Thursday, February 28, 2008
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Respect
Now that I have written about my deceased grandparents, this blog will be silent for the rest of the week to show them my respect.
You'll have to hang in there to find out what is going on with illness du jour. -
It Is Only Fair
Since I wrote about my paternal grandma, it is only fair to write about the other two that had gone before her.
My paternal grandfather died when I was a MSII- he died from colon cancer. I felt really removed from his process of dying because I was so far away, and although I heard the snippets from my parents, it was weird to see him well, hear about the diagnosis, and then to fly home for the funeral.
What was so special about him, was that his written English was FABULOUS, and it was all self taught. It was, and still is, not so clear what he did for a living, although there was a rice delivery business at some point. In his down time, he mastered English. He also had great handwriting- good handwriting is a highly desirable quality for Chinese folks- shows your diligence, learnedness...etc. He wrote a lovely letter to me as I was leaving for college, I ought to go find it and read it again.
My maternal grandfather had died after my first year at college. He died from complications of diabetes. Interestingly, I was volunteering at the same hospital while he was there. Believe me, if one needed reasons to start aggressively manage blood sugar, one simply needed to see my poor grandfather. He had severe neuropathy, vision loss, and worst of all, sacral decubitus. It was so bad, that my mother did not let us see the decubitus. After I finished my shift, (of delivery medical charts, a truly relevant experience for a career in medicine) I would swing by his room to say hi, and occasionally, translate for the rounding team. My mother always shooed me away when they examined the decub. He was going to the OR for debridement every other day...and eventually, sepsis set in. What I remember about him was that he was a fantastic chef- he would make these amazing feasts, of courses after courses of banquet food. Yum! He also used to give me money so I would go around to the corner store to get him a beer, and there was always $ left for me to get a pack of seasoned seaweed. Perhaps something was amiss about a five year old being able to get beer...
When I was growing up, I was so proud that I had all four of my grandparents! And now, I just have one left. Still, I am glad that the other three are no longer suffering and are dancing with Jesus. Not that I am in a hurry for my maternal grandmother to go dancing at all. Just so we are clear.
Tuesday, February 26, 2008
In Her Memory
My maternal grandmother died late Sunday evening after a series of complications that began in the spring of 2006. BIG SIGH.
I wasn't particularly close to my father's family- we lived closer to my mother's family when we lived in Taiwan, and while my mom would take us children to their home for 2 weeks in the summer, and another week with my dad for Chinese New Year's while we were growing up, it never felt like we spent enough time with them.
Nonetheless, I have some vivid memories of them.
I was about six year old, and somehow, got chewing gum in my HAIR! Whenever we visited, I loved having grandma do my hair every morning, and she was really good at pulling my hair taut and braiding it all. With all that gum in my hair, and the more I touched my hair, the more I spread it all out, the more shrieky I got. She calmly used vinegar to wash my hair and got it all out, and thus, I didn't have to have my hair shaved off.
She spent the whole day cooking. She made rice soup for breakfast, or perhaps rice cake soup, either sweet or savory, and eggs, and all sorts of goodies. Then, she went to the market for fresh produce and fish. For lunch, even though it was just her and us, she would make at least five dishes, with soup. She then went to take a nap, when she woke up at 3 pm, she would cook dinner, even more courses then lunch! She also made cake- which was highly unusual for Chinese folks- she steamed her cakes! It was incredible to watch her work in the kitchen. I remember that I once exclaimed, "Wow! Mom! Look, Grandma really chops her vegetables so fine! Why don't you do that?" I am quite certain, that I had embarrassed my mom quite a bit, the daughter-in-law. One time grandma asked me what I wanted to eat, and that she would make whatever I wanted. I was reading a fiction about some American families and how they ate roasted chicken. I then requested roasted chicken- never mind that her kitchen didn't come with an oven! My brother thought I had lost my mind and gave her an impossible task. Nonetheless, she made a roast chicken!
When I was about to go to college, she and my grandmother immigrated to the States and lived with us for a while. Those were interesting times. She saw my prom picture, and asked my mom, "How come Michelle is engaged and we didn't know about it?"
After my grandfather passed away about 7 1/2 years ago, things just weren't the same for her anymore. Then my parents moved to the Midwest, and then she really went south. After her right cerebral stroke, causing left hemiparesis, (see, neurology is SO useful) she moved to a nursing home close to my parents, needed surgery, developed complications, namely, left cerebral stroke, causing right hemiparesis and aphasia, and the ultimate complication, death.
I am glad that she is now rejoicing with God, without pain and full of joy. Nonetheless, we will miss her here.
Saturday, February 23, 2008
So It Goes
It is true, Zoe does have conjunctivitis- and now she is on medications, hopefully, it will clear up very soon.Meanwhile, I made some muffins today. This was a tremendous milestone for me. There had been NO muffin making for the last FOUR years. One of the things I was so excited about while we planned our wedding was the registry- when would I have another opportunity to shamelessly, unbashfully, ask for all those beautiful things? We eagerly put a lot of bakeware on the list! Prior to that, I had used a cookies sheet that was a dollar- definitely did not brown well and was all-stick. With the registry, I got Calphalon cookies sheets, square cake pans, big cake pans, small cake pans, pie pans, you name it, I probably asked for it, and got it all. I put them to good use: in the first two years of our marriage, I made our own cookies, scones, and cakes, from scratch. Even cheesecakes.
These days, my supply had been stashed away in the corner closet...collecting dust. While I had made some lemon loaves for Christmas in 2006, there had been essentially, absolutely no baking.
Tonight, I planned on serving split pea soup, and thought it would be so cute to have corn bread muffins. They were very yummy, although, they were from a mix. I wonder, when will my kitchen be a baker's kitchen again? Baking from scratch, that is.
Friday, February 22, 2008
What is Worse?
We suspect Zoe might have conjunctivitis. She had this eye goop yesterday after nap time, and today, when Hubby picked her up from school, the same eye, her left, looked a little pink to me. Blah!I have had a few ophtho issues in my adult life. The first was from first year of med school- we were in the midst of this neuroscience block, 3 months of endless torture over neuroanatomy. The anatomy was quite complex, and it did not help that the main lecturer was an Indian guy with a British accent, to ramble on and on about the corticospinal tract and the striatum, and blah, blah, blah! It made NO sense whatsoever. I developed this practice of not attending lectures, simply because they were useless. Instead, I tried to memorize the trusted Board Review Series: Neuroanatomy, cover to cover. One morning, I got up, and went to the exercise room, for some quality time with the stair machine and my BRS. Within five minutes of this, my eyes started to water profusely, and I could barely open my right eye. So what did I do? I went back to my room, and cried. "THIS IS MY WEEKEND TO STUDY!! I AM GOING TO FALL BEHIND!" And since it was the weekend, I didn't have student health to go to. My insurance was so minimal that I didn't even bother finding an ophtho guy in the community. Instead, I did a cranial nerve exam, figured my CN II, III, IV, and VI were still all intact. Then I looked at my own eye, decided that there were no obvious lesions, that I probably just irritated my poor eye, my one right eye, because of wearing my contacts for too long, and basically, studying too hard. Since narrow angle glaucoma was rather unlikely. For the rest of the weekend, I studied with my left eye. And by day 3, I was back to using my eyes, and it was Monday, but I had no reason to go to student health.
My second run-in with eye issues was last summer, with a newbie, wearing contacts for too long, I got an eye infection. This time around, I was desperate enough to go see my optometrist, got eye drops, and took care of it within one day.
All this got me thinking,
What would be worse? Conjunctivitis or stomach flu? I suppose we are in for some form of super contagious bug- we have not dealt with conjunctivitis, or stomach flu. Upper respiratory is our specialty.
It got me thinking, what would be worse?
A baby that is a great sleeper but an unenthusiastic eater or an awful sleeper but a great eater?
A baby who refuses the bottle or a baby who refuses the breast?
A child with attention deficit disorder or depression?
To have to go to jail or to have to admitted to a hospital for chronic medical problems?
Chronic medical problems or mental illness?
I have asked various colleagues, would they prefer to have cancer or schizophrenia. Everyone said they rather have cancer over schizophrenia.
Clearly, this train of thought is becoming more gloomy by the second.
Switching gears.
Aidan told his teachers that, "Zoe is my princess." I could eat my kids, they are so delicious.
Wednesday, February 20, 2008
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A Surprise!
I wrote about that cognitive behavioral therapist who was murdered in her office last week. Then, the next day, I was summoned urgently by overhead paging to our front office, because an arrangement had come for me. At first, I thought, "That Hubby, surprising me the day after Valentine's Day with flowers." Then, I saw this.
