Well, This is Just About the Cutest Thing Ever

So far this week, I have had patients who have been 87, 88, and 95 (all women).  The two older ones are just as sharp as tacks, and the two younger ones are just as sweet as they can be.  :)  Interviewing them can be tough and time-consuming, because they can be pretty hard to understand (none of them have many teeth left), but ohmygoodness is it worth it.  Hysterically funny and totally adorable.  It has been especially cute and hilarious how many of our senior lady patients have had not-so-secret crushes on the two young male doctors on our team this month.  

I randomly came across this ridiculously sweet video today (which is in no way related to my most recent post and only because I have had so many precious octogenarian patients recently) and thought I'd share.  It's short - enjoy!  :)

Marrying At 100
from Zack Conkle on Vimeo.

Inauguration

The past couple of weekends, while rounding on patients, I got to periodically keep up with the various playoff games as they were happening because so many patients had the games on in their rooms.

Today, everyone had the inauguration ceremony on.  Our team just happened to stop into two consecutive patient rooms with serendipitous timing, the first just at the right moment to see the swearing-in and then the second just in time to catch Beyonce's national anthem.

Our patient, when Beyonce started singing - quietly, musically, sweetly - said out loud, "Why she singin' like that?  Why she bein' all quiet like that??  I don't like this voice."  Her mother chimed in, "That's not Beyonce!"  And then, a couple of seconds later, when the singer opened up her famous pipes and started belting it out, they both together said, "There she is!!"

So there was our whole team, six of us, standing in a semi-circle around our patient's bed, with our patient and her mother sitting on it, and all of us in the room watching the TV screen for the whole two minutes and twenty-five seconds it took for our national anthem to be sung, not moving.

And I have to admit - I got ever so slightly choked up.

Looking around the room, I was suddenly filled with pride, even patriotism.  The people in that room represented at least five different ethnicities.  We had originated from at least three different countries.  We hailed from several different states and had very different backgrounds.  Most of us spoke different languages from each other.  We all stood, spellbound together, and watched our democratically-elected African-American president be inaugurated for the second time, peacefully and with great celebration, in front of an enormous crowd at least as diverse as the group we made up.  It was sort of beautiful.

I was also thinking about where I was four years ago, when President Obama was sworn in for the first time.  I was in Charlottesville, VA, in the middle of my post-bac year, probably studying for an organic chemistry exam and praying with all my might that my efforts in that program would get me into a medical school.  And that made me think something else, too - it continually amazes me how crazy-fast time flies, but not only that, it made me realize just how glad I am to be here, in this place, doing this work, with these people, today.  I may not always feel it, but I am lucky.

Day One

The patient was not a young man, but his disabilities and medical problems far outstripped his chronological age.  Chief among them was diabetes.  Disadvantaged circumstances, hard living, some drug use here and there, and good dose of the euphamistically-termed "health illiteracy" were among the many factors that got him to where he was that day.  Admitted to our service from the ED with a chief complaint of chest pain and syncope, he nonetheless had a laundry list of different issues we would need to address, including a seeping wound left behind from the recent amputation of all of his toes on one foot, the unfortunate and unfortunately predictable consequence of an advanced diabetic foot ulcer.  It was actually the least of his worries on this hospital visit.

The resident who had worked him up introduced him to the rest of the team and summarized his lengthy problem list, verifying details with him and clarifying others.  There was a serious discussion of the points that most concerned us regarding the state of his health.  The patient nodded along.  Very little of this was new information for him, but this most recent incident seemed like it had hit home in a rather new way.  He seemed eager to collaborate; he spoke of experiencing a wake-up call and told us that he fully intended to live a long life, as healthy as he could make it.

The attending wrapped up the summary of the plan going forward, checking to make sure all the patient's questions had been answered and that all of us on the team were on the same page.  The patient shook her hand and looked around at everyone else in the room, saying how much he appreciated the help.

There were the usual "okay"s and "very good"s and "we'll be back to check in on you, sir"s as we collectively straightened up and slowly turned to shuffle for the door.  His face still worked, betraying unfinished thoughts.

