dog days

Jack and I are, rather suddenly, now the proud (well, proud except when he FREAKS OUT WITH EXCITEMENT in Petsmart and everyone stares) owners of a 1-year-old energetic spotted mix named Ollie.  He's very good generally, though he's exhaustingly fond of playing fetch.  On the bright side, though, he'll play fetch with himself by rolling his ball off the edge of the couch, too, which is fairly amusing.

back, with an embarrassing story

So the other day I'm working in the peds ER, doing all sorts of peds-ER-related things... which mostly involve reassuring parents, and wondering why they bring non-emergencies to the Emergency Room where they have to wait 5 hours, instead of to their pediatrician where they have to wait maybe 45 minutes.  The world is full of mysteries.

But SOME Emergency Room visits are legit, such as the small child I saw next with a big deep nasty-looking cut.  Ouch.  Definitely needed stitches.  So the attending and the ER tech (both guys, which is vaguely pertinent) and I get everything ready, numb the kid up, and set about repairing skin.

ATTENDING:

[pulling back skin flap] Whew, this is a deep one.

EMILY:

[holding child's extremity still so attending can work]

Wow, it is. Yikes.

CHILD'S MOTHER:

[turns slightly pale and quietly leaves the room]

ATTENDING:

[begins to squirt sterile water under skin flap to clean it]

CHILD'S WOUND:

[begins oozing copious amounts of blood]

CHILD'S OLDER BROTHER:

[turns slightly pale and quietly leaves the room]

EMILY'S THOUGHTS:

...Is it getting hot in here?

ATTENDING:

[lines up skin and prepares to suture]

EMILY'S THOUGHTS:

...Um, okay.  Feeling kinda woozy.  This is not good.

CHILD'S FATHER:

[stoically watches from a corner of the room, arms folded]

ATTENDING:

[lifting skin flap once more and dabbing away blood]

Oooh.  I think that might be the bone we can see in there.  Or the tendon at least.

ER TECH:

[peers calmly at wound, shaking head in sympathy for child]

EMILY:

[also peers at wound, genuinely interested]

EMILY'S THOUGHTS:

Wow, that's kinda cool.  I mean, not for the kid, but... OKAY, WHY AM I FEELING DIZZY?!  BLOOD DOES NOT BOTHER ME!!

ATTENDING:

[begins suturing]

EMILY'S THOUGHTS:

What the heck, body?!  You can't go all vasovagal on me now!

CHILD'S FATHER:

[continues to stoically observe]

EMILY:

[surreptitiously leans on table in an attempt to recover without being noticed]

EMILY'S THOUGHTS:

Must.  Not.  Be.  Nauseous.

ATTENDING:

[wields needle-holder with expertise]

EMILY'S THOUGHTS:

Okay, fine.  I give up.  You win this time, autonomic nervous system.  I shake my fist at you!  ...Only not literally, because that would be weird right now.

EMILY:

[pulling off sterile gloves, sheepishly]

I um... this is kind of embarrassing, but I think I need to go sit down for a minute.

ATTENDING:

[looks at her mildly]

ER TECH:

[with mild concern]

You are looking a little pale.

EMILY:

[halfway out the door, almost running]

I'm really sorry!!

EMILY'S THOUGHTS:

Wow.  I am super-lame.  And apparently, super-girly... and not in a good way.

how quickly we forget

So after putting in a load of laundry and starting up the Roomba (my birthday present from Jack... which I love), I was preparing to wash a massive amount of dishes.  And I was thinking idly to myself how cool it is to live in such a time when machines can do chores for us.  I mean, back in the day, women would have to drag out their washtub and clothesline to do laundry, and it would take all day.  And most people still clean their floors themselves, with a broom or a vacuum cleaner, and it takes just way too long to be fun.

And then as I turned on the faucet, I thought, "Man, wouldn't it be nice if there were some kind of machine that could wash dishes, t..... oh.  Right."


(Also, here:  have a video of my Roomba in action, and be suitably envious.)

keeping busy

What have I been up to?