And it didn't come from Hubby. It came from a patient! Now, in my line of work, I don't get gifts often, and when I do, I usually talk about 'why are you bringing a gift to me' with my patient. That usually leads to feelings about something in their real lives. Accepting a gift, is actually considered a boundary crossing, not a violation, but a crossing. That perhaps the patient felt obligated to thank the therapist, or unable to use words, or something. Case and point, I once treated a patient who brought me a CACTUS at our last session. A CACTUS! Did she think she was prickly? Or that I was prickly? Or that therapy was prickly? Or did she feel that she is as sturdy as a cactus, who can be neglected for a long time and still survive? Did she feel her needs were met in therapy? Or not? You see, inevitably, the gift is no longer just a gift, it is about this patient's unconscious- and I just can't look at the gift the same way. Still, I typically accept these small gifts, because, how devastating and rejecting would it be that you bring your doctor a plant and she makes you take it home? So far, no one had offered me a new car, so I have not actually violated my boundaries.
Anyway, I called this patient, and thanked her for this gift. Interestingly, what lead up to this gift wasn't really anything psychiatric- I had helped her navigate some of her physical health issues. In a way, that long march through internal medicine paid off! -
Crafts
When I went back to work today, and my friends asked me what I did over the long weekend, I thought about my ruined laundry, but also, about crafts.
We had grand plans of going to Monterey, to see the sea otters at the Aquarium, or to San Francisco and explore Japan Town, or even Napa, to catch the wine train. But alas, Aidan was not in the mood to go far, he just wanted to play with Lego bricks, and Hubby got caught up doing crafts.
For those of you who know us, I bet you didn't think Hubby was the crafty type- but he had a grand plan, to make something out of black straws, for something about optics, for some pictures he wanted to take of his beloved models. So there I was, running around town, looking for black straws, and he spent hours, cutting the straws, lining them up, gluing them, taping them, in a very meticulous, true to his engineering training way. Because apparently, no one sold this apparatus and a community existed on-line to discuss the utility of these black straw things, and their magical abilities to focus the flash on the desired objects...
By Monday evening, we looked at each other and decided, that this long weekend was all about straws. Perhaps he will discuss these straws on his blog sometime. When he emerges from straw land. Meanwhile, here is a sample of this focused lighting...as a foretaste of the new Agent Aidan and Agent Zoe movie!
Tuesday, February 19, 2008
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A System...
Clearly, this house hold needs a new system for laundry, because, in the last few months, I have managed to ruin:
1. A merino wool cardigan for me.
2. My favorite pair of black pants.
3. Another merino wool/silk blend sweater for Hubby.
All were mistakenly stuck in the dryer and became doll clothes.
4. Then, Hubby's cell phone went through the wash.
And the most annoying part,
5. I dried a load with chewing gum.
AH! The shrunken clothes were just sort of a bummer. The wet phone was sad, but as they say in China, "If the old stuff don't go, you won't get new stuff." And I suppose Hubby is in need of a better phone and we could both use some new clothes anyway. But, the chewing gum... I didn't want a new dryer! Hubby ended up scrubbing off all that streaky, goopy, c.r.a.p.
I need a new system, but I don't quite know what would work with my life at this juncture. If only we still live in NYC, and I would just outsource this. But alas, we live in the 'burbs, and I must figure it out. Perhaps I need to slow down and actually look at my laundry instead of just shoving it in while cooking dinner, or packing lunch, or half asleep.
For now, Aidan earns a buck when he helps me to put laundry away. Perhaps in another few years, A&Z will be in charge of laundry! -
The Long March...
I last wrote about my ob/gyn rotation- and then life kind of took over- busy with A&Z, studying, thinking...
Anyway, I finished MSIII year with internal medicine- kind of a strange rotation to save for the last possible block, since, well, internal medicine is the bread and butter of being a doctor. But for me, that was just how the cookie crumbled.
Allow me to go on a somewhat tangent thought. Competition. We all competed to get into med school, but this issue didn't end there- that was the competition to win the scholarships- of what I remember, it was about $15,000 each year for three years. Not a huge amount of greenbacks, but certainly not useless either. I had grand plans that I was going to be a recipient of this scholarship, but that fantasy quickly faded after the first anatomy exam. Aside from winning these award-type things, useful for the resume, there were also intense competition to get into the right housing, the right order of rotations, the right team (as I had alluded to previously.) Certainly, competition is still very much a part of my life now. Fortunately, it eased up considerably after residency- although I still find being competitive a natural streak in me- just can't help it: I want to be the best psychiatrist wherever I happen to work at the time. Partly, because I think people deserve to be treated by the best physician, but also partly, it is middle child syndrome. Imagine my glee, when the nurses, at my previous gig, told me that I was the chief's 'favorite' employee!
Alas, back to picking rotations. There was all this strategizing and planning for everyone: you must get the winning rotations, with the right sequence, and at the best institutions. Well, I ended up at a great institution for medicine, but just not quite the right order.
Medicine at Vinnie's was great, if one could look beyond the endless rounding. The preround, the work round, the attending round. My 12 weeks there were divided into 3 different wards: general internal medicine, where the attending was a rheumatologist; then oncology, then infectious diseases.
What was most memorable? The rheumatologist always brought us donuts and we rounded with him sitting down. The endless lectures of oncology and research, blah, blah, blah. On the oncology unit, most patients were 'private patients', meaning that they had a real doctor who came in to round on them and gave orders so that the teaching team was minimally involved. Therefore, we had very few 'service patients'- mainly, people without insurance- no one to bill and therefore, no doctor. The attending, a brilliant guy, had no one to really talk about with us, but still felt obligated to enlighten us EVERY DAY. I thought retracting was bad, trying to sit incredibly still (at least we were sitting, I guess) while looking interested, and not yawning, was very difficult. As for infectious diseases: it was mostly HIV patients spiking fevers, and I did endless blood cultures.
It wasn't a bad rotation, but it was incredibly tedious. And it lasted TWELVE weeks... then it ended, and thank God, third year was over.
Thursday, February 14, 2008
Professional Woes
I suppose most people have read about it some where- the therapist who was murdered in her office. Ever so often, I think about my safety- I usually feel quite safe at hospitals, and my clinic is ok also. However, when I am just going about my business, taking my children places, seeing patients in my plush private practice office, I sort of worry about this a little. Inevitably, a psychiatrist, or any physician, can make a patient angry- for not returning phone calls, for not doing refills on time, for denying refills of addictive substances...etc. But which one of these patients will jump out with a cleaver? Yikes.
Then there is the question of my patients googling me. GREAT. Since I started a facebook page, I am now extra paranoid about people finding me. I think, there will come a time, when I am going to have to shut down this page, facebook, and all, just so I won't have to worry about this. Drats.
For those of you out there, what do you think?
Tuesday, February 12, 2008
Reality
Sometimes, I am in denial of reality- for instance, that I really DO have 2 kids, that Hubby and I have been married for eight years, that I am a working mom, and that, I am a PROFESSIONAL. As much as I don't think about things in this way, it is true, I am a real doctor.
The group that I am connected with for my private practice has a website, and my little bio is getting posted on the site. Fortunately, I have great access to a professional photographer- HUBBY! Last night, after dinner, he took some 'professional' pictures of me- with special lights to give my hair a sparkle and everything. It is real now- that I am a doctor, with a professional picture, business cards, and the responsibility to return phone calls within 24 hours.
Monday, February 11, 2008
Making Her Laugh
WWJD
This morning, in my mother's group daily digest- (Go BMC!) someone had contributed this:
Because of recent abductions in daylight hours, refresh yourself of these things to do in an emergency situation...
This is for you, and for you to share with your wife, your children, everyone you know. After reading these 9 crucial tips, forward them to someone you care about. It never hurts to be careful in this crazy world we live in.
1. Tip from Tae Kwon Do : The elbow is the strongest point on your body. If you are close enough to use it, do!
2. Learned this from a tourist guide in New Orleans. If a robber asks for your wallet and/or purse, DO NOT HAND IT TO HIM. Toss it away from you.... chances are that he is more interested in your wallet and/or purse than you, and he will go for the wallet/purse. RUN LIKE MAD IN THE OTHER DIRECTION!
3. If you are ever thrown into the trunk of a car, kick out the back tail lights and stick your arm out the hole
and start waving like crazy. The driver won't see you, but everybody else will. This has saved lives.
4. Women have a tendency to get into their cars after shopping, eating, working, etc., and just sit
(doing their checkbook, or making a list, etc. DON'T DO THIS!) The predator will be watching you, and this
is the perfect opportunity for him to get in on the passenger side, put a gun to your head, and tell you where to go.
