afghani food. It was tasty and rice-y. It was also nice to not have to eat a hamburger for dinner.
Next month (as in, on Monday) I start on pediatrics. More fun stories from the OTHER end of life. So you'll hear from me then. I promise.
Today is my first 24-hour call for psychiatry. And my first weekend call. It's been interesting. I have certainly been learning a lot: we've covered some consult patients (tell other services about their crazy patients), we sent someone to our other psych hospital (tell the patient that she's crazy)--against her will (take away the rights of the crazy person)--and we've answered some calls about outpatients (help soothe crazy people). Meanwhile I have been hanging out with the nurses (we are all crazy people here).
It's been interesting, although I have really started to hate the sound of my pager.
I have spent the last month on our geriatric psych unit, which is actually the only psych floor in the main hospital. It's a unique kind of set-up, different from Vermont: the elderly and medically complicated patients stay here, and any other kind of patient (children, adolescents, and medically stable adults) go to the off-site psych hospital. We rotate there second year of residency. It's almost like we do most of the "medically complicated" stuff our first year: our geri floor, medicine (or pediatrics) floors, and the ED. After that we get to start forgetting everything we know about medicine: antibiotics, chest X-rays, anticoagulation, IV fluid rates, etc. It's kind of sad, in a way, although we start learning more and more specific psych information. I guess we can't know EVERYTHING--it's why we specialize, right? A pulmonologist probably forgets what he knows about renal, too. But it's still kind of weird, and sad. Chris definitely wants me to hang on to my medicine knowledge, and while I am using it, I know I will. And when I am not using it? Well, there's always my palm pilot. And the internet, of course.
So, it's been going okay. I am starting to get to know everyone. I like most of my fellow interns. There is one psych intern whom I do NOT like. I'm working on that and trying to be gracious and understanding and etc, etc, etc, but when my friends who are interns on OTHER services say, "We can't believe how you have to put up with this person," well, then it's harder. One thing that made me upset, though: when she first had her name badge made, she didn't put her last name on it. I have seen nurses do this sometimes on psych, especially if they are rotating in from other services. It's like there is this idea that in some way, putting your last name on your badge makes you vulnerable: that somehow, a "crazy" person (and crazy = bad, of course) will find your last name out and then, like, STALK you. Why is this a problem to me? Well, first of all, there is that stigma thing. As a "mental health professional," I am deeply interested in decreasing the suffering of my patients. This includes the societal and psychic suffering that comes from being judged because of one's illness. And second? For right now, most of my patients are so out-of-their-mind demented that they can't even remember my FIRST NAME, much LESS be interested in my last name. One of my patients has given up and just calls me "Red."
Plus, it's cool to be introduced as "Dr. Brownlowe."
So, life is going pretty well right now, and I am working hard and learning a lot and doing well. Chris and one of the new interns, Amam, have been hanging out today and brought me dinner: Afghan food! No, not made of a blanket, but actually Afghani food. It was tasty and rice-y. It was also nice to not have to eat a hamburger for dinner.
Next month (as in, on Monday) I start on pediatrics. More fun stories from the OTHER end of life. So you'll hear from me then. I promise.
Sunday, July 03, 2005
Monday, June 27, 2005
Mainely doing well
Get it, with the post title? Because I'm in...well, never mind.
It's been a long hiatus, because I have been working hard on getting the new HOUSE, that we BOUGHT, and then stripping wallpaper, painting, moving in, geting the WORST COLD KNOWN TO MAN, getting better, starting resident orientation, having the husband show up, also with THE WORST COLD KNOWN TO MAN, and then (on the same day, of course) having his PARENTS show up. At our house. That is filled with boxes and random decorations like, on the floor, and on shelves, and piled on corners. And then my best friend, who I have known since high school, also flew in from Ohio. On the same day.
I should really be rewarded for the fact that I have not: a) said anything mean or hurtful to anyone, b) shouted "GET OUT OF MY HOUSE, EVERYONE," and c) cried. Instead I have been quite the hostess, running the dishwasher and blotting up cat vomit with ease and grace. Really, it's been lovely.
Chris is starting to get over his cold, but it's hanging on to him for MUCH longer than it did me, so he keeps having coughing fits that just go on and on and on, combined with the hacking up of loogies and spitting of loogies into kleenex and trash cans. And, sadly, these most frequently occur in the middle of the night. While I am sleeping. This makes me unhappy. And cranky.
I'm going to start feeling better soon, I just know it. Maine is pretty, I am meeting interesting people, and on Friday I get to start the Intern Year, known to all as the year of fun and excitement, as well as enlightenment and personal growth. (Not.) I'm pretty terrified, especially because I haven't done anything with psychiatry since last April. So there's that, too.