Knitting (of course):

Munching on Easter candy:

Trying my hand at making bagels (they were good!):

Doing seemingly endless paperwork for my residency program:

Preparing for a friend's wedding:

Baking cookies (chocolate chip meringue... yum!):

Getting ready for graduation (eep!):

Celebrating spring with fresh flowers:

sentiment

Apologies for the long hiatus (if anyone is reading this). Just here briefly to post this image, which is so true, and random, it makes me laugh.

whoops

So does this mean if I didn't bring a pet, I won't receive service? Wish I'd known that ahead of time...

brainwashed

You know there's something wrong with you when you actually develop quite a fondness for hospital vending machine coffee.

tv show pet peeve

Picture this scene (you know you've seen it many a time):

A terrible accident has occurred, and now a character whom you've come to know and love is lying in a hospital bed, barely clinging to life (and, I might add, looking remarkably attractive and well-groomed for someone so Critically Ill... usually without even a nasal cannula, much less an endotracheal tube, to spoil the effect).

Suddenly, the rhythmic beeping in the background gives way to an ominous hum, and you know the terrible truth. The heart monitor swings into view to show you the all-too-recognizable flatline.


Instantly, doctors and nurses rush in. What is the first thing they do? Check the Airway, Breathing, Circulation? Start chest compressions? No way, baby, because in medical drama there is nothing more glamorous than the all-powerful defibrillator. One of the (also remarkably attractive) doctors grabs those paddles, slams them on the patient's bare chest, yells "CLEAR!" and the patient jerks violently.


Lather, rinse, repeat. This goes on for a grand total of about 30 seconds (despite the fact that real codes can last more like 30 minutes at times... and do, in fact, typically involve chest compressions) before the Doctor In Charge wipes his/her brow, fights back tears, and says, forcing stoicism, "Call it."

So what is the pet peeve here? The unlikely attractiveness of... well, everyone? The fast-forwarded code blue? The lack of oxygen therapy (or any kind of medical device) on a patient who is evidently Hovering Near Death? Actually, no.

People. Asystole is NOT a freakin' SHOCKABLE RHYTHM!

four things

Thing #1- Hello, smog. Lovely to see you this fine morning as I gaze from the hospital window.


Thing #2- Why do I always manage to spill coffee on myself the mornings when I'm post-call?

Thing #3- The computers in the pediatric conference room are using a 10-year-old operating system. Awesome.


Thing #4- My school-distributed pager has them beat, though, because whenever I change the battery and the date resets, it asks me if I would like to set the year to 1999. Um, no.

five stars

So today I'm On Call. This basically means I'm in the hospital for 24-30 hours, doing admissions, helping out the residents, etc. I don't have to work the entire time, necessarily; I just have to be there. There's actually a room where I can sleep if/when I get the chance. (Incidentally, the reason residents are called "residents" is that they used to be On Call in the hospital all the time. Residents of the hospital, you see.)

And now, without further ado, this is the peds student call room, where I'll be spending the night tonight!

Look! Swanky, no?


I'll also have a desk (of sorts) and even my own sink. What more could a girl want?


I especially like how, if you look closely, you can see where past students have been practicing their surgical knot-tying skills.

(I really do like it, by the way; I'm not just saying that. It makes me feel sort of connected, in a weird way... to all med students, past and future, who have ever sat in a stark call room in ill-fitting scrubs, whiling away the wee hours of the morning practicing the intricacies of surgical knots on leftover sutures donated by some thoughtful scrub nurse... or something along the same lines. Oh, med school. How very un-glamorous you are.)

marshmallow world

View from the Pediatric Student call room in the hospital:


Some of us had to dig out our cars, but even with a Level 2 snow emergency in place, all 10 people on the ward team made it to morning sign-out on time!

(Because kids still get sick when there's a 9-inch snowfall within a 24-hour period. In case you didn't realize.)

the truth, the whole truth, and nothing but the truth

In pediatrics, usually one finds oneself taking the history from Someone Other Than The Patient. Because, y'know, the patient is a wailing 21-month-old. So for every pediatric H&P, it's important to include the line "history given by ______" and it's not uncommon to add a comment on the apparent reliability of said history-giver.

More often than not, the historian's reliability-- or lack thereof-- is pretty apparent. For example:

EMILY:
So, has she ever had any other medical problems?

PATIENT'S MOM:
Nope, nothing else.