"Hey, Doc?  Can I tell you somethin' that's really just been on my mind?"  His voice dropped, softer, timid, something maybe a little bashful about it.  His fingers worried the thin sheets in his lap, rolling and twisting the fabric in small movements.  His chin dropped to his chest as his eyes momentarily closed; every muscle in his face moved together to paint weariness and suffering into deep crevices.

"Diabetes just... sucks, man."  Head lurched with voice for greatest possible emphasis.  "I just... caint even tell you how much it sucks.  It just makes everything bad, man..." he heaved a great sigh.  "I just caint even describe to you all the suffering it causes me.  It's just right up there next to marriage!"  And with that, hands slapped thighs, head lurched again, this time with crackly laughter.  His eyes twinkled at us, checking to make sure we got the joke, as he shook his head, shoulders bouncing.  A fine tension dissolved as we broke into smiles along with him, an unexpected bit of levity trailing behind us as we left his room and moved on down the hallway.

Welcome to the medicine rotation.

Smartypants

She was six years old, tow-headed and blue-eyed, whip-smart and just as precocious as she could be. 

She had a raging, fluctuant abscess in her axilla about the size of an egg.  It had been there, erythematous and growing, for six weeks by the time they finally came in to be seen.  It was painful for her - and it looked it.  Luckily, the treatment of an abscess is straightforward: you incise and drain it.  For a pediatric patient, this would be done under anesthesia in the operating room.

She came in to the hospital with her father, and they were shown into one of the day surgery suites, where they would wait until she was taken back to the OR.  The surgical intern went to do her pre-operative history and get consent for the surgery.  When she was asking details about the time course of this rather large lump in the patient's armpit, her father explained that they had noticed it a few weeks back, but that he had not brought her in sooner because he had assumed it was an enlarged lymph node.  She had had a recent cold, and her father chalked it up to that for a while until he realized it wasn't resolving.  

The intern began to explain to him and his daughter that it appeared that the lump, instead of an enlarged lymph node, was actually an abscess. 

"This basically means that it is a collection of pus from an infection somewhere that the body has walled off into this pocket, and that is what we are going to drain today."

The father politely cut off her explanation, "Yes, I know what an abscess is.  I have a PhD in Biology."

The  daughter piped up:

"Yeah, and he thinks he is smarter than aaaallll the doctors!"

Quickie

Heyyy!!  Howzabout squeezing in one more post for the month right at the last second??  Surgery is  just killing this whole blogging thing over here... so it's gonna be all pictures, sorry.  :)  Here is another handful of shots I took last week.  

Enjoy your weekend!!

Back

Back to life in Atlanta, back to surgery, back to hot showers, back to studying, back to my puppy, back to worrying about lots of the same shit.  In other words, plusses and minuses.

Haiti was amazing.

I feel rejuvenated, revitalized, re-energized, re-excited.  Mostly, though, just so incredibly blessed to have had the opportunity to go on this trip, and incredibly fortunate to have a passion that I am lucky enough to follow.

I'll write more about the trip later, and just post a few quick pics right now.  I took way fewer pictures this year, and those that I took were mostly nowhere near as good as the shots I got last year, but a few other people took a bunch, so I will post a lot of good ones when I get the chance.

In the meantime, happy belated Thanksgiving, friends.  So much to be thankful for.

The Score So Far

One and a Half Weeks In: 

I have to preface this by saying that I was really, really nervous about the surgery rotation, for a few reasons.  The main reason is that I am not a morning person, I hate getting up at unreasonable hours (and for me, anything before 8 am is unreasonable), I am always late to everything, I am naturally a diehard night-owl, and I do not function well on little-to-no sleep.  Granted, I do it all the time, but I rarely feel like I am functioning well.  Anyway, needless to say, all those factors taken together made me very afraid that I was a) probably going to be the worst surgery student of all time and b) certainly going to be totally and completely miserable on the rotation.

The uniform.

I was also nervous because I hate feeling inept, and even though I feel that way every single day in medical school, I figured that feeling would be intensified on surgery (and this has actually turned out to be more or less true.)