But everyone will hear about all this in times to come. Next time, stories about why I will NEVER take wallpaper off of walls again (my mom is a genius with the patience of Mother Teresa and the looks of Grace Kelly and Jackie O combined, no SERIOUSLY) and about how I can walk for five minutes from my house and be on the beach.
And p.s., the cats say hi to everyone.
It's been a long hiatus, because I have been working hard on getting the new HOUSE, that we BOUGHT, and then stripping wallpaper, painting, moving in, geting the WORST COLD KNOWN TO MAN, getting better, starting resident orientation, having the husband show up, also with THE WORST COLD KNOWN TO MAN, and then (on the same day, of course) having his PARENTS show up. At our house. That is filled with boxes and random decorations like, on the floor, and on shelves, and piled on corners. And then my best friend, who I have known since high school, also flew in from Ohio. On the same day.
I should really be rewarded for the fact that I have not: a) said anything mean or hurtful to anyone, b) shouted "GET OUT OF MY HOUSE, EVERYONE," and c) cried. Instead I have been quite the hostess, running the dishwasher and blotting up cat vomit with ease and grace. Really, it's been lovely.
Chris is starting to get over his cold, but it's hanging on to him for MUCH longer than it did me, so he keeps having coughing fits that just go on and on and on, combined with the hacking up of loogies and spitting of loogies into kleenex and trash cans. And, sadly, these most frequently occur in the middle of the night. While I am sleeping. This makes me unhappy. And cranky.
I'm going to start feeling better soon, I just know it. Maine is pretty, I am meeting interesting people, and on Friday I get to start the Intern Year, known to all as the year of fun and excitement, as well as enlightenment and personal growth. (Not.) I'm pretty terrified, especially because I haven't done anything with psychiatry since last April. So there's that, too.
But everyone will hear about all this in times to come. Next time, stories about why I will NEVER take wallpaper off of walls again (my mom is a genius with the patience of Mother Teresa and the looks of Grace Kelly and Jackie O combined, no SERIOUSLY) and about how I can walk for five minutes from my house and be on the beach.
And p.s., the cats say hi to everyone.
Thursday, June 02, 2005
Kate wave
Look! Hey, look everyone! It's a real diploma! Wooo-oooo!
Yeah, I'm working on packing, I just wanted to take a little break and play around. I have a lot of photos that we took last weekend, but I uploaded them onto Dad's computer and now they are . . . in Staten Island. I might burn them to a CD and then bring them back that way.
One parting question--have you ever seen people take pictures at funerals? Well, not AT the funeral, but some of Fred's family was taking photos at the lunch afterwards. It was something interesting that I'd never seen before...
I'm going back to work now! I promise! Geez, you people.
Yeah, I'm working on packing, I just wanted to take a little break and play around. I have a lot of photos that we took last weekend, but I uploaded them onto Dad's computer and now they are . . . in Staten Island. I might burn them to a CD and then bring them back that way.
One parting question--have you ever seen people take pictures at funerals? Well, not AT the funeral, but some of Fred's family was taking photos at the lunch afterwards. It was something interesting that I'd never seen before...
I'm going back to work now! I promise! Geez, you people.
Forging Ahead
Fred's funeral was actually a relatively nice affair, as funerals go. My dad, who is a chaplain, conducted the service and managed to get through without crying. Me on the other hand . . . well, I'm a total girl, and let's leave it at that. It was nice to see my family again, especially the Wallendjack aunt, uncle, and one of the three cousins. We also saw Thomas Lally very briefly--he got into Penn for post-bac, woo-hoo! He is looking forward to joining the ranks of the sleep deprived residents, I can tell. So it was a good weekend, encompassing good food, a few too many drinks, and excellent company.
What it did NOT include was PACKING!!! for the MOVE!!! That is in 13 DAYS!!!!
Bad Katie. Bad, bad.
Since I am taking off again TOMORROW for New York, for the Yard Sale to End All Yard Sales, I'd better get cracking. I think the cats might help. Right, guys? Guys? Meow?
Also, in need of a new project that is more transportable than the sweater I am finishing (3 rows left, I hope!) I started Clapotis, from Knitty. I'm using Cascade 220 in a nice variegated yellow-and-green. I'm working it on bamboo needles, which are just so, so nice. I have a collection of hand-me-down metal needles that really end up hurting my hands after a while. And since, during our rheumatology lectures, the rheumatologist grabbed my fingers, squeezed 'em hard, and told me I was going to get arthritis . . . I'm going to do all I can to be nice to my hands.
Better go. The little orange cat wants a shoulder to ride on, and I've gotta get back to work.
What it did NOT include was PACKING!!! for the MOVE!!! That is in 13 DAYS!!!!
Bad Katie. Bad, bad.
Since I am taking off again TOMORROW for New York, for the Yard Sale to End All Yard Sales, I'd better get cracking. I think the cats might help. Right, guys? Guys? Meow?
Also, in need of a new project that is more transportable than the sweater I am finishing (3 rows left, I hope!) I started Clapotis, from Knitty. I'm using Cascade 220 in a nice variegated yellow-and-green. I'm working it on bamboo needles, which are just so, so nice. I have a collection of hand-me-down metal needles that really end up hurting my hands after a while. And since, during our rheumatology lectures, the rheumatologist grabbed my fingers, squeezed 'em hard, and told me I was going to get arthritis . . . I'm going to do all I can to be nice to my hands.
Better go. The little orange cat wants a shoulder to ride on, and I've gotta get back to work.
Thursday, May 26, 2005
Packing, and sad
I finally aroused myself from a post-graduation stupor to obtain more packing supplies and start packing the house in earnest. We are going to be at mom and dad's for a few days and I wanted to get a jump on things, since closing is only TWO WEEKS AWAY! Holy cow, where did the time go? One minute I looked at a calendar stretching out before me, with closing in the great distance, and now....it's close. Too close.
Then I called my mom and found out that a close family friend had died. He has known my mom since she was a little girl, and in the last few years has been very close to my widowed grandmother. He was at my college graduation and at countless family holiday celebrations. He would always bring wonderful deviled eggs to parties, and my parents had a bottle of Bombay Sapphire in the freezer just for him. He and Grandma made a good pair, and they were so good for each other.
He had a stroke a few weeks ago, and horrifically laid on the floor of his kitchen for at least 24 hours until he was found. I saw him at the hospital, his right side completely paralyzed, but he smiled and kissed my cheek and seemed to recognize me. He'd recovered enough to make it to a nursing home, but after Grandma's visit last night (when she showed him photos from this last graduation . . . ) he started to have more trouble breathing, and this morning he died.
I'm sad for his family, for his kids, for my grandmother, and for his community. We have all lost a wonderful man, who has a terrific sense of humor and a smile or a kiss for everyone. The past few years I've felt like he was more my grandfather than any other I've ever had. But I am relieved that he is at peace, and will no longer suffer the indignities of a body that won't do what he wants, a body that leaves him victim to the tender mercies of others. He was too vital, such a full inhabitant of his life, to drag out through months or even years of slow rehab and loneliness, all too aware of what he has lost.
Goodbye, Fred. We will miss you and think of you always.
Then I called my mom and found out that a close family friend had died. He has known my mom since she was a little girl, and in the last few years has been very close to my widowed grandmother. He was at my college graduation and at countless family holiday celebrations. He would always bring wonderful deviled eggs to parties, and my parents had a bottle of Bombay Sapphire in the freezer just for him. He and Grandma made a good pair, and they were so good for each other.
He had a stroke a few weeks ago, and horrifically laid on the floor of his kitchen for at least 24 hours until he was found. I saw him at the hospital, his right side completely paralyzed, but he smiled and kissed my cheek and seemed to recognize me. He'd recovered enough to make it to a nursing home, but after Grandma's visit last night (when she showed him photos from this last graduation . . . ) he started to have more trouble breathing, and this morning he died.
I'm sad for his family, for his kids, for my grandmother, and for his community. We have all lost a wonderful man, who has a terrific sense of humor and a smile or a kiss for everyone. The past few years I've felt like he was more my grandfather than any other I've ever had. But I am relieved that he is at peace, and will no longer suffer the indignities of a body that won't do what he wants, a body that leaves him victim to the tender mercies of others. He was too vital, such a full inhabitant of his life, to drag out through months or even years of slow rehab and loneliness, all too aware of what he has lost.
Goodbye, Fred. We will miss you and think of you always.
Tuesday, May 24, 2005
Busted
He totally DID read it. And then he called me. Lame, lame, lame. But! I was actually PACKING as he called. I have a lot of the spare room done and now am getting ready to move on to the living room, or maybe the bedroom.
The cats are strutting around, enjoying all the boxes in the living room. They're very excited that their mommy has turned the whole entire living room into a place for cats to scratch! On the boxes!!! And it's near their food--it's like kitty heaven!
Well, that's what I keep trying to tell them. Then they just LOOK at me, and jump up onto the counters.
Bad, bad cats.
That is all.
The cats are strutting around, enjoying all the boxes in the living room. They're very excited that their mommy has turned the whole entire living room into a place for cats to scratch! On the boxes!!! And it's near their food--it's like kitty heaven!
Well, that's what I keep trying to tell them. Then they just LOOK at me, and jump up onto the counters.
Bad, bad cats.
That is all.
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