Don't Forget to Wash Your Hands...

Preparation

2010-06-15T17:11:00.001-05:00

If I knew I would have to do some hard manual labor, I could go to the gym and pump some iron.

If I have a big test coming up, I can shotgun a pot of coffee and stay up all night studying.

If I was about to go into a land of famine for an extended period of time, I could increase my carb uptake (not a stretch for me) and pack on the pounds in order to be prepared for the coming need of energy.

Our bodies allow us to mentally and physically prepare for a multitude of impending situations. Therefore, I find it unfair, and actually a bit upsetting, that we cannot stockpile sleep.

I am facing the countdown to the an era of sleep deprivation like my body can not even fathom, yet, no matter how lazy I am now, I know it will still likely drive me to the brink of insanity, or at least make me more than a little grouchy. Overall, I think we I get to heaven I might talk to God about the possibility of installing a "sleep saver" option in the generations to come. They can thank me later.

Washed by the Water

2010-06-02T08:27:00.002-05:00

A lot of things have happened in my life since I last posted, and I've spent the last several days trying to figure out which one I should start with to break the blog ice. And, it became clear which one is truly most important...

On May 23rd, I was baptized! I finally made the outward expression of an inner change. In front of my husband, family, and a whole lot of strangers, the preacher proclaimed my testimony and I was dunked in the baptismal pool. I came out of the water as a new creation in Christ! It was a great day.

Excuses to Use When Late For Rounds

2009-09-06T14:53:00.002-05:00

-- “I had to change my scrubs. In other news… Mr. Jones -- emesis times one this morning.”

-- “I was examining Mrs. Smith when she suddenly went into V-tach and became unresponsive. I was about to call the code, when Chuck Norris walked in and gave her a roundhouse kick to the chest precordial thump by just looking at her. Don’t worry, she’s back in sinus rhythm.”

---- “Oh! We started rounds on 4South? I thought since it was Wacky Wednesday we started at the bottom of the list…”

-- “I decided to do a Ovid search on the latest journal articles related to Mr. White’s condition. I had just formed a evidence-based clinical question, picked the most appropriate MeSH, limited my search to recent publishings, and exploded diagnosis and treatment, when I realized it was time for rounds.”
(This one might actually get you out of any pimping on the patient’s condition too as you have expressed a failed attempt to research. Niiice. Double word score.)

-- “No, this isn’t fresh coffee. This is actually the same cup I’ve had since Monday. I’ve been working so hard I still haven’t had a chance to finish it, so I just keep reheating it.”

Line Up

2009-08-18T18:09:00.002-05:00

I will be the very first to say that I am living in the dream in the NSICU leaving by 1pm everyday, but don't think that doesn't mean I'm not doing important things.

Need a central line? I'm on it. No... None of that femoral stuff, I'm going straight for the subclavian. I laugh in the face of a pneumo. Or at least see it as another chance for a procedure.

What about A-lines, you ask? Give me your hand, and I'll give you a beautiful arterial wave form. I'll even do the Allen test to be safe.

Of course, things are a touch easier when patients are heavily sedated...

Bean Update

2009-08-15T09:44:00.002-05:00

The Butterbean has been doing alot these last few months. The Bean has all ten fingers, and all ten toes, ears, a little bit of hair... oh and girl parts! Yep, we have a She-Bean!! I know all this because I recently had a chance to meet Butterbean in person during a contraband ultrasound. She was moving about, and, as a lady should, had her legs crossed at the ankles and tried to cover herself when the doctor went to look at her girl parts.

And, just last week, she made her presence known for the first time and kicked her mama. Her mama probably deserved it. Probably because the Butterbean's blog hasn't been updated in months (yeah I said it.)

So, the Butterbean has officially celebrated her five month pre-birthday. Which means she's over half ready to come out of the oven. It won't be long now until she makes her appearance! And her Aunt Lulu can't wait!

Sound Byte from the NSICU

2009-08-14T10:34:00.001-05:00

Standing outside the room of a patient with ESRD:

Ortho Intern, looking at what appears to be a foley bag-- "What would you rather do... Lick the floor of Trauma 2 after an alpha activation... Or drink some of that man's urine?"

Me-- "That man's in end stage renal disease. That's not his urine. That's a rectal tube. I'll take the floor of Trauma 2."

Tales from the Basement II

2009-08-12T10:40:00.001-05:00

Woman comes into ER after being seen a few days earlier after a car crash. She is complaining of forearm pain. When I start talking to her, she expresses her extreme concern because her arm is hurting AND it's starting to change colors. The area where it hurts when you touch it has been getting darker since the accident.

Yes, this lady waited for 4 hours for me to tell her she has a bruise. Oh, and don't you worry, that visit was billed directly to middle class taxpayers.

A New Hobby

2009-08-11T16:03:00.004-05:00

Sparked by a book found at the treasure trove of all stores T.J. Maxx, I have decided to discover my inner baker. Well, I've always enjoyed baking, so I guess it would be more accurate to say that I have decided to discover my inner Cake Boss.

Here is my latest, and first, creation which was in honor of the Cutest Boy in the World's birthday.

Caught in the Act

2009-08-11T15:54:00.002-05:00

After month, nay, years of wondering how candy bars, gum, and breath freshners came up missing, the mystery was finally solved...

Tales from the Basement

2009-08-04T10:47:00.002-05:00

A new series (hopefully) of posts that will chronicle a journey through a month in the ER.

A man is brought in by JPD because his arm has gone completely numb, ironically at the exact moment he was put into handcuffs. On exam, this numbness extends from his fingertips of his right hand, crossing the midline to his left shoulder blade. (Explain that one Dr. Haines...)

Other than that, physical exam was fairly normal. You know, regular rate and rhythm, clear to auscultation bilaterally, you know all that jazz. Later, on obtaining surgical history, he tells me he had his entire left lung removed.... Interesting...

Disposition and plan on this patient? Discharge to jail.

Three Quarters Down

2009-08-01T17:57:00.000-05:00

I have officially passed my Step 2 CK! The score came in, and I was happy. Not only did I pass, but I actually did better than I would have ever imagined taking into account the utter despair I felt when I left the testing center that down.

Unfortunately, a passing score on the CK is only half the battle. I had to take the other half of the Step 2 this week The Clinical Skills exam was designed to weed out foreign physicians that can't speek a lick of English who are trying to chase the American dream.

It's 8 hours of interviewing fake patients. The actors playing that are only allowed to say specifically scripted lines ("No. My back does not hurt.") which makes it very difficult for me to stay in my fake doctor character. But, I made it through the day. So, now, all I need is a passing score, and I'm home free to graduation.

The CK

2009-07-01T16:16:00.001-05:00

For Step 1, the fear of the test was born out of the fact that although it seemed like an infinite amount of information, it was learnable. If you memorized one more fact, you could hopefully get one more question correct. Therefore the amount and hours of studying was directly related to your score.

Step 2 CK, however, was a whole new beast. It was a test on management and treatment of patients. These topics are why it is called the "art of medicine." You can't memorize the answers to these scenarios. You have to pull from your entire wealth of knowledge, and combining it with a mix of intuition and discretion. This made studying painful. You can't learn clinical decision making in a book. That random fact about gangrene doesn't put you any closer to getting an answer right.

But, despite all this. It's over. I took it. It was the longest, most demeaning test of my life. I have never left an exam feeling less confident. Guess I better get used to it; that's probably how I'll feel my entire intern year.

Newbies

2009-06-17T10:19:00.003-05:00

I went to the school library yesterday hoping that being surrounded by vast chronicles of knowledge would inspire me to stay motivated in my studying. While there I saw my first M3. I knew it was a new M3 by his clean white short white coat with a few bare essentials in the pockets but not quite overloaded as it could be and the look of excitement mixed with panic on his face.

At first, seeing the M3 made me feel really cool and important. "Look at him, so lost and overwhelmed. But, I.. I am a seasoned veteran! I know the codes to the supply closets and where to find standardized order forms! I am an M4!"

But then it made me feel old.

Then reality set in and I started to freak out-- I'm now the one that is suppose to know the answers if the M3 doesnt. I'm the one who is suppose to actually know what the next step in management of the patient is. I'm the one who is suppose to be working on a CV and a personal statement and residency applications! Oh, and I'm the one who is going to be a DOCTOR in a year!!!