New fall shoes! :)

Other reasons I was nervous include some of the questions mentioned in my previous post (and, full disclosure: the last question/concern was actually mine).  I was feeling really bummed that my heretofore somewhat-respectably-consistent exercise routine would be over forever, and that my much-healthier eating as of late would be out the window also.  

However, I am very happy to say that so far, none of my fears have been realized.  (Major caveat: I am starting out on my specialty surgery half of the rotation, and I am on the plastics service... they are notorious for having amazing hours - read: only somewhat longer than regular working hours, as opposed to inhuman hours - and they are also just a very laid-back and fun service to be on in general.  In other words, THIS COULD/WILL ALL CHANGE when I go to general surgery next.)  

In terms of getting exercise, I have actually made it FitWit most nights so far, and squeezed in a run one night when I couldn't go!

[winner: me]

Haters gonna hate.

How about eating healthy?  For the most part, I think I have done fairly well.  Eggs for breakfast!  Salads for lunch!  Apples for snacks!  Boo-ya!  Today was actually the first time in over two months that I have not packed my own lunch for work.  Pretty good streak, right??  But it might be over, sadly... I have no more groceries at home.  And today I had not one, but two Cliff Bars.  And a burrito.  And a beer.  And lots of Halloween candy.  Soooo... let's call it a wash.

Social life?  Haha... ok, this one has been sort of legitimately sucky.  Thank God I live with people I like talking to, because I have pretty much only seen them.  And I have only seen them a handful of brief times.

[winner: surgery]

But!  On plastics, you basically have weekends off (shhh, don't tell the other surgery students!), so this past weekend, I was able to drive up to Chattanooga to visit my great uncle John along with my mom, aunt Jane, and brother Martin.  Beautiful chilly fall weather, gorgeous leaves, lots of good food, plus seeing my great-grandparents' old home for the first time in probably 17 years...

[winner: me]

Great Uncle John, Aunt Jane, Mom, Martin, yours truly

And of course, there have been some holiday celebrations... that have consisted mainly of making Izzy wear this awesomely adorable costume (hey, it's my first Halloween with a dog!  I couldn't help myself.)  The roommates and I also carved jack-o-lanterns last night, which I haven't done in years.  It was a lot more work than I remembered!  But so fun.  And we also roasted the seeds... yummmm.  It also took a really long time, and so I didn't study at all and I went to bed really late, which made today sorta rough.

[winner: me, I think]

Izzy the WonderDog!

(She doesn't love wearing costumes.)

Also, on a somewhat surprising note, I have found that I am kind of loving surgery.  Like, a lot.  So all in all?  I'd say, so far... I'm still coming out ahead.  :)

Surgery Has Started....

Today, in orientation...

Clerkship director, MD: "So let me just take a few moments to address some of your fears about this rotation."

[Student concern.]

"You are worried about getting enough sleep.... You'll be fine.  You'll be really tired, that's just the way it is.  But you will be fine."

[Student concern.]

"You don't think you will be able to study enough and learn all there is to know?  Ha.  Yeah, you won't.  Don't even try."

[Student concern.]

"Your knowledge of anatomy is rusty?  Um, yeah, none of you know anatomy.  Don't worry, we expect that."

[Student concern.]

"Getting enough exercise and eating healthy??  Oh, forget it!"  [Laughs hysterically.]  [Recovers a little.]  "Seriously, though, take the stairs."  [More laughter.]

This is Your Life on Psych

Good morning, Grady!

Whoa.  I have been majorly blog-slacking this month.  

You might think this is because I am on a really hard and intense rotation... but you would be wrong.  (Well, intense is definitely accurate, but not because of long hours or some crazy call schedule...)

I am on psychiatry right now, and life is good.  So good, in fact, that I have been way too busy taking advantage of the relatively normal working hours to play that I have not stopped to do much of anything else over the past two weeks.  Have no fear... there is a lot to say about what I have seen so far on the rotation, and I am taking plenty of mental notes.

For now, though, and without further ado, here is a small glimpse of life on the psych rotation.

~ ~ ~

Morning sunlight on the Emory campus.

The weather here has been crazy lately.  Around late afternoon/early evening, dark clouds gather and the skies open up, unleashing enormously fat raindrops, thunder and lightning to awesome effect.  I personally love a good summer storm, so I have been enjoying it, even though it has meant canceled workouts or braving the deluge most days, wiping down muddy dogs every time they want in, and a few hours without electricity here and there.

Last Wednesday, there was a torrential downpour just in time for our getting out of a full day of lecture.  I happened to be wearing my favorite sandals, which were most definitely NOT made to get wet.  The pounding rain subsided to a sprinkle after a few minutes, but the streets and sidewalks were already rivers.  

There was no way I was going to ruin my sandals to make it to the parking deck.

I checked with my friend Naomi, to make sure it wasn't completely crazy of me (I mean, we are on psychiatry; it doesn't hurt to get a second opinion about these things) and she confirmed this as an acceptable decision.  

So, I took my shoes off and just went for it, walking a couple of blocks to where my car was parked, totally barefoot.  And it was awesome.  The summer rain washing down the scorching Atlanta sidewalks turned the gushing water into warm rivers that contrasted with the cool raindrops soaking my shoulders.  I strolled past plenty of people who gave me quizzical looks, but I was having too much fun to care.  I used to run around barefoot in the summer all the time, and getting my feet wet in a summer storm took me right back.  Life, people.  It's all about the little things.

Stop judging me.

This rotation is six weeks long, and among other reasons to kick back just a little, the clerkship director is very big on self-care.  In fact, we have to write a short paper - a letter to ourselves - on what we have learned about self-care during this rotation to turn in at the end, and he then mails our letters to us during our intern year after we have graduated.  Cool, right?  Anyway, so I figure all of my extracurricular activities right now also count as educational.  :)

I have been working out every day, going to yoga classes, enjoying dinners with friends, kicking ass at trivia with my FitWit buddies, putting on red lipstick for girls' sushi night, salsa dancing for the first time in forever (twice last week!), even getting in a little pool time with a good book.  And it. Has. Been. Awesome.

Also, I know it can be totally annoying when you open a website and the music is on auto-play and you have your volume turned up and then it's really embarrassing when you are in public (or even worse, a library or a lecture), but I do sort of miss my little playlist feature.  I really liked picking out a new song for every post, matching its feel to my mood and the post's content.  For some reason it doesn't play embedded in blogs anymore, but if it did, today's music selection would be Good Time by Owl City and Carly Rae Jepsen.  It makes me happy.  I also love this song because it reminds me of my sister, even though we have never talked about it together... we don't even have to, it's just the kind of song I already know she loves.  Cheesy?  Yep.  Do I care?  Nope.

I have even done some crafting!  Haha... I tried out this make-your-own workout shirt idea from Pinterest with an old 5k race shirt that I never wear.  Cute?  I dunno... jury's still out.

Speaking of exercise, this past Saturday morning I competed in the 1st annual FitWit Games!  (Sort of like a very, very, small-fry, local version of the CrossFit Games, I guess.)  Anyway, it was super hard but really fun.  I don't remember the last time I was in an athletic competition.

There were five separate events, and we competed grouped by gender and age.  Jaclyn, the girl next to me on the bar and fellow Midtown camper, won the whole shebang for women under 40, and I tied for third.  The pic below is from our timed pull-up hold.  (Oh, and before you make any cracks about my outfit, the Midtown crew decided that we were wearing team uniforms and that our theme was AMERICA.  Hence Jaclyn's and my coordinating red, white & blue and matching armbands.  Yeahhhhh team spirit!!)

Afterwards I joined friends for a delicious brunch at Le Petit Marche... awesome meals after a hard workout have got to be pretty much the best thing ever.

Followed up later that evening, of course, with more good times with friends.  And maybe a few adult beverages.

To (mental) health and happiness!  :)

Gratuitous doggie cuteness: Izzy snuggling with her pal Luna