EMILY:
Great. [writes this down] And does she take any medications?

PATIENT'S MOM:
Um, no.

EMILY:
Okay. Any surgeries?

PATIENT'S MOM:
Just the biopsy I mentioned.

EMILY:
Okay, good. [makes a note of this, then turns the page] Now I'm going to ask about family history, okay? Anyone in the family have a history of asthma?

PATIENT'S MOM:
Well, she does. [indicates the patient]

EMILY:
[taken aback] Oh... she has asthma?? Um, okay. [flips back to the Past Medical History section and adds this] Does she take any medications for that?

PATIENT'S MOM:
Well, yeah. Singulair, and Pulmicort. And albuterol.

EMILY:
[resignedly writing this down] Do you happen to know the doses?

PATIENT'S MOM:
[looking puzzled] No.

EMILY:
Okay. That's okay. Now. Anyone in the family have seizures?

PATIENT'S MOM:
[indicating the patient again] Well, she had seizures. That's why she's on the Keppra.

EMILY:
[sighing, flipping back to the Past Medical History section again and writing this down] Okay. Seizures. Keppra. Got it.

[after a few more questions]

EMILY:
Has anyone ever told you she had a heart murmur or anything like that?

PATIENT'S MOM:
Yeah, she had one when she was a baby, but not anymore.

EMILY:
Oh, okay. Did she have a congenital heart defect?

PATIENT'S MOM:
Yeah, a PDA.

EMILY:
[remembering the lack of surgical history] Oh, so they just closed that using medicine?

PATIENT'S MOM:
Oh, no, she needed surgery for that.

EMILY:
[not even surprised anymore]

can't we all just get along?

Anyone who has ever gone through medical education has some familiarity with the type of nurse depicted in this comic. (For those too lazy to click on the link, I'm talking about the Nurse Who Eats Medical Students For Breakfast.) I had a run-in with just such a nurse today, which I shall now replay for your enjoyment.

EMILY:

[writing busily in chart while copying lab values from computer-on-wheels]

NURSEZILLA:

[approaching with two nursing students in tow] Oh, THERE it is! We were looking all over for that! I need to use it.

EMILY:

[thinking she means the computer] Oh sure, no problem, let me just log out.

NURSEZILLA:

[impatiently] Yeah, the patient's going down to ultrasound, so I need the chart.

EMILY:

Oh... um... okay... [removes her progress note from the chart so she can finish writing it]

NURSEZILLA:

[grabbing the chart] Is that just your note, or is someone else's on the back of the page?

EMILY:

Oh, right, there is another note on the back.

NURSEZILLA:

[in a tolerantly amused tone, as though speaking to an idiot] See... they'll need that information. We have to make sure allllll the information goes with the patient.

EMILY:

Right, of course. [starts to put it back, then realizes Nursezilla has now opened the chart to a different place]

NURSEZILLA:

[with an air of great patience and long-suffering] Nope, not there. You have to look at what you're doing. [turns to nursing students] See, now if we do things right the first time, then mistakes won't be made.

EMILY:

[fantasizes about beating Nursezilla over the head with the chart, but instead turns back to the computer and starts copying down all the labs... again. sigh.]

more cuteness

My favorite patient this week so far has been a 2-1/2 year old who, whenever I asked him, "Can I look in your ears?" "Can I listen to your heart?" "Can I feel your belly?" would grin and say "No way, Jose!" in his squeaky little toddler voice, and then giggle. And then let me do whatever anyway.

See? This is why I love peds!

prepare to die of cuteness

Just a brief entry, to provide you with a link to one of the blogs I read. Click and then scroll down to see the most adorable child who ever lived, before you collapse from the overload of sheer cuteness.

Link

oh brother

Once upon a time, there was a little girl who had (besides two older sisters) a baby brother, who was not-quite-two years younger than she was. And he was pretty cute.


He liked to do things like ride his bike, play Super Mario Brothers, eat dill pickles, watch Teenage Mutant Ninja Turtles, beat all his siblings at chess, and play soccer.

(Sometimes he also liked to be annoying and yell "TORNADO" and then knock all his sister's Barbies over and destroy their Barbie houses, and then laugh. Mostly he didn't, though.)