Bring on the Zofran...

Back to the Grindstone

2009-06-15T10:09:00.002-05:00

So I finished my week of Board Exams (finals, basically), and I took an entire week off. Yep, despite the fact I brought books for the six hour drive, I ended up playing my new Nintendo DS instead. And, all that time spent laying about with my Step 2 Secrets book within arms reach, I decided to focus on tanning, napping, and watching America's Funniest Videos instead.

But now I'm back to Jackson, the real world, and yes, even studying.

As of right now, I have 334 hours to study for my USMLE Step 2 Exam. I've set myself up on a fairly strict study plan, supplemented by a solid prayer plan. I'm hoping the combination of the two will pull me through.

Torture

2009-06-04T14:59:00.002-05:00

For the Chinese it was drops of water, for the British it was the Iron Maiden. For me, it is a week long of exams. Every day my desire to study lessens. I seem to be turning my exams a little earlier each day as move through the exams quicker, my will to care gone.

Good news, one more.

Butterbean alla Canizaro

2009-05-30T08:46:00.003-05:00

It's official, and officially out of the bag, I am going to be an Auntie! Yep, featured above is my little neice/nephew, only the size of a butterbean right now. But as it turns out, I love butterbeans! Don't worry, there will be lots of updates on this one!

Double Feature

2009-05-28T10:01:00.007-05:00

Recently the Jackson installment of the Miller Gang joined together to go see a movie. Which turned into two, with a quick meal involving Wendy's and a big purse in the middle. First on the agenda, Star Trek.

I loved it. I've never been a huge Trekkie. I think I've only seen two of the older Star Trek movies, one when James T. Kirk comes back to save the whales, and one when Jean Luke Picard meets up with James T. Kirk to save the universe. But, this movie had a great mix of old and new. It explained everything to a non-Trekkie, and gave me just enough glimpses of classic Star Trek to make me feel cool (hey, everybody has heard "live long and prosper.") I think they've made a Trekkie out of me yet. Oh, and Chris Pine beats William Shatner anyday.

I give Star Trek a ONE on the Pain Scale.

Next up, Angels and Demons. Now, I have been adament for a long time that this book was much better than The DaVinci Code, and I think the same holds true for the movie. Tom Hanks' hair isn't nearly as skanky; the premise isn't nearly as far fetched and controversial. Plus, it holds a special place in my heart because I've been there. I've seen some of the landmarks in the movie, heck I specifically searched out some just because of the book.

Without the hunk factor, and probably partially due to the fact I knew what was going to happen and it was my second movie to watch in that day and my booty was going numb, I give Angels and Demons a THREE on the Pain Scale.

Graduations

2009-05-27T16:39:00.007-05:00

This past week I have enjoyed two commencements. First, the Cutest Boy in the World walked across the big stage. He started at one end as just another student, but stepped off the other end as a Doctor of Physical Therapy. I was so proud. In the words of a mother on a game show, "That's my baby!"

Then, a few short days later my other baby walked to the tune of Pomp and Circumstance. Lanie graduated from Obedience School with a Bachelor in Decent Behavior. We did not bring home the Top Dog Award, again this year, but she did get an honorable mention for Perfect Attendance.

Let the Studying Commence

2009-05-24T12:46:00.002-05:00

After 11 months of getting through M3 year on the most minimal studying required, it is finally time to get serious. Boards are upon me, and the Step 2 is following quickly on their tails. But, if I can make it through this next month especially, then the dream begins: M4 year. Except for the whole "choosing what I want to do when I grow up, filling out applications, and interviewing" thing...

Pi Phi Wedding

2009-05-17T15:49:00.002-05:00

After a three year dry spell, the Pi Phi 2002 Pledge Class had a wedding this weekend. Girls came from near and far to see one of our own tie the knot... And to spend a reunion weekend in New Orleans. Surprisingly, the weekend went smoothly. The wedding went without a hitch, no one went to the ER for stitches, everyone kept their shoes on, and as far as I know everyone made it back to the hotel.

Happiest Place on Earth

2009-05-12T11:09:00.002-05:00

This week I am working in the happiest place on Earth, the well baby nursery. There are lots of little beds filled with happy, healthy, chubby babies. And I get to squeeze them on a daily basis. And, if I have some down time, I just grab one up and rock him/her for a while. I can't help but leave with a smile on my face.

Happy Numpsey Day!

2009-05-10T11:20:00.001-05:00

Home Improvement

2009-05-09T06:24:00.004-05:00

I'm not sure how exactly it happened. I don't know if I got fed up with the stick down fake tile in the kitchen not matching the adjacent living room's beautiful new tile floor, or if somehow I forgot how incredibly painful it was to tile the first half, but somehow the Cutest Boy in the World and I opted to finish our ongoing home improvement project. We're officially over the worst part of our adventure, having layed backerboard and mortared down the tile. Of course, we still have another three days worth of work that will probably take us ten. Moral of the story, I now know why God created Mexicans...

Wolverine Origins

2009-05-07T13:49:00.006-05:00

I love X-Men, and anything mutant. So, of course, I was very excited to go see the new Wolverine movie. It did not disappoint. It had everything I wanted... Lots of new mutants with their fun mutant powers, some oldies but goodies mutants from the original comics and cartoons, jam packed full of action fight scenes, and a touch of romance...

Oh, and Hugh Jackman is only fully clothed in approximately 30 minutes total of the movie. And he is NOT ugly.

I give this movie a ONE on the Pain Scale.

Burnt Out

2009-05-06T13:51:00.003-05:00

I have been on Pediatric Wards for 24 days.

I have been an M3 for 11 months.

I have had 53 days off in the last 339 days, which averages to one day off every 6.4 days.

And I am officially burnt out.

I'm tired of getting up in the morning to write progress notes that no one ever reads. I'm tired of having exams, and boards, and Step 2s looming in my future. I'm tired of constantly asking about bowel movements.

On the other hand, I will be an M.D. in 13 months, and will be doing this for the rest of my life.

Bueno Cinco de Mayo, Ya'll

2009-05-05T14:05:00.000-05:00

Fluids

2009-05-01T11:49:00.002-05:00

This week I was hit with an old fashioned stomach bug that rendered me worthless on the bathroom floor for the better part of 9 hours. On the brink of dying, my life was saved by a doctor working the night shift, a prescription for Zofran, and a 24hr pharmacy. Although I slept for 22 of the next 24 hours, the damage had been done. My fluid status was in dire straits. And after attempting to survive rounds, I realized that the pain in the general area of my kidneys and the fact that I had not peed for about a day was not normal. I needed fluids. And I needed them now.

So, any normal person would have gone to the ER. Oh, no... I've paid entirely too much into the MS Health Care system in the form of tuition to sit in the waiting room with the peons! I started calling in favors. This is how I ended up in a small computer room on the second floor of the hospital having a surgery intern start an IV. Despite the fact that this is not in her normal job description, she stuck my dehydrated vein like a champ. At this point of the procedure, when blood started pouring out the end of the angiocath onto my leg, is when her ignorance to actually hooking up an IV became apparent. But, 100ml later of precious life fluid on my scrubs later, I was ready. With a few liters of fluids in my bag, some IV tubing, and a whole lot of gusto, I headed home to turn my bedroom into my very own ICU.

The line worked great. Fluids flowed right in. Maybe using a floor lamp as an IV pole was a bit ghetto, but I think I get points for creativity. And not counting a 10 minute pulmonary edema scare including shortness of breath, dry cough, and chest pain, my rehydration went without a hitch. So, I am back to normal fluid volume status.

Oh yeah, take that Montezuma....

On Call

2009-04-24T15:37:00.003-05:00

When you think of a doctor on call, images of someone in scrubs walking briskly down a hallway, white coat flapping in the wind, and the sound of a pager incessantly beeping and the words "Code Blue Room 114" probably come to mind.

However, when you think of an M3 on call, a more accurate description would be two students sitting in a lounge, maybe sleeping on the couch or playing on the computer wondering when they'll get to go home... no beepers, no Codes...

Yeah... I'm the one at the computer...

Senior Planning: Part Duex

2009-04-14T15:42:00.001-05:00

Senior Planning Day came and went. Yes, I even turned in a schedule. But have I made a decision on what I'm going to be when I grow up? The answer to that is a resounding heck no...

Instead, I have turned in a schedule that allows me to postpone the decision a few more precious months. I actually don't think I have to have an answer until November when applications are due, and even then I can delay the inevitable by applying in more than one specialty.

So, for anyone out there who is sitting on the edge of their seats waiting to know which clinic to make an appointment with in 2010 for Dr. Miller, you might want to start some prophylactic heparin for the DVTs you might develop.

Birthday Baby

2009-04-10T15:48:00.002-05:00

As fate would have it, I was assigned to be on Labor and Delivery the week of my birthday. And as my pure and undeniable bad luck dictated, I was working L&D nights.

Well, trying to be positive, the good news is I had the opportunity before me to deliver my very own birthday baby. And just to keep it real special, my resident was no other than my very own sister, Dr. Can-O'-Whoop-Ass.

I would like to believe this baby knew the gravity of the task at hand. It had pretty big shoes to fill to share my birthday (my silver annivesary of birth, if you will). So, instead of coming into this world the regular old, fairly undramatic way of through the birth canal head first, at about 1am this baby decided to send it's umbilical cord as a scouting party. This condition (called cord prolapse) is an emergency. So with Dr. COWA on the OR table underneath the drapes desperately trying to hold the umbilical cord in the uterus to prevent the baby from essentially suffocating itself, I scrubbed in to help cut the baby out in a STAT C-section (skin cut to deliver time less than 90 seconds).

So, it was dramatic, maybe a little over the top. But, I have to admit, Birthday Baby, you did me proud. I like your moves. I like your style.

Spring Cleaning

2009-03-07T16:47:00.002-06:00

So, working 12 hour days, being on call every 4th day, and overall hating my life for the last 3 months did not exactly lend itself to coming home from work to clean my house. Plus, with The Cutest Boy in the World out of town, I didn't have the motivation or need to prepared to entertain. So, the Studio 54 has been slowly gathering a layer of dust, Louis hair, and empty water cups.

But now life is returning to its semi-normal state. So, today, was Spring Cleaning day. The Cutest Boy in the World helped hang pictures, do heavy lifting, and even the occasional sweeping. I spent the day trying to figure out where to put all the random stuff that piles up in 3 months, cleaning up old Lanie tail blood, rotating loads of laundry, and doing a whole lot of dusting.

Yet, somehow, hours later, the house still seems to be in disarray. Why is it that things just seem to get worse long before it ever gets better? And where does all this dust come from? And how much does it cost to hire a maid???

Senior Planning

2009-03-05T19:28:00.003-06:00

The time is finally upon me to make the decision I have been postponing for 7 years... What do I want to be when I grow up?

Tomorrow we plan our senior schedules, the first year of medical school that we actually get to choose electives to help gear our education toward our specific future professions. And yet, here I am, feeling barely closer to making that decision than I was 7 years ago. So, when everyone is worrying and talking about what electives to take, I'm going to remain focused on the only thing I know for sure--- I'm going to get 4 months off next year, and love it.

Benign Gyn

2009-03-04T19:39:00.000-06:00

I've started my OB-GYN rotation-- 6 weeks of va-jayjays, ba-jingos, and the occasional hoo-ha. And the rotation has started on Benign Gyn, a nice mix of Pap smears, hysterectomies; clinic time and OR time.

My thoughts thus far:
- I am definitely not a Medicine person. I'm finally DOING something!
- It's so so very nice to be back in the OR, even if my life does mostly consist of retracting with the occasional suction.
- Pelvic exams are a lot less awkward than I first expected. Much less so than the dreaded Dr. DRE. At least women who come to the gyno are expecting the exam... As compared to that person who comes in with fatigue and gets a surprise gloved finger up the rectum.

We'll see how it goes...

The End of Medicine

2009-03-02T19:14:00.000-06:00

So, I have put in my time. I have finished my rotation on Medicine. It was... Well, let's just focus on the positive and say that's it's over.

(For clarity sake-- "Medicine" is the specialty that is kinda the catch all. Like if you were going into the hospital just because you were sick, you'd be treated by a Medicine doctor.)

As predicted, I'm just not a Medicine girl. It was 3 months, call every 4th night. And lots of sitting around (or often standing in the hallway) talking about things, about patients, about plans, about orders--- for hours upon hours... Yet never actually DOING anything.

Once again-- positive, it's over. Even more positive-- another specialty marked off the list.

Song From Past

2009-02-11T20:06:00.003-06:00

Do you ever hear an old song that you haven't heard in many years and you actually had forgotten existed yet you still know all the words? That happened to me the other day. I heard "In the Light" by DC Talk, and as I was singing along, I realized how great the lyrics are. I have decided that it should be played more often, maybe daily...

I keep trying to find a life
On my own, apart from You
I am the king of excuses
I've got one for every selfish thing I do

What's going on inside of me?
I despise my own behavior
This only serves to confirm my suspicions
That I'm still a man in need of a Savior

I wanna be in the Light
As You are in the Light
I wanna shine like the stars in the heavens
Oh, Lord be my Light and be my salvation
Cause all I want is to be in the Light
All I want is to be in the Light

The disease of self runs through my blood
It's a cancer fatal to my soul
Every attempt on my behalf has failed
To bring this sickness under control

Tell me, what's going on inside of me?
I despise my own behavior
This only serves to confirm my suspicions
That I'm still a man in need of a Savior

I wanna be in the Light
As You are in the Light
I wanna shine like the stars in the heavens
Oh, Lord be my Light and be my salvation
Cause all I want is to be in the Light
All I want is to be in the Light

The Dark Side

2009-02-11T19:50:00.002-06:00

I have debated for a long time on whether I want to get a new phone. I have researched service providers and all the latest phones and gadgets, yet I was no closer to making a decision than when I started. Then the Zoolander phone made the decision for me. I accidently dropped Blue Steel and it broke into three pieces. So I went to the AT&T store, and joined the Dark Side. I bought an iPhone. And I love it.

Angel of Death

2009-02-04T12:02:00.003-06:00

Angel of Death. 007. Dr. Flatline.

I have gone 24 years without killing anyone. Yet, in the last month, I've had 4 patients die.

I can take this one of a few ways...

1) Assume that it was due to my own negligence, and file a malpractice suit against myself.
2) Quit medical school now and start selling off non-vital organs to pay off my school loans.
3) Blame it on the service and decide that I'm just not meant to be a Medicine doctor, based purely on this.
4) Shake it off, realize that there was nothing I did or didn't do that caused their deaths, and just keep on working my tail off trying to be the best I can.

So, as predictable as an AfterSchool Special, I've chosen #4. But let it be said that 1 through 3 are still really really high in consideration.

No Comment

2009-02-04T12:01:00.003-06:00

I will not comment on my sabbatical. I'd love to say I was doing something so super cool for the last two months that I didn't have time to blog... The truth is probably somewhere closer to the opposite: I've been doing something so super mind numbing I could not bring myself to write about it...

Random Challenge

2008-11-10T10:04:00.003-06:00

So my friend Hari Krishna, has challenged me to what can only be described as the blog-equivalent of one of those "get to know you" chain emails. Seeing as I've got and hour and half until rounds and nothing to do except study, I have decided to rise to her challenge.

So here are six random things about me, appropriately in random order...

1. I am daily amazed at how blessed I am. Sometimes it takes my breath away.

2. I have a borderline unnatural interest in dragons. Had it not been for finding cool friends in elementary school, I might have ended up being a third level wizard in the local Dungeons and Dragons club. Instead, I just spend too much time reading dragon related books and watching dragon based tv shows and movies (think Harry Potter, Eragon series, DragonHeart, etc).

3. Despite the fact that I have completed approximately 5/8 of my medical career, I am still scared to death of getting my long white coat, more specifically the responsibility that comes with it.

4. I love the holiday season, especially Christmas. I love hearing the same cheesy Christmas songs sung by the "original" artists (think Frank and Bing) a thousand times. I love candlelight Christmas Eve service. I love the twinkling lights. I love the cold. And, secondary to this love of Christmas and my present state of free time, I have already started decorating my house. Just the inside. I figure that I don't exactly entertain on a weekly basis, so I can get by with starting to deck the halls with bows of holly, and no one but me will know the difference. I won't consider this abnormal until I start doing it before Halloween.

5. Sushi has become a staple in my life. Every time the Cutest Boy in the World mentions eating out, my first thought is always sushi. I try my hardest to suppress this so that he can enjoy some variety in his diet, but somewhere deep inside as I stuff my face with cheese dip and chimichanga, I feel disappointed that its not sushi. I'm pretty sure I could eat it, realisitically, three times a week. Yum....

6. I think Ann Taylor Loft should pay me a small advertising fee. Thanks to my recent need for professional clothes, my wardrobe is almost entirely sponsored by the store. Don't get me wrong, I go shopping other places. But I always end up getting scared by the trendiness or overwhelmed by the selection or disgusted at the prices. Therefore, I head back home to the Loft.

ElectroShock Therapy

2008-11-10T09:08:00.002-06:00

Electroshock Therapy, or as it is properly known in the medical community ElectroConvulsive Therapy (ECT), seems very archaic, medieval even. It's a form of therapy that has been used in psychiatry for over 70 years to, well, basically knock the crazy out of people with a jolt of electricity. Most people probably think of One Flew Over the Cuckoo's Nest, with Jack Nicholson being forced down to have metal probes attached to his head while he's desperately fighting against restraints when they think of ECT. Or maybe they just imagine a mild form of an electric chair that leaves the patient a zombie instead of a corpse. I'm not going to lie. That's what I thought.

Until today.

ECT is still commonly used in psychiatry to treat patients when all medications have failed. So, I followed down two of our patients as they went for treatment. As it turns out, the patients are sedated and given muscle relaxers. Then metal electrodes are placed on their heads, only causing their face to tighten into a deep grimace as the electricity is administered. It's actually a very benign procedure. The only evidence of the seizure being induced is one foot, that has the muscle relaxers blocked by a blood pressure cuff, which goes into myoclonic seizures... Just flapping around until the seizure ends.

Here's the kicker though...

I administered my patients' ECT. I held the metal electrodes to their temples. I caused that electricity induced seizure.

I think I can safely say that my ignorance and misconceptions surrounding ECT is no longer...

Dictation

2008-11-06T20:30:00.002-06:00

I did my first dictation this week. Here's a glimpse of how it went...

"The patient was admitted on 11/1/08 with the diagnosis of.... uh..... with the diagnosis of.... uh.... (pause system)... ... ... ... ... (unpause system)...
Axis I major depressive disorder... next line...
Axis II borderline personality disorder... next line...
Axis III none... next line...
Axis IV none... next line...
Axis V GAF 40 out of 100... next line...
to 7 west under the care of... uh.... uh... Dr. Smith... wait, error, scratch that... under the care of... uh... uh... Dr. Jones... period. (This continues for a long time)

Dictated by Lindsey Miller, L-i-n-d-s-e-y M-i-l-l-e-r, M-3. End dictation."

It was a pretty painful experience.

DayLight Savings Time

2008-11-02T19:55:00.002-06:00

I've got one word for it: Phooey.

It's 8pm and it looks like its 2am outside, which means my body thinks that its at least midnight... And that means it's way past my bedtime.

I'll say it again... Phooey...

Reunion

2008-10-31T17:44:00.000-05:00

I went up to 7West today, the inpatient psychiatric ward, to finish off my psych rotation. Well, for the last three weeks, we've been sending patients from the ER up to 7West for extended stays. That means today was like a reunion. All my old friends from the PES and me, together again for the next 3 weeks.

Fun Crazies

2008-10-28T09:41:00.000-05:00

Some of the crazies I've seen in the PES are just plain fun. I mean, I realize that they do suffer from an illness and it's not anything they asked for or can help, but I'm sorry, some delusions are entertaining. Here are some of my favorites thus far:

-Thinking the reason people bump their shopping cart into yours at the grocery store is because a voodoo man has cursed you

-Watching TV and then the preacher stops, looks at you, then puts his ear against the TV screen to listen to what you are saying to him

-Carrying around a bag of roots and branches because you recently remembered that a few hundred years ago you were a Native American

-Looking out your kitchen window to see three dinosaurs playing in your backyard

(This post will hopefully have an addendum before the conclusion of my psych rotation.)

Back of the ER

2008-10-20T09:28:00.000-05:00

Every Thursday night at 9pm on NBC for the last fifty-two years, the show ER comes on. This program is full of fast moving, life-and-death action as gunshot wounds, stabbings, car wrecks, and the like pour through those sliding glass doors into the trauma rooms. And during my surgery rotation I saw a glimpse of this. I was in the room as codes were run, both successfully and unsuccessfully, arteries squirted blood across the room, amd bones stuck out of people's skin at unnatural angles. That was my life in the ER, and I wouldn't have been shocked if Dr. Carter or Dr. Benton had walked in at any moment.

Now, I'm back in the ER, but life has changed dramatically. I'm in the Psychiatric Emergency Services (PES): three bare rooms with uncovered windows and a small nursing station in the very back corner of the ER. It stays quiet back here, except for the bihourly floor buffing. We are so isolated from the rest of the ER, I wouldn't know if all the victims of a 12 car explosion on State Street were being rolled in as I type.

I just sit back here in the PES, part of me hoping that some weirdo will walk in off the street complaining of being chases by pink elephants and part of me hopes nothing will disturb our little corner of peace and quiet, but always wondering what's going on in the real ER.

Psych

2008-10-13T08:02:00.000-05:00

I see crazy people...

One for the Textbooks

2008-09-08T21:15:00.003-05:00

"If you hear hoofbeats, it's probably not a zebra."

In medicine this phrase means anticipate the exotic, but expect the obvious.

In Family Medicine, my current rotation, I find myself chasing zebras daily...

High blood pressure, sweating, insomnia in a nervous woman? Probably just anxiety, but I had my money on a pheochromacytoma.

Sore knee in an 18 year old volleyball player? Most likely just twisted, but I swore it was gonoccal arthritis.

But, today, we had a woman who woke up this morning with an extremely tender neck and throat, and completely unable to swallow. Strep throat? Oh no.... We ended up sending her to the ER with the possibly fatal condition of epiglottitis. This is when the epiglottis swells, closing up the throat and eventually the airway. It is most often caused by a bacteria that is now vaccinated against, but this lady was 80 years old, so she missed the vaccine boat.

Epiglottitis is something we read about in textbooks all the time, but as it turns out, this was the first time my attending had ever actually seen a case. Guess my African safari skills finally paid off.

In The Words of Mark Twain

2008-09-08T06:55:00.001-05:00

The rumors of my death have been greatly exaggerated.

I'm still alive. I'll update my faithful reader soon.

Pimp Slapped

2008-08-12T18:29:00.002-05:00

Today on formal rounds with the attendings, I had to present a patient who has been a resident of the VA for over a month. I stumbled through my presentation semi-triumphantly, only to be hit by the pimp sessions of all pimp sessions.

I was pimped on drugs. I was pimped on procedures. I was pimped on physiology. If your wildest medical imagination could dream it up, I was pimped on it, for 20+ minutes. I could actually see my fellow M3s pleading to the attendings with their eyes to stop the brutality. But I actually thought I did decent... I mean, I knew, maybe... half of the answers....

I can remember the days of my life when I used to know all the answers, routinely make 100s on tests. Nowadays, however, knowing around 50% is something to celebrate. Oh how times have changed...

It All Comes Down to Poop

2008-08-06T16:18:00.000-05:00

My time on General Surgery can really be summarized in one word: Poop.

Every morning I go in and see my patients, and they want to tell me about all their problems. But all I really need to know is if they have pooped. Then, depending on the patient, I might be interested in the color, quantity, or quality of said poop.

And at least a few times a week General Surgeons get pooped on. For example, during one rectal prolapse repair last week, our patient opted not to finish her colon cleansing dose of Golytely, and throughout the case we had to stop the case to clean up while she pooped on us.

So, I guess it's not hard to guess that my opinion of General Surgery might also be summarized in one word: Poop.

Life's Too Short

2008-08-03T15:45:00.001-05:00

When I was in Italy, I spent the day at a gorgeous vineyard in Tuscany. The mansion on the hill that was once owned by the Medici family overlooked hundreds of hundreds of acres of land arranged in the perfect rows of grape vines. Here we had a wine tasting, which is really just a socially acceptable excuse to get drunk in the middle of the day. At the end of it all, I came home with many bottles of wine, but my favorite was the Malenchini Bruzzico Toscana.

Now, for three years I've been saving this bottle of wine, thinking to myself "I'll open it for a special occasion." Well, when special occasions have arisen I have either forgotten about the wine or sheepishly decided to wait for something a little bit more special. Until this week.

This week, I decided that life is too short to save wine. Wine is meant to be enjoyed amongst people you care about, or sometimes people you've just met. Moral of the story, it's meant to be enjoyed. So I popped open my bottle of Bruzzico this week, and enjoyed every sip of it with The Cutest Boy in the World. It reminded me of all the fond memories I have from my time in Florence, but, as I believe was this bottle's purpose in the world, it opened up all the possibilities of the next time I go to Italy.

Wine Tasting at Malenchini.

Beginning and End

2008-08-01T08:44:00.001-05:00

There are a few milestones in a surgery case. First, the patient rolls back to the OR. This signifies that case is a "go." Then the time out. This is when all involved agree upon what patient, what surgery, and what site is about to be performed. Next comes the first incision. The case has officially begun. The final milestone is closing, this means the case is over.

This week, I made the first incision. I started a case. I asked the nurse for the scalpel, announced "incision" to the room, sliced, and drew blood. Then, I closed the case. I sutured the skin shut and dressed the wound. I was the last person to have my hands inside this patient.

How much I participated in between... Well, that's beside the point.

Not Just Another Night On Call

2008-07-26T09:41:00.002-05:00

Usually after a night on call I think of all the funny or crazy things that happened that I want to share. Of course, I have yet to find the time to do this. But, this past Tuesday something terrible happened.

At about 8:30pm, a child was brought in that had been attacked by a pit bull. The child was in asystole. It was my first time to see a true code, chest compressions and oxygen desperately attempting to keep this child alive. Forty-five minutes later it became my first time to see a time of death called.

Watching death win in front of your very eyes despite the overwhelming efforts of doctors and nurses alike is tough enough. Add in the fact that this was an innocent 3 year old, it makes it truly devastating. My heart broke in that trauma room that night.

Bud Light Lime

2008-07-20T20:10:00.008-05:00

At my alma mater, I had a friend that, thanks to his love of starting his nights with a bad decision in the form of a tequila shot, always had lime on hand. Playing off his love for Corona with lime, much to the amusment and ridicule of his friends, he started putting a lime in his Bud Lights.

This weekend as I turned back a few of Bud Light's newest craze, I realized this man apparently possessed inginuity before his time. If only he had patented it when he had the chance.

So, here's to you, the originator of making Bud Light a little more exotic.

Don't call it a comeback... You've been here for years.

Fitting for My 100th Post

2008-07-20T19:59:00.003-05:00

I realize that I haven't posted in a while, and I would like to blame that on the fact I've been trying to come up with a post worth of my 100th. Unfortunately, I'm terrible at lying via the typed word, and must admit that I have just been too darn busy to update the blog. But, as Providence would have it, my 100th post is an exciting one.

The results for the USMLE Step 1 exam have been released... and I passed!

Years of worrying, months of procrastinating, and weeks of studying relentlessly finally payed off. I am one milestone closer to tacking on those two sweet letters behind my name. Did I doubt myself? Yes. It seems like scores were passed out at random, with people you not only never expected to fail but those you expected to blow the thing out of the water receiving a failing score. Seeing as if you fail, you are pulled off your M3 service, this exam was like a diluted form of the Rapture. One day you're writing progress notes next to someone, next day they are gone.

But, I survived. And now I am just left with the daunting task of just deciding what I want to do when I grow up.

24 Hour Call

2008-07-08T16:33:00.002-05:00

My original intention for my first 24hr call was to jump on the computer every hour or so and put in an update on what I had done. That didn't work out so much, seeing as I'm getting the reputation around the Surgery Lounge as being a cursed medical student because no one ever sleeps when I'm on call. And, come to think about it, if I even think about sleeping the trauma pager goes off. So, because I think this was still such a great idea, I'm going to work on a 24hour log of the day (that actually turned into more of a 40 hour day) and post it. So please refresh this page every 30seconds until that appears...

The New Nicorette

2008-07-02T16:43:00.000-05:00

The last two days I have followed Dr. Pittman, UMC's Head and Neck attending surgeon. In the OR in order to remove mouth cancers we removed half of patient's jaws. We inserted tracheostomys, and biopsied tumors. At the Cancer Institute in clinic I saw a range of patients, from age 25 to 85. I saw patients breathing out of holes in their necks, speaking out of holes in their necks, and disfigured by tumor removal.

The common link between all of these patients? Smoking.

I think the Surgeon General's warning on packs of cigarettes should include pictures of these consequences. Instead of classy red designs with manly logos or sleek blues that are suppose to make women feel sexy for carrying them around, how about packages with a picture of someone missing half their face?

And then, when you buy your 100th pack, you win a free trip to the Cancer Institute to see and meet yourself in a few more years. I think it'd work better than Nicorette.

Beat Up By A Girl

2008-06-25T15:46:00.000-05:00

Today I broke a 16 year old boy's nose.

Okay, so yes, it was part of a deviated septum repair and rhinoplasty, but the fact still remains it was me on the other end of that mallet and chisel.

Otolaryngology

2008-06-25T15:37:00.000-05:00

My ENT rotation is more than a little bit different than the surgery I am used to. Instead of getting to the hospital at 5am to write notes on patients, I roll in at 7. Instead of following patients pre and post op, I just follow a resident from one surgery to the next. It's a great way to get a taste of what an ENT gets to do, without being tainted with what all an ENT has to do.

Frostbite

2008-06-24T19:10:00.000-05:00

I have broken my toe...Yes, its one of those times in your life when you wish you could tell some amazing story that involves saving babies playing with puppies from a fire. Unfortunately, it was nothing that dramatic. I was rushing through my living room to grab a textbook as I was hurrying to my first day of ENT, and caught my sweet little baby toe on the ottoman.

I've stubbed my toe before, this was different. I heard a crack. It immediately started swelling. I stuffed it in a shoe, and headed off to the hospital. But walking was miserable, and I watched it slowly turn purple. It is now a nice necrotic diabetic toe color, or for those who are not blessed to know what this looks like, think serious frostbitten toe, with a pretty intense margin of blue.

But, surgery stops for no toe, so my toe and I spent the day in the OR.

Surgery Arcade

2008-06-21T11:18:00.001-05:00

After finishing rounds and writing countless orders on our patients, my resident took me to the holiest of holy places for the surgery residents, the Simulation Lab. Only surgery residents are allowed in to practice laparascopic skills and techniques in this roomful of arcade-like games. I felt as if I should take my shoes off before entering.

So, he described to me the different laparoscopic "games" including dropping a bean into a cup, running the "bowel" (which is actually a rope), and the ultimate challenge loading a needle, suturing, and tying, all laparascopically. And, yes, I went for the granddaddy of all challenges.

Surprisingly enough, I owned it. Within 20 minutes, I had finished a knot from start to finish. This is something that 3rd year surgery residents still have trouble with. Now, I realize that this was mostly beginner's luck (because it then took me another 40 to merely throw a second knot without all the suturing), but hey, at this point in my career, I'll take luck.

Whipple

2008-06-20T11:08:00.000-05:00

The Whipple procedure, technically known as a pancreaticoduodenectomy, is when you remove a patient's duodenum, part of the stomach, gallbladder, and part of the pancreas. Then, you reconnect everything to a part of the small intestine farther downstream. It's a massive procedure, the surgery lasting 6+ hours. And it doesn't happen everyday. Some residents go through their entire residency without seeing one.

And I helped on a Whipple. I scrubbed in; I suctioned; I helped tie the anastamosis of the stomach to the jejunum. It was absolutely amazing. I had my hands in a patient's abdomen, nearly up to the elbows. I felt a beating aorta. I held intestines. And strangely enough, 7 hours flew by!

First Call

2008-06-19T19:44:00.000-05:00

Every morning as the M3s walk into a darkened surgery lounge with residents, interns, and students sprawled across the couches catching precious moments of sleep, we dread the day it will be us. The first question we ask our fellow M3s is "how was it?" quickly followed by "did you get any sleep?" Well...Tuesday night I took my first night of Trauma Call.

I picked up my pager at 4:30, sat down to look at the surgery consult sheet sheets that I'd be expected to fill out. This was the only time I sat all night. The pager started beeping, and it didn't stop all night long. We had two kidney transplants, a GSW/knife wounds, an assaulted prostitute, a ligated ulnar artery, lots of bloody vomit, a scrotum the size of a canteloupe, and a little boy that swallowed a nickel. I didn't even have time to look at one of the couches longingly.

So, 31 hours later, I got to sleep. I put my swollen feet up and slept through the Loo barking up a storm at the mailman, the UPS man, and whoever dropped off the phonebook. It was probably the hardest I've ever slept. Then, entirely too short of time later, I got up, and went back to the hospital. Yep. Welcome to medical school.

When It Rains, It Pours..

2008-06-16T20:19:00.000-05:00

So, at the end of last week I was a bit more than a little frustrated at my experience as an M3. Or, to be more accurate, my lack of experience. But, today has compensated and then some. Today I was in the OR for 11 hours plus. My feet hurt. My arms are sore from retracting. But, I must admit it was fun. I got to scrub in, have someone hold open the sterile gloves for me. I got to suture and staple the wounds that I will be required to check tomorrow morning at 5am. It was pretty freakin' cool.

Organ Donation

2008-06-14T17:32:00.000-05:00

Seeing as I am the M3 Transplant Team for another week, I feel it is my obligation to make a plug for organ donation. Basically, I'm not going to try to convince you one way or the other, although my personal thought is I'm not going to need them once I've gone on to happier hunting grounds, but I think you should know about some new legislation in MS.

As of July 1, 2008, the First Person Consent Law will take affect. This means if you have that little heart on your Drivers License, you are officially in MORA's (Mississippi Organ Recovery Agency) website as an organ donor. So, no matter what you're family, power of attorney, or great aunt Marge thinks, you're organs are going on to help those in need. (Compare this to when that heart was only a suggestion of your wishes.) In case you haven't registered with the DMV, you can still go to msora.org to be put on the registry.

Thanks. This public service announcement was brought to you by milk. Milk, it does a body good.

Nurse, Scalpel.

2008-06-12T13:21:00.000-05:00

We know we are complete and utter nerds, and as green as Granny Smiths, when the talk of the surgery lounge today was the fact that I got to do an I & D today.

An I & D stands for incision and drainage. This is just a fancy way of saying that I drained an abscess today. I donned my sterile gloves, injected local anesthetic although this didn't stop the patients wailing, grabbed the scalpel and made a 3cm incision. Oh, and then came the floodgates of blood and pus. Gross? Yes, maybe to some. But to me, it was a chance to cut. I realize its only my second day, but I've got to admit, I think I like that feeling.

Blog's Namesake

2008-06-10T19:01:00.000-05:00

After a riveting day yesterday of M3 Orientation where I was reminded about the rigorous rules of HIPAA, and the incompetency of the UMC Financial Aid Department, I donned my white coat today for Surgery Orientation. We talked about HIPAA a bit more, learned how to throw some knots, and, the highlight of the day, we learned how to wash our hands.

Now, almost everytime anyone does orientation in a hospital setting they are taught to wash their hands before and after coming in contact with patients with soap and water. But, today, I got the mother of all handwashing lessons. I learned how to properly scrub in for surgery. Yes, the count method. Scrub ten times on every surface starting at 2 inches above the elbow. A rough estimate, that is about 6800 scrubs for each surgery.

So, now, I meet my resident to go on transplant rounds at 6:30 tomorrow morning. I have no idea what I'm suppose to do. I barely know where I'm suppose to go. But, if all else fails, I'm going to remember to wash my hands.

The Grass is Greener on the Other Side

2008-05-30T09:08:00.000-05:00

I'm done. I have made it to the other side of the Step 1. And it's a lot like going through Post Traumatic Stress Syndrome.

First there is anger. Yesterday I was pissed off at the exam, frustrated at the things I didn't study and even more at the things I did and weren't on the exam. I found myself taking this anger out on random people and things, as just a way to relieve some of the pressure that had been building up for the last month.

Then, I went numb. My brain just quit working. Last night I couldn't figure out how to order a pizza, pick a beer, or even remember my birthday at dinner with the girls. It was like I just completely shut down.

Next were the flashbacks. I had dreams about the questions on the exam last night. And, where I couldn't remember more than 2 specific questions when I walked out yesterday, today they have been coming back to me like a flood. Questions I got right, or got wrong, or even worse, changed from right to wrong.

If this pattern keeps on, next up should be either psychosis or recovery. I'm hoping for the latter. I'm thinking I might clean my house today, run a few fun errands, then go out to dinner with The Cutest Boy in the World. No more worrying, no more studying... At least for the next week.

And I Shall Do No More.

2008-05-28T17:37:00.000-05:00

360 Clinical Vignettes...

250 Flashcards...

320 pages of First Aid...

26 pages of hand written notes...

314 pages of other review books...

2190 Qbank questions...

That might look like a lot of studying to you, but to me it looks like a poor excuse for trying to prepare myself for the Step. But, it's all I've got. I'm done. I'm out like the fat kid in dodgeball.

So, I'm taking the night off to watch movies and tv, and tomorrow I shall put on my bravest face as I go to face the music.

Call 911!

2008-05-27T19:59:00.000-05:00

What is the absolute worst thing that could happen to an M2 only 36 hours before taking the Step?

Power outage? No, I could embrace the ways of the Amish and study by candlelight.

The entire city of Jackson being out of coffee? Bad, yes, but I could switch to Amp or Vault or cocaine.

Being hit by a car? Actually that might be nice. Maybe the USMLE gods would have mercy and let me post-pone taking the exam.

No, the worst possible thing to happen to an M2...

QBank is down!!

Fourth Quarter

2008-05-25T09:25:00.000-05:00

At the beginning of the fourth quarter of every Alabama game, all the Crimson Tide fans hold up four fingers. This, probably a tradition set forth by The Bear himself, is meant to signify, "We own the fourth quarter." It is a rally. There is plenty of ball game left to come back from behind or stomp the opponents farther into the ground.

I have four days left before the Step. Although I am constantly on the verge of tears induced by stress, feelings of imminent failure, or intimidation by the vast amount of knowledge I am being tested on, I have decided to take a deep breath, and boldly hold up four fingers. I own these last four days.

"If you believe in yourself and have dedication and pride - and never quit, you'll be a winner. The price of victory is high but so are the rewards." -- Paul "Bear" Bryant

Six Days

2008-05-23T16:13:00.000-05:00

God created the entire universe in six days. Light, dirt, water, birds, humans, the shiny slime slugs leave behind... everything. So it should be chump change for Him to help me learn the entirety of man's medical knowledge to date in the same amount of time. Here's praying...

A Letter to Microsoft

2008-05-22T15:22:00.001-05:00

Mr. Gates,

I realize that your engineers are probably all working on the disaster that was Microsoft Vista, but when you get a moment, I have a request. Microsoft Internet Explorer has a feature called "Favorites" and I would like you to please change this. I believe this is a misnomer. You see, everytime I have to go to that tab to go to Qbank to practice more USMLE Step 1 questions, and inevitably be reminded that I might forever be an M2, I cringe at the thought of calling this website a "favorite." It is far from it. It is a nemesis. A bane in my very existence, albeit only for another week (fingers crossed.) In conclusion, I would like to recommend the name "Frequently Visited Websites" as an alternative. Thank you.

Sincerely,
A Stressed Out Medical Student

Addition to the Family... Almost

2008-05-19T11:42:00.000-05:00

During a leisurely day at Dogwood with The Cutest Boy in the World this weekend, we wandered over to the bank parking lot to see the puppies for sale. This was a dangerous undertaking to begin with in light of my history of impulse puppy buys (Heidi "Trailer Trash" Ho.) But, it turned out I wasn't the one we needed to be worried about...

The Cutest Boy in the World has always wanted a blue Great Dane, and as luck would have it, someone was selling blue Great Dane puppies. Oh, he held one, loved on it, and got lots of puppy breath kisses from it. Had he not have been leaving for two months, I could almost guarantee that the Loo would have a little sister right now. Whew... That was a close call...

Back to C-Town

2008-05-16T18:27:00.000-05:00

In one of those strange freaks of medical school, I have found out my schedule for September before finding out June. But, as luck would have it, I am returning to my old stomping grounds for my 4wk Family Medicine Preceptorship. I can almost guarantee that this trip down Memory Lane will probably just remind me why I'm glad I left. Even if I do only live 30min away, it's basically like another area code compared to the Twilight Zone that is Clinton, Mississippi.

News Flash

2008-05-12T16:45:00.000-05:00

The Miller clan, including the annexed portion of the Canizaro clan (e.g., David), met this weekend to celebrate family, motorcycles, and food. In light of the CEOs of Miller Inc relocating the home office to Chattanooga, TN, this was the last of such gatherings in the stinky state of Louisiana. Also, owing to the upcoming loss of free time of the youngest Miller and Ashley's current shortage, time coordination will also become more difficult. Therefore, no expense was spared to make this past weekend fun for all...

David opted to try the once popular jiggle method of weight loss by riding his motorcycle 5 hours down to Zachary and back. Sources say he reports a two inch loss from his ass, although statistics have not been released whether or not this results from the 5 hours of compression or the vibration.

Popscicle made Miller family history by not being called into work for the first time during a Canizaro visit. Of course, after turning in his resignation and missing a 10 o'clock phone call, Entergy might just finally be getting the hint.

Ashley has embraced her inner Pam and was seen purchasing multiple leather garments at the local Harley store. With this large of a cowhide purchase, insiders are questioning whether she has actually taken to moonlighting as a dominatrix.

Numpsey still waits patiently for her Mother's Day gifts. Sources say she has been seen peering out the front door windows waiting for the UPS or mail man to bring her the very large box she knows she is getting.

In unrelated news, Al Copeland, the owner of Copeland's Cheesecake Bistro has recently purchased a private yacht. Although no official statements have been made concerning this extravagant purchase, he is reported to have claimed to have had "a very profitable weekend."

Keys to a Good Residency

2008-05-07T18:22:00.000-05:00

At the ACOG conference (yes we actually did go to meetings), program directors of various residency programs gave tips on how to stand out as an applicant. Here are the top five, and I'm not making any of these up for entertainment sake.

1. Find a mentor.
This presents a problem seeing as I have no clue what I want to do. Plus, its not exactly like I'm a baby bird in a Dr. Suess book that can go around asking every moving being in a long white coat, "Will you be my mentor??"

2. Have overcome a debilitating personal struggle.
Examples were given such as "having a dead parent," "losing a limb," or "surviving cancer." I feel rude asking one of my parents to keel over to help my chances of having a good Match Day. And, I've become rather attached to my limbs. But, I do have a habit of not putting on sunscreen so maybe all those years of worshipping the sun gods will pay off on the cancer front in the next year.

3. Be a single parent.
I guess this one is do-able. I'm 24, which means in Mississippi I'm borderline advanced maternal age. Even if I could skip the whole 9 month gestation thing and pop out a kid today, he/she'd still be the one with the "old mom."

4. Climb Mount Kilimanjaro.
Completely disregarding the fact that I get winded climbing three flights of stairs to my classroom, I'm not exactly sure when I'm expected to squeeze this into my schedule when I'll soon only be getting one day off every seven days. I mean, by my calculations, even if I took a plane to Tanzania, a helicopter to ten feet from the zenith, climbed to the top, slid back down those ten feet, took a helicopter down, and flew back, I'd still be late for rounds the next morning.

5. Be a normal human being.
Now this one I think I could maybe manage. If for a few hours during interviews, I can hide the fact that medical school has brought out my inner control freak, has left me so stressed out I find myself crying when I can't find a parking spot, and has reduced my sense of humor to using such one liners as "I'm so hungry I could go Leish-Neihn on my hand." I am worried however that for some people in my class this one is just as unattainable as the Mount Kilimanjaro thing.

Howdy Gyneroos!

2008-05-07T17:23:00.000-05:00

The last few days of my life have been filled with speculums, contraceptives, and hurricanes.

Yep, I've been at the American College of Obstetricians and Gynecologists Annual Clinical Meeting in N'awlins, Louisiana. Needless to say, when you check cervixes all day, you know how to have a good time after work. Good times were had by all.

Viva Las 'Dega

2008-05-02T13:22:00.000-05:00

Talladega has come and gone, but the pictures will last forever. (The memories might have already been partly washed away by the beer.)

The homestead. Two campers united under Old Glory and Hendrick Motorsports.

Our half of slice of heaven. This was basically the same position we stayed in all weekend, although most of time our hands were full of beer, our mouths were full of food, and discussing the status of the black water.

They make such a sweet couple.

"Fat man in a little car." We were afraid we were going to have to get the Jaws of Life.

The Cutest Boy in the World, looking oddly out of place in his pink Polo, but I guess it brought him luck because the fool picked the winning driver, Kyle Bush.

Numpsey and Popsicle enjoying a day at the races.

Selective Hearing

2008-05-01T16:12:00.000-05:00

My dog will go crazy at 3am because a cat has wandered into our front yard...
But she will watch in silence as a squirrel eases its way closer and closer to the open back door.

She will protest any loud vehicle on our street, the next street, or even the interstate...
Yet she will have no idea that a car has pulled into our own driveway.

The Loo will bark like somone is literally breaking into our house when the mailman steps on our front step to put my countless AMA fliers and magazines in the mailbox...
But she won't even move from her spot in the sun when The Cutest Boy in the World comes over until he actually rings the doorbell.

Words on a Page

2008-04-29T10:12:00.000-05:00

After two weeks of nearly constant studying, I had hit a point where my brain was full. I could not have learned one more fact without it immediately oozing out my ears. I found myself just staring at black print in symbolic shapes on paper, not absorbing a word of it. My eyes hurt, my neck hurt, and needless to say, my head hurt. There were a few times when I truly didn't think I was going to survive.

But, although we lost a few good men out there (mostly hours of sleep and sanity), I made it through. And now after the most relaxing weekend imaginable (pictures to follow soon), I'm back. Back to the library, and back to the grindstone. But, surprisingly, I have somehow found more room in the ol' noggin. I'm wondering what got pushed out... I'll probably go to get gas this afternoon and discover that I no longer how to turn the pump on.

The Tally

2008-04-23T10:35:00.001-05:00

Seven down, two to go!!!

Sad Day

2008-04-21T17:02:00.000-05:00

My friend Emilee passed away today. Please pray for her family.

It All Comes Down to Poop

2008-04-19T15:01:00.000-05:00

As I spend my weekend delving into the word of pathology, discovering ever minute detail about nearly every disease the human race has ever been inflicted with, I have come to one clear conclusion. Half the planet must have diarrhea.

Okay, maybe that's exagerrating, but at least 95% of the people in the hospital do. I'm surprised the floor isn't covered with it. Or you don't have to dodge flying diarrhea as you walk down the halls.

Not only do I find myself greeted with diarrhea under every Clinical Manifestations heading, but it must be adequately described. Here are some adjectives (and if you are a medical student, as you read them the name of the causitive organism/disease process will miraculously appear in your head):

"frothy," "particularly foul-smelling with bits of undigested food," "like rice water," "bloody and mucoid," "partially formed stools," "coffee grounds"

Heck, I don't even think I know what rice water is.

The other 5% of the people in the hospital aren't blessed with normal bowels however, they're just suffering from obstruction, anticholinergic syndrome, or opiate overdose and they're constipated.

No Time to Celebrate

2008-04-18T15:56:00.000-05:00

I have just finished a week of exams. Normally this would mean joyous outbursts of jubilation, tickertape parades, and enough beer to drown a cat.