AS SOON AS YOU GET INTO YOUR CAR , LOCK THE DOORS AND LEAVE.
If someone is in the car with a gun to your head DO NOT DRIVE OFF, repeat: DO NOT DRIVE OFF! Instead gun the engine and speed into anything, wrecking the car. Your Air Bag will save you. If the person is in the back seat they will get the worst of it . As soon as the car crashes bail out and run. It is better than having them find your body in a remote location.
5. A few notes about getting into your car in a parking lot, or parking garage:
A.) Be aware: look around you, look into your car, at the passenger side floor , and in the back seat
B.) If you are parked next to a big van, enter your car from the passenger door.Most serial killers attack their victims by pulling them into their vans while the women are attempting to get into their cars.
C.) Look at the car parked on the driver's side of your vehicle, and the passenger side.. If a male is sitting alone
in the seat nearest your car, you may want to walk back into the mall, or work, and get a
guard/policeman to walk you back out. IT IS ALWAYS BETTER TO BE SAFE THAN SORRY. (And better paranoid than dead.)
6. ALWAYS take the elevator instead of the stairs. (Stairwells are horrible places to be alone and the perfect crime spot. This is especially true at NIGHT!)
7. If the predator has a gun and you are not under his control, ALWAYS RUN! The predator will only hit you (a running target) 4 in 100 times; And even then, it most likely WILL NOT be a vital organ. RUN, Preferably in a zig -zag pattern!
8. As women, we are always trying to be sympathetic: STOP
It may get you raped, or killed. Ted Bundy, the serial killer, was a good-looking, well educated man, who ALWAYS played on the sympathies of unsuspecting women. He walked with a cane, or a limp, and often asked "for help" into his vehicle or with his vehicle, which is when he abducted his next victim.
As for me, what are my plans? Well, I plan on thinking about WWJD. First, I would pray- because that is always a good answer to What Would Jesus Do. Then, I would think about. What Would Jack (Bauer) Do. Yes. Jack would probably crash a car to get away. Go 24!
Looking Good!
While on a walk as a family on Saturday.
Aidan: "Mommy, your hair is beautiful."
Hubby: "How about mine?"
Aidan: "Not good." Giggling endlessly.
Hubby: "Really? How about Zoe's?"
Aidan: "Looking good!"
This guy is SO funny.
Egos
To pick up where I left off with the ob/gyn rotation-
The reasons that my ob/gyn rotations was miserable were as following,
1. They were really tired. ALL THE TIME. There was this resident, who used to be an attending in ob/gyn somewhere in Eastern Europe, was working so hard, that when he had a bad cold, he just kept taking decongestants, until he got a nose bleeds that acted like a geyser. He had to go to the ER to get his nose packed. Then he went back to work.
2. These people had very big egos. One of the attendings there wanted to deliver his own kids at home- he ended up getting in an ambulance to get his wife in for a c-section. Seriously. We had these M+Ms on a weekly basis: Morbidity and Mortality conferences. Truly painful. Beyond words. To watch these attendings go at each other over the management of their own patients was like watching preschoolers throw mud at each other.
3. Gossip. Because these residents spent SO much time together, they gossiped A LOT. And no one ended up being happy. The only single straight guy left after one year- to do anesthesia- because he said, at least as an anesthesiology, you sit undisturbed, most of the time, in the OR.
For me, the best moments about this rotation involved gaining control of my autonomic system and catching a baby.
I was on-call with this really cool attending (that no other attending liked, and made it known to him), as this woman, Ruby, was about to deliver, he talked me through catching the baby! It was awesome. Then, we clipped Ruby's hemorrhoids. They were HUGE, like tangerine oranges- I bet you will never look at one the same way again. Now, in retrospect, perhaps this attending was disliked because, he was unusual. Most ob/gyns do not do hemorrhoidectomies immediately after delivery, because the whole region is so vascularized, the risks of a very brisk bleed is quite high. Nonetheless, it was cool, for me, to suture up hemorrhoids.
As for my autonomic system becoming under my control...remember when I fantasized about being able to pass out while scrubbed in the OR during general surgery, just so that I didn't have to retract anymore? Well, gynecology required more retracting, mostly to remove tennis/grapefruit sized tumors (benign) from uteri. I was so cold, tired, hungry, that I willed myself to pass out. AND I DID! I got sent out to the staff lounge, where I watched CNN for a while and sipped my hot chocolate. I was a malingerer!
Why would anyone choose this for themselves? I don't know. I suppose the thrill of catching a baby is pretty awesome. And I guess there is more to life than just the residency and being on call. Reproductive endocrine would be interesting, gyn oncology is so necessary. But definitely not for me.
P.S. I thought about putting up a picture of a BIG hemorrhoid- but count youselves lucky, I remembered all those folks who were so grossed out after the pilonidal cysts...
Friday, February 08, 2008
Seeing Double
We knew our kids would have our mannerisms, looks, and interests, but still hilarious to actually observe these similarities.
A & Z both have Daddy's nose. They have my complexion, and Aidan definitely have my coloring, while Zoe is more of a mix. Aidan has Daddy's spatial abilities, but he has an interest in the human body that is definitely mine. As I have said before, I am a physician for a few reasons, including: purse issues, and the fact that I find pilonidal cysts interesting. Along with those lines, I find sputum, phlegm, pus all incredibly fascinating. The color, the consistency, how the body makes this stuff- I can study about this for HOURS.
Lately, as our household battled various colds, Hubby and I had coughed for a long time, especially Hubby. He had been, quite copious, in his sputum production...
Hubby coughs, runs to the bathroom to get rid of the sputum.
Aidan drops whatever he is doing, runs after Hubby. "Where is it? I want to see it?!"
Hubby: "I am sorry, Aidan, I flushed it already."
Aidan: "I really want to see it, save it for me next time!"
He is like my double!
Thursday, February 07, 2008
Feeling Old/Young Something...
So I caved and signed up at facebook.com Find me and be my friend!
I always thought facebook was for 'young people', like my sister. But when I signed up, all these people were already on facebook. I mean, MY FRIENDS. It is really bizarre, actually, to see all these people I respect on facebook- you know, people who are older than me. It makes me feel old/young/out of place.
Then all this internet stuff is taking up so much of my time. Hours are spent profitably/unprofitably daily on keeping up with the blog, reading these blogs...etc. Hubby knows that I am desperate for his attention when I log on to Trulia, or Blue Fly, or Woot.
The Grumpy People Rotation
My ob/gyn rotation- the rotation full of grumpy people. This sentiment is shared by pretty much everyone I know- although I know a few happy ob/gyns these days. However, that was NOT the case of my rotation.
Essentially, everyone was sleep deprived, the interns were angry. The residents were angry, and the attendings, were the most angry. Because, even though they were making lots of greebacks, they would go for days without sleeping in their own beds.
What were the residents so angry about? One of the residents got pregnant, unexpectedly, and went into preterm labor, WHILE SHE WAS ON CALL. There was more, AND NO ONE ELSE KNEW SHE WAS PREGNANT! Like I said before, one would think that ob/gyns would have the most knowledge and hopefully, have the most tools to control their fertility, but that was just not the case. Perhaps she was so tired that she forgot how birth control worked.
Anyway, so while she got tucked away into a private room in the corner starting from week 24, the rest of the crew had to divvy up her call. Ob/Gyn interns typically took q3 call- which would be staying in the hospital on Monday, then Thursday, then Sunday, then Wednesday... (Actually, I had some classmates who matched at places that had q2 call in their intern years- that would be Monday, then Wednesday, then Friday, then Sunday... I would have died) Anyway, with one more person's call to cover, it was HEINOUS. Mind you, no one got extra pay. I think the pregnant resident finally delivered when she was around 34 weeks or so, and she took another 6 weeks for postpartum- which added up to over THREE months of staff shortage.
If these resident's weren't bitter before, this would certainly dampen one's spirits. But they had other issues to be bitter about, which I will describe tomorrow...
Beyond Me
While I used to feel that neurology is completely unfathomable- with the help of Kauffman's Review of Clinical Neurology for Psychiatrists, I am actually really enjoying the journey of "where is the lesion?" If only I got this awesome read as a student!
What is completely beyond me, is this presidential primary. I tried Wikipedia, and the explanation, while somewhat useful, wasn't complete.
What I want to know: Who came up with this system? Who determined which states have caucuses versus primaries? Where would people know to show up to caucus? How can the Democrats just not count Florida? And who decided that the votes within one state can be split? And that the Democrats and Republicans do not have the same rules? Superdelegates? Who really decided how may per state and who can hold these special positions? Basically, who made up the rules? Because, at least with neurology, I can figure out an anatomical rule and everything would make sense. Left hemiparesis usually implies no aphasia, because it would be right side that was damaged, and most people use their left brains to determine language. See, that makes sense. The primary system doesn't not.
Perhaps that is why I am a physician: a world where RULES work. Go evidence based medicine!
Tuesday, February 05, 2008
Tuesday, February 05, 2008
Dinner!
It is always so interesting to watch my children eat. Zoe, although just 10 months old, already developed her preference for yogurt- she signs for more, and clearly indicates that is exactly what she wants.
Aidan eats dinner, but much rather discuss Lego stuff. We had gone to the Lego store that morning, and he proudly purchased a set for $20 from 4 weeks of allowance. I chipped in for tax. Meanwhile, I bought an Advent Calendar, for next Christmas- Aidan was really curious where it had gone, and that box, was the set that he referred to in the video.
Monday, February 04, 2008
It is SO High School! Totally.
Medical training is just like high school. Totally. I was definitely NOT a popular girl. How could one achieve such popular status? Well... For some, it involves, un hem, staying busy. I think one of the girl who supposedly was, hmm, busy on the bus ride back from the class river cruise trip, was definitely popular. For some others, the 'right connections' was key, to have a parent who is the chief of some department helped. Seriously, it was like high school. Only some of us studied a little more.
Case and point. On my psychiatry rotation, our team included the following folks,
The Popular Girl- Although, I don't think she achieved popularity in the above mentioned ways. She hung out with the 'right people'.
The interns on the team were these:
The Cool Musician
The Rebellious Asian Girl
The Nice but Nerdy Guy
This Popular Girl really wanted The Cool Musician Intern, the one I was assigned to- I guess she had heard along the grapevine that he was 'cool.' Whatever. I told her that maybe we could switch midway. At the midpoint, I told her, hmm, no thanks. I rather not switch. Truth be told, the interns were more or less the same. There really wasn't that big a difference between our work load, or what we learned. The difference? The Cool Musician was cuter than the Nice but Nerdy Guy. I probably didn't switch with her just because I didn't feel like it.
The Rebellious Asian Girl went to undergrad at MIT, and then med school in Jersey, and she was incredibly smart. But she really didn't want to be a doctor, and only became one because her parents wanted her to. She chose psychiatry because it was the specialty her parents really didn't want her to pursue. Nope. Absolutely no resemblance with me whatsoever. Really.
The Nice but Nerdy Guy did want to be a psychiatrist, and did actually become one.
Popular Girl went on to do anesthesia.
I went on to do Ob/Gyn with Popular Girl's good friend...
Saturday, February 02, 2008
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The Long Awaited Confinement
Upon taking the shelf board exam for pediatrics, we fled NY for 2 weeks of rest back in CA for Christmas. Oh, how I yearn for more of these days, to be on vacation from school, while Hubby is also on vacation from his school. We played, ate, visited family, it was so fun.
When school started up again, I began my 6 week rotation in psychiatry. The psychiatry in-patient unit at Vinnie's was a separate hospital, connected to the main hospital via a long corridor, with its own separate entrance. Each floor had a different 'theme,' Reiss 2, was for the geriatric patients, Reiss 3, mostly substance dependent patients...etc. It was a locked facility- and because it was so old, we needed physical keys to let ourselves in and out. It was unclear, to me, how these patients didn't get worse because the unit was so small- there was no outside space, at all. But it was what it was. The patients were all very interesting, even though I knew very little psychopathology, even less about psychopharmacology, it was still a great rotation. I learned a lot, and by week 3, I had decided, that I wanted to be a psychiatrist.
Particularly, a few patients were quite fascinating. I worked with a Chinese woman with postpartum psychosis, whose baby was previously on the pediatrics service that I rotated on. They had left their two older daughters in care of their parents back in China to come to the US to make some serious green. Unfortunately, with no support, no greens, and possibly less-than-desirable genes, she became so psychotic that she wasn't able to care for her newbie. The baby eventually ended up in the care of the foster care system for a while, so that the mother could be better. The mother was convinced that her husband was having an affair- psychotic or true? No one ever knew. Sad, sad, sad. I must have been, and still am, a sucker for sad, sad, stories. And, the patients I encountered in psychiatry, in my opinion, had worse outcome than patients with serious medical problems. Is life worth living if one can't ever know what is real or not? How does a Christian person cope with a thought disorder?
Part of the reason I chose psychiatry, is because of these cognitive dissonances between psychiatry and Christianity. There seems to be no right answer, other than, of course, life is always worth living for. But why would a psychotic person have religious delusions, "I am God's son! Jesus is my brother!" "The demon is after me." I also love knowing the nitty gritty details of people's lives- the decision making process, how they love- the who, what, when, where, and why. To sit in my chair and watch my patients, while I listen, and wonder, "What makes this person tick? What are they really telling me?" No two people are the same, and what a privilege!
While I sit with my patients, I also think about these questions, what disease would I rather have? What would I do if I had this person's illness? Schizophrenia vs. breast cancer? Obviously, neither would be preferred, but please God, let me have my mentation. Please, no Alzheimer's for me. No Pick's Disease. No Alien Hand Syndrome- you know, where one can't recognized one's own hand, usually, the left hand (due to injury of the nondominant parietal lobe, usually the right parietal lobe) that in one case, tried to choke the owner of this hand?! God, please, just let me have a HUGE stroke, while I am asleep, when I am about 80.
So I have totally digressed. Tomorrow, or short after, I will talk about the residents... -
A Detour
I had to take a couple of days off from writing, because, well, Kauffman's Clinical Neurology for Psychiatrists had just been SO fun to read, that I forgot to blog.
And now, after my recent reading of various blogs, I need to take a detour from the Journey of My Clinical Training. Mainly, to defend my choice to work. It is hard to not be defensive about this...
Now, it is VERY important, that these are MY thoughts, MY opinions, there are some vague reasonings behind my choices, but because what I am about to discuss can be, shall we say, contentious.
Kjerste have recently written about why she plans to not send her kids to daycare. An anesthesia resident have described her conflicted feeling about taking her two year old son to school. My colleagues and I constantly bemoan the woes of us working outside-the-home moms, yet when I talk to my friends who are stay-at-home moms, I don't wish I were a stay-at-home mother. Nonetheless, as most of the mothers at our church are stay-at-home moms, sometimes, it gets a little lonely.
My mother worked as a teacher when we were in Taiwan- we all had the same schedule- and I actually attended her school for a couple of years. I spent a lot of time with my maternal grandparents as a little toddler and preschooler, and there was never a doubt in my mind, that I, too, would have a career and a family. When we came to the US, mom stayed home and then started her piano studio, essentially, she worked from home. Ironically, we always wanted her to be out of the house, so we loved it, when she took seminary classes on Saturdays for a while when I was in high school. When I was in college, there were a few stay-at-home mothers that I befriended at church, and I must have insulted them once, by saying, "What, exactly, do you do all day?" Once I started down the track of medicine, there was no turning back, I mean, I could, I suppose, after eight years of post college training, but why would I? Besides, who will pay back my student loans?
We love Aidan and Zoe's school, I guess I always refer to it as 'school', because somehow, that sounds better than 'daycare'. At the same time, we get weekly curriculum, so it really is school, besides, they pretty much potty trained Aidan, taught him how to feed himself, and how to sit still and pay attention. Yes, I believe in outside instruction, perhaps we nearly border on other people raising our children, but alas, that is just what it is. There are studies showing that children, especially younger than 36 months, have elevated cortisol level when they are in a group care setting- the effects of which are somewhat unclear. That daycare children have behavioral problems later- although they do slightly better academically. But what are the other options?
Home care- just not for us. We like our school to be accredited- and A&Z's school, just got re-accredited!
Nanny- again, we like that structure, supervision, and that we never have to worry about the nanny getting sick.
Me staying home- well, I like my work, and there is this pesky thing called student loans...
Hubby- well, he likes his work, and there is this thing, the mortgage, his student loans...
So, our school is the best solution for us. Do I feel guilty about it? Yup. Do I wish I can sit at home with my kids, be on a leisurely pace (those are my imaginations), and maybe even home school? Sometimes. And I sure do wish there are 'role models' for me at our church, older women who worked outside of the home when their kids were little. But like I say nearly daily now, to myself, to Aidan, to anyone who complains, "It is just what it is." And that every family is different, with different needs. This is just us.
I hope I offended no one... If I did, please leave me a message so we can discuss, clarify, and gain some new insights!
We shall resume disgusting surgical issues tomorrow.
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