Then, as we all do, he started to grow up and turn from "cute" to "awkward."

(That's as awkward as we'll go. We'll skip high school. See what I do for you? See what a good sister I am?)

Anyway, after the awkward bit, he was grown up. He still liked to play video games and eat pickles and play chess. He also developed a penchant for medieval trivia, playing saxophone in school bands, weight-lifting, and wearing funny t-shirts.

(This shirt says, if I remember right, "I used to be schizophrenic, but we're okay now.")

He danced in his sister's wedding (actually, all three sisters' weddings, but this is the one I have pictures of, unsurprisingly).


And he was a great favorite among his many nieces and nephews, who (depending on age) enjoyed being wrestled, chased, tickled, or tossed into the air, among other things.


Anyway.

Happy 24th birthday, Sam! Love you, little brother!

a tale of danger!

Imagine this:

You're riding in the passenger seat as your husband drives down the highway on a DC evening. He merges onto another highway, and the driver already in the right lane on that highway takes issue with the fact that your car is now in her lane.


Aaaaand pretty soon she's so close behind you that you can't even see her headlights when you turn around and look. Don'tcha love a tailgater?

a PSA from Florida! woohoo!

Unfortunately, you soon learn the reason tailgating is illegal. A second car pulls in front of you, and proceeds to suddenly decrease in speed. Your husband slams on his brakes and manages to avoid hitting the car in front of you. However, the driver behind you (being approximately two inches from your rear bumper) is not so successful.

(In case you haven't figured it out, this story is not so much a hypothetical "imagine this" as something that actually happened to Jack and me a few days ago. Had you figured it out, smart ones that you are, hmm?)

Miraculously, despite being involved in an accident ON THE FREEWAY, we weren't hurt, didn't lose control of the car, and (it turns out) escaped with only a slight displacement of one bumper panel.

But! The story is not over!

Now, seeing as we were in a not-so-good part of a large and unfamiliar city, at night, we didn't feel particularly safe pulling over. We were only a mile or two from the navy base where we were staying, so we decided to just head there, figuring that the driver behind us would cut her losses, flee the scene, and never be heard from again.

However, incredibly, she followed us onto the base. To make a long story short, it turned out she apparently had some idea that she could:

• show up on a military base after rear-ending another vehicle (belonging to an officer in said military, no less) on the highway
• have no proof of insurance to show the police who showed up
• have no plausible story other than "I just know something hit me, I don't know what"
• point out only front-end damage on her car
• and think she could get some money out of us to repair what actually seemed to be previous damage.

Needless to say, it did not work out well for her, and she not only received several tickets, but will no doubt be a major character in humorous anecdotes told by the gate guards for weeks to come.

interview season

Because of Jack being in the military, and thus already knowing where he matched, I limited my interviews to programs in the same geographical area. That means I only have five, and they're all in the same two-week span... which is good, because even just five is still enough to get sick and tired of them.

The basic outline for an interview day in pediatrics, I have learned, is generally as follows:

7:45 AM- Show up. Start consuming free bagels and coffee.
8-9 AM- Observe morning report.
9-10 AM- Hear a presentation (likely PowerPoint) about the program, designed to intrigue applicants and/or answer potential questions, likely repeating information given on the website.
10-11 AM- Two 30-minute interviews, where the most popular question seems to be, "So where do you see yourself, career-wise, in 10 years?"
11AM-12PM- Go on a tour of the hospital. Ignore growling stomach.
12-1 PM- Lunch. (Most common? Sandwiches. Most interesting? Indian food. Yum.) Talk to the current residents.
1-1:30 PM- Wrap-up talk, then leave.

Now, I am not stupid enough to actually type out my opinions of said programs and post them on the internet before Match Day. But I do have a favorite, yes. And I actually have a second-favorite, too.

After the interviews, the rest of the residency-application process is pretty easy. Make a rank list in February, get your answer in March. Can't wait until it's all over and I can relax (aka, freak out about something new).

whoops

Wow, I am a blogging slacker.

To make up for it, here are some cute videos of my adorable two-(almost three!)-year-old niece.

Lucy speaks Spanish:



Lucy sings the Beatles:



Lucy shows us how to get down: