Thursday, January 28, 2010

Runner's Log

1.5 miles; 286.66 to go

Quotable Quote of the Day - from the VA

Joe Veteran, obese, in wheelchair: That's gonna make you fat, you know...

Me: It's a DIET Coke. Zero calories.

Joe Veteran: Say, when are you girls going to graduate to be nurses?

(We all have on white coats that say School of Medicine)

Austin: We'll be doctors in a year.

Female in elevator: Well, my husband is having surgery today and his surgeon is a LADY! and BLACK!!! (said in such an incredulous way) He's just so impressed with her! It's amazing how things are now!

*slap myself on the forehead*

-10 points for feminism and the civil rights movement

Tuesday, January 26, 2010

Neuro Exam

At our institution we spend 2 weeks on Neurology. During this 2 weeks they have a pretty stringent list of things to be done in addition to things we already have to do for Internal Medicine at the same time. One of those requirements is a witnessed neurological exam to be graded by your attending or 4th year neuro resident.

My group has known that we were having ours today for a week, but it's still nerve wracking. We were expecting to do the exam on a patient or on each other but our attending had a different idea.

He took us into an examination room and had us do an entire simulated patient encounter with him, as well as the full neuro exam - on him. They say you should be able to do one in 5 minutes, but I think it took all 3 of us at least 15 minutes a piece. It was a bit scary but I really enjoyed 2 parts of it:

1 - asking him to smile because I had not yet witnessed it. Just as I expected, he wasn't very good at it...

2- the Babinski reflex :) Let me explain. To see if a patient has a Babinski reflex you have to apply a painful stimulus to the bottom of the foot and see if the big toe goes up or down. Upgoing toe is Babinski + and abnormal. Downgoing toe is normal. So to elicit this reflex you have to take an object (the pointier, the better) and starting at the heel drag it very deeply and painfully up to the pinky toe and then around to the big toe. My other 2 classmates were pretty gentle with him, but I really let him have it. He had downgoing toe before I even got to halfway down his foot.

3 more days of Neuro - on call tomorrow, so they'll be a long 3 days...

I've run 5.58 miles since last time I posted. Only 288.16 miles to go this year. I'd better get on it!

Monday, January 25, 2010

Oh, Dell

I'm not sure if many other med schools do this, but as a way to make things as *easy* and *stress-free* for us as possible (and possibly make a ton of profit)they peer-pressured us into buying these crappy Dell computers before our 1st year started. They only charged us $2500 though! what a steal! Ha.

They never point blank stated that we had to buy them, but made it sound tempting with promises of free tech support and whatnot. Well - it's a good thing, because I've needed every bit of it. My hard drive crashed during October 2008, after using the computer 1 year, and had to be replaced. Fast forward to 2010 and 2 weeks ago my computer got a terrible virus. I took it in last week. Here's the discussion that went down with our school's tech support today.

Me: "Hey, how's my computer doing? I haven't seen it in a week. Any progress?"

IT: "Yeah, you see what it's doing here... It's been stuck on that same screen since Friday. I think we're going to have to replace your hard drive. I'm going to have to call in a specialist from Dell."

Me: "Awesome. Well, I have a question for you... I have to put this program of practice questions on my computer that costs around $300 and my computer needs to be functional for at least 4 months so I don't lose it. Do you think I should put it on there once you get it fixed?"

IT Lady: "Hmmm... This isn't something you could backup on a disc is it?"

Me: "No, it's highly copyrighted. You can't copy/paste any of it."

IT Lady: "Yeah, you're better off putting that on your husband's computer. You only need this computer to last until next year though, right?"

Me: "Ugh, yeah, I guess?..."

IT Lady: "Good, good. You know, these laptops have actually held up pretty well!"

Oh mercy, y'all. This does not look reassuring. What if I went to do surgery on someone and said - Hey, you only need this colon to work for the next 4 months, right? Methinks I'd be getting sued for sure.

Sunday, January 24, 2010

Neuro Call

I was on Neuro call today. It consisted of arriving at 7am, seeing a pt we'd never seen before, then rounding with the head of the department. My partner, A, presented to him, but luckily he ran into another attending who my pt belonged to and I didn't have to present anything. Score! Thank you Jesus!!! Honestly, I'm grateful. I'm not just using the Lord's name in vane. Anywho, around 1:30 or 2 we got a consult from the ER:

"22 yo female c no past medical problems here for R sided weakness"

Sounded simple enough, especially since there aren't very many 22 yo females who actually have strokes. None of the tests had actually come back by the time we left around 3:15 this afternoon, so I don't know what was wrong with her..

other than the fact that she was 28 WEEKS PREGNANT!!!

Our residents spent a lot of time with her doing a very detailed neuro exam, asking about any meds she took, etc. and she neglected to leave that little detail out. Because she was already an obese woman it made it hard to tell on observation. Here's my favorite parts of the interview process:

Resident: "Have you had any surgeries in the past?"
Patient: "Just 3 c-sections, had my last baby in 2008"
R: How many pregnancies have you had?
P: "4; 1 miscarriage"
R: "Are you on any form of birth control?"
P: *bewildered look on face* "No."
R:(Moving along with the social history) What do you do? Do you work?
P:bewildered look again* "No."
R: Why not?
P: *in disbelief he's asking* I don't know.
R: How do you afford things?
P: I got people to help me out. My dad helps me. (And me, and you, and Uncle Sam)

And now for my favorite part:
R: "When did you realize you were pregnant?"
P: "Oh, about a month ago."

Seriously?!? She almost made it on that TLC Show - "I Didn't Know I Was Pregnant."

Also, just as an aside - when I have my M.D. in 1.4 years and am taking social histories (are you married? where do you work? kids? tobacco/alcohol use?) from my patients I plan on doing the same line of questioning. People who are able to work but just sit at home and con the welfare system should be guilt-tripped. My family/little old ladies from church/peers would have guilt tripped the hell out of me if I hadn't applied myself and gone to college, etc... so why don't these people deserve the same thing? I just want to fulfill my social duty as a friend:)

Wednesday, January 20, 2010

Ah, Vets...

Favorite quote at the VA today - happened as a caretaker sat a vet down for lunch and basically screamed - "Stay there!":

"One is the loneliest number. Now I know how Jesus felt up on the cross."

What Had Happened Was...

All the comments after my last post made me laugh so hard. Here's what happened:

At 4:00 today we had finished up in clinic and were prepared to head home, just waiting for the magic words from our residents. My partner, A, was on call tonight and supposed to be over at the main hospital within the next 5 minutes or so. WRE (Worst Resident Ever) decided that was a good time for us to give our presentations on ours topics we looked up yesterday. I gave him the most simplistic explanations ever pretty much from wikipedia, of what he told me to look up (which he DIDN'T EVEN REMEMBER!!!) Since he didn't remember, I felt it wasn't necessary to include the parts that were ridiculous - like the the dysautonomia and "pearl" from Sapira.

K - I just might have to say something about the hair. That would be the funniest thing ever. Also, Chaka Khan is AWESOME. We definitely try to stick with him whenever possible. When I asked him a question about all that crap I had to look up up he said "Here's the deal. You can either spend all your time trying to look up this super specific stuff over the next 2 weeks or you can just spend the 2 weeks trying to learn about Neuro in general and perfecting your Neuro exam." Made so much sense. Just gonna try to survive!

Tuesday, January 19, 2010

And I Thought Endocrine Was Bad...

Oy. Neurology is going to be the bane of my existence for the next 10 days of my life. I can already tell. Here's some of my favorite quotes from today from the worst resident I have ever come into contact with in my life:

To dear old veteran who is in excruciating pain and trying to give a good history of why he is hurting: "NICE STORY; NOT RELATED to what we're dealing with." He said this very, very loudly and then just bustled out of the room. I dearly hope he goes into private practice and STARVES - because no one will come to him voluntarily, EVER.

To me:
"Hey you, tonight I want you to look up myelopathy, spondylolisthesis, dysautonomia, and compression fractures as it all relates to that patient and give us a presentation tomorrow. I also want you to throw in one pearl from Sapira's book - you know, the one no one bought." (Yeah, I don't have that book. It's from 2nd year and I didn't even buy it then.)

It's gonna be a long 10 days.

Saturday, January 16, 2010

Things That Happened This Week

It's been quite a week.

***Warning*** ***Rant ahead***

Had a slow leak in my tire since I went sliding on the ice and I went to get it fixed earlier this week. I really needed an oil change, new brakes, and maybe a new tire but decided just to just go to Wal-Mart and let them deal with the oil and tire. I was pleasantly surprised when the guy working there told me I had a nail in my tire and that he was able to patch it. No new tire. Money saved. Woohoo!

Then I got home from the hospital the next day, walked by my tire and saw that it was once again low and now missing the hubcap. Alas...

The water pipes in Jackson needed to undergo extensive repairs leaving several people without water. Fortunately I don't live there and had plenty of water - so much in fact, that I was able to wake up sitting in 3 inches of it on Thursday morning.

It's a long story, but it all starts with me losing my phone on Wednesday. Turns out it was at the VA. Hooray! Found! (See, I'm trying to be positive about all the crappy things that have happened!)

I usually use my phone as my alarm clock with my other huge, incredibly loud alarm clock as a backup. It's a delicate system that sometimes breaks down, but it's worked most every day this year to get me to the hospital on time (praise Jesus!). I really had a hard time getting to classes on time the last 2 years, but haven't has as much trouble getting to "work" on time this year. Anyway, back to the story. My phone alarm snoozes for 5 minutes and that's normally the perfect amount of time to run my bathwater. On a normal morning I get up, cut the water on, and get back in bed for 4.5 minutes of glorious sleep. On this morning, without my phone and without wanting to wake Kris up again with the loudest alarm clock in the world snoozing every 5 minutes I just went into the bathroom, cut the water on and took a seat on the floor. I laid my head in my hands on the edge of the tub and left one hand dangling in the tub so I'd feel the water and wake up. Well, you guessed it.

I woke up sitting in 3 inches of water. I also used up all the hot water. So I tried to be a kind, considerate wife and clean the floors and boil some hot water so at least Kris could take a hot bath. When I asked him if he wanted to take a bath he was so confused and then he got all mad and started yelling something about me "needing to get 8 hours of sleep." You can imagine where this went. I would LOVE to get 8 hours of sleep every night, but sometimes it's just not an option and you deal with it.

Anyway, long story short, it's been a rough week. While some people didn't have to go in to school this week because of the water outage we were rounding. We stayed until 6pm Friday and at one point I got pimped by the head of the department and I didn't even realize he was asking me a question. He said something about the side effects of phenytoin and then looked at me and started saying "1,2,3,4..." It was pretty funny because none of us knew that he was asking a question. He then asked my partner a more straight forward question about diabetes. What on earth?

Things could be worse, and I didn't mean to throw a pity party all over this post. At least I have a warm house to come home to unlike those poor people in Haiti. I'm really not even upset about the week. I just think it's weird when everything happens at once. At the end of the day I know all this work and humiliation in front of attendings will probably be worth it. Right? Right?

Wednesday, January 13, 2010

Running Log

Ran 3.55 miles yesterday. Still 290+ miles to go this year. Hmmm...

Monday, January 11, 2010

You People

Just another lovely day in the world of Endocrine.

80 yr old attending: "Hey, you people(me and my partner), who on earth is responsible for teaching you at the bedside?"

Us: *deer in headlight stares directed at him, thinking to ourselves - "YOU!!!!"*

Thursday, January 7, 2010

Easy, Healthy Banana Bread

Hey y'all. Just made this banana bread recipe and it turned out pretty decent so I thought I'd share:


* 1/3 c. natural applesauce
* 3/4 c. brown sugar
* 3 egg whites
* 2-3 bananas
* 1/3 c. water
* 1 2/3 c. wheat flour (I used whole wheat pancake mix - cause I didn't want a huge bag of wheat flour that I wouldn't have time to use before it went rancid...)
* 1 tsp baking soda
* 1/4 tsp baking powder
*OPTIONAL - chocolate chips, walnuts, dried cranberries, etc... I added chocolate chips and it was pretty dang delicious. Other than that I don't think this bread has much fat/cholesterol in it at all.


1. Preheat oven to 350 degrees.
2. Mix applesauce and sugar.
3. Stir in eggs then bananas then water.
4. Stir in dry ingredients.
5. Pour mixture into a loaf pan and bake ~35 minutes or until knife comes out clean.

This bread was a tasty end to a not so awesome day on Endocrine. I just don't really "jive" with the people who have chosen to do endocrine as their careers. It's not that I don't like them or respect them. We don't fight or disagree or anything. They're just kind of... different. They definitely don't have the same sense of humor as me and my partner. I'm not sure if I've ever seen one of them laugh - ever. They do stare a lot though. Here's a few reasons Endocrine is just not jiving with me:

1. We round at 2:30 in the afternoon, mostly because our attending is semi-retired.
2. They're big THINKERS; not so much DOERS. They're very nice, but I'm more of a doer for sure.
3. Today we met to round/have a case study with our attending at 2:30. He gave us the case, we all pondered it. At one point my partner and I were discussing what hormones were secreted from the anterior pituitary vs the posterior pituitary. It was all pertinent to the question he had just asked us. At that point he says, "Girls, pay attention now..." as if we're his 5 year old great-grand children or something. (He graduated from med school 50 yrs ago, literally. He told us so.) I really had to bite my tongue.
4. After berating us for discussing the pituitary gland, he then asked me a question and when I had to think about it for a second he said, "Come on Ashley, give us an answer." Is my name Ashley? No. thankyouverymuch.
5. About 30 minutes into our case study some nice gentleman came into our room and stated that all the students were to be dismissed because of the bad weather and that only the department heads had gotten the e-mail. Our attending stated that he saw that, but didn't think it mattered. He then proceeded to keep us for the next 45 minutes before letting us go to "do whatever it is we do all day." Yeah, he said it.

Can you tell someone's made my sh*tlist???

Tuesday, January 5, 2010

Saturday, January 2, 2010


I've read a lot of posts about new year's resolutions, summaries of the last decade, and what's to come in the next decade. I probably should have been thinking about these things more but I've figured out that I'm more of an "in the moment" type person. You know how some people live in the past? I'm definitely more involved in what's happening right now. I think my friends will agree with this.

My one good friend J can tell you exactly what she was wearing and everything she did last Tuesday and how she felt about it all. I usually cannot even tell you what I did 2 days ago. I used to be able to do that. Maybe the mind is slipping? Maybe I should start quantifying things like that? Who knows. It's probably not ever going to happen though. My other good friend A will ask me about plans for the weekend or plans for next year, etc... and my answer is almost always "Oh, I hadn't really thought about it yet." So, with all that said, here's some resolutions for 2010:

In 2010 I would like to:
*run/walk at least 300 miles (treadmill or outside). I think this is a very realistic goal. Keeping it all recorded, on the other hand...

*quit being so self-centered. Maybe it's part of living in the moment, but I often forget things people tell me, not about themselves but mostly in reference to time. I forget that a friend will be coming into town or that my husband has to work all weekend.

*get this house organized so there's a place for everything and everything in its place. I'm getting closer every day, but there's always more to be done. I joke with K that as soon as I have everything just like I want it, it will be time to move.

*watch less tv. A friend of ours in class, S, who just had a baby has one night per week with no tv with his family. He was my partner for part of the psych rotation and he claimed after trying it out the first night that he felt like he's been cheating himself for years. That kind of stuck with me. Think of all the things you could do if not glued to the tv. Granted, I usually am folding clothes or doing sit-ups or painting my nails while watching tv but you get the point.

*Eat more steak. Probably sounds like a weird resolution, but it's one of the few meats I know how to cook decently that doesn't ever really disappoint. It's lean, it's fast, and it feels like an indulgence for much, much cheaper than even a meal at McDonald's.

*Cook more - kind of goes along with be more organized. Ideally I'd like to cook 2 days a week (Sunday and Wednesday) and eat leftovers all week. It would be such a timesaver. Also, related - I'd like to pack my lunch more often. That would save tons of moolah.

I could keep writing forever, but I need to get off my sniffly little butt and get some things done around this place before the hustle and bustle starts back on Monday. K and I both have moderate cases of acute sinusitis right now which has resulted in lots of lounging, reading, and movie watching together over the last few days. I guess if you're going to get sick, it's nice to have someone there with you. While other people were toasting champagne and kissing at midnight on New Year's we were popping Aleve-D out of the foil backing and washing it down with water. Such a glamorous life...