Not this time.

I'm in the library, on a Friday afternoon, gearing up for Round Two.

My Best Friend

2008-04-14T10:29:00.000-05:00

If you're a product of the 90s like me, then this catchy commercial jingle will ring a bell deep in your childhood subconscious:

My Buddy, My Buddy
Wherever I go, he goes
My Buddy, My Buddy
I'll teach him everything I know
My Buddy, My Buddy
My Buddy and me!

Back then, this infectious tune brought images of three-foot tall Chucky-esque dolls complete with blue jeans, collared pullover, and a baseball cap, that could finally give form to your imaginary friend. Although I was never so lucky in my childhood as to own a My Buddy doll, or his counterpart Kid Sister, that void has finally been filled. Now I have a First Aid Review Book.

First Aid is the M2's red badge of courage; we carry it around both proudly as if to say "Behold! I am M2!" and grudingly, like a heavy burden that only we can bear. Everywhere I go, school, library, dinner, gym, my First Aid won't be far behind. It is covered in sweat, coffee stains, water damage, a tear or two, and even a little bit of blood, thanks to that period of time when Lanie's tail liked to bleed on everything. I will be surprised if my First Aid makes it to the Step. By then it will be probably taped together, or just a box full of loose pages. Oh, what a bittersweet day May 29th will be when I have to say goodbye to my dear friend...

A Place To Call Home

2008-04-11T15:12:00.000-05:00

With Jackson being the home of Tougaloo College, Jackson State Univeristy, University of MS Medical Center, Belhaven College, and Milsaps College, you'd think you wouldn't be able to swing a dead cat without hitting eight to ten suitable places to study. Wrong. Let's review...

UMC Library- You could cut the stress in the air with a knife. Even if you feel good about an upcoming exam, the panic is infectious. Plus, distractions (or maybe just irritation) abound when you're surrounded by the same people you've been around for the last two years day in and day out.

Barnes & Nobles, County Line Road- Acceptable. Not the best coffee, but the acoustics allowed for less irritation toward the non-studying patrons. Plus, large tables and electric outlets were more numerous than fleas on a junkyard dog. Unfortunately, closed for business.

Willie Morris Public Library- Minus the occasional deaf geriatric screaming at the clerks trying to get his/her library card replaced, overall very peaceful. Coffee is available, although it might be drink at your own risk. Downside, the place has converted to the way of the Amish and closes when the sun goes down.

Starbucks- Not a single table with a radius larger than 12" and even these have cushy chairs that aren't suitable for causing pressure ulcers while studying. The pain reminds you that you're alive, and you need to keep studying.

Cups- Good coffee, best in the city if you ask me. Small though with terrible acoustics, anyone's business is now your business. Also, they only upgraded to the 20" table to get a small one-up on Starbucks. The rumor is there is a secret "library" perfect for studying hidden away in the back, but I'm pretty sure there are more people camped out waiting than for the premier of Star Wars Episode I.

Barnes & Nobles, Renaissance Colony- This new location does not even compare to its former glory. Although the cafe area is larger, the promise of Cheesecake factory treats can not overcome the fact that all the tables are two-seaters and there is only one electrical outlet in sight, which, ironically, isn't even near one of the tables. The few larger, "study" tables scattered throughout the store are electrical islands, unless you bring a 100'+ extension cord.

Borders- Adequately sized tables are usually easy to come by, although only one offers the promise of electricity. But, be sure to get there early, this is a haven for junior high kids drinking Javakulas with extra whipped cream while waiting for Mom to come pick them up and Tuesday night knitting club. Also, the staff (not deserving of the title "barista") are prone to think the world is their stage and their shift is an 8hour comedy show for the patrons enjoyment.

The Final Hoorah

2008-04-10T15:04:00.000-05:00

The last seven months of M2 Preceptor-ship has finally drawn to a close with the completion of my witnessed H&P. After countless times of silently standing in the corner of the room while my preceptor engaged patients, asking them questions and performing physical exams, the tables were turned. It was my show. Unfortunately, this is only my second true full history and physical, so it wasn't quite the moment of victory it sounds like. I was sweating like Michael Jackson at a tee-ball game.

But, I pushed through. Yes, I forgot to do things. Yes, I forgot to ask important questions. But, its over and that's all that matters right now. And, my preceptor seemed fairly impressed. Maybe because I did a good job, or maybe because he was amazed I did decent despite the lack of instruction he gave. Either way, I'm one step closer to being an M3.

Words of the Day

2008-04-09T17:06:00.000-05:00

phud-dy dud-dy [phuhd-dee duhd-dee] noun, one who possesses a PhD degree, and therefore has no understanding of clinical medicine; lectures are known to be composed purely of useless basic science knowledge that will never be of help to a practicing physician

mud-phud [muhd-fuhd] noun, one who possesses both an MD and a PhD degree, therefore they once knew actual clinical medicine but have long forgotten it in order to barricade themselves in a laboratory doing research; known for making outdated and ridiculous comments, for example "spider bites are sustained by rolling over in bed, putting on socks and shoes, and carrying boxes out of a dark basement"

They Say Its My Birthday...

2008-04-08T11:21:00.000-05:00

Today is the 3rd anniversary of my 21st birthday (yeah, that's how I'm going to think about it... you do the math.)

It has started off quite well. The Cutest Boy in the World came over this morning, brought some staple groceries (milk, eggs, cheese) that I lost due to power outages, and made me breakfast of cinnamon rolls and scrambled eggs. From this alone he might have elevated himself to status of The Cutest Boy in Solar System. Then he gave me just what I wanted, and asked for (gotta love a boy that listens), a pretty cookbook and a food processor. This is worthy of being called The Cutest Boy in the Universe. Yes, to some this might sound extremely domestic, and I realize that it is, but cooking is my hobby. So, homemade pesto for everyone!

Then, tonight I think my family (minus Daddy, but he'll be with us in spirit) is going to PFs... Oh I love birthdays...

Jack-town Twister.. and that's not a fancy new martini

2008-04-06T11:00:00.000-05:00

First off, me and mine (meaning the Loo and The Cutest Boy in the World) have survived The Storm of 2008 unscathed.

But, Friday, I knew according to the Weather Channel's Local on the 8s that Jackson was expecting some severe isolated thunderstorms. So, I went home at lunch to let the girl out before the rain came. After eating, I sat there studying some whatnot. All of a sudden, like God spilled his Diet Coke on the sun, it got real dark. The power went out and the wind started blowing in sideways. I watched all this from my back living room, feeling overcome with the feeling of "this ain't good." Well, I had to run out to my shed to close the door that I had left unlocked and on the run back I was getting hit by pea-sized hail. "This ain't good at all." In the next 5-10 minutes, I stood frozen, watching with bated breath to see what Mother Nature was about to do. But, almost as suddenly as it began, the spookiness ended and it merely started to rain.

I was expected at clinic at 1, so I collected my effects and headed to the car. The scene that met me was staggering. Trees were uprooted everwhere, or snapped off on top of houses and power lines. My house was actually the first on my street that did not contain a new pine tree fixture in the living room. But, being the dedicated medical student that I am, I drove under downed power lines, around trees and roof debri, and through nonfunctioning traffic lights from my house to clinic. Of course, clinic also was without power and I was told to go home after 40minutes of just sitting around wasting oxygen.

Supposedly, a tornado passed directly over my house. Reports say that the damage was worse than what hit Jackson during Katrina. All I know is that God Himself protected my home that day.

A Lot to Learn

2008-04-03T13:00:00.000-05:00

Yesterday I donned my dreaded short coat and my "dressed to the coat" clothes, and headed to 5 South to interview a patient. My first challenge was to find said 5 South, which, this being my second time in the new hospital, was a bit more difficult than it sounds. Then, I went in to do a full H&P on my patient. It took an hour and a half, and I still walked out and realized I had skipped a lot of stuff (checking lymph nodes, CN VIII, asking about allergies, etc). So, here I am, hopefully going to be a M3 in a few short months, and I can't get a simple history and physical on a very nice lady with colon cancer right. I sure hope this all "comes to me" soon...

A Confession

2008-04-02T13:44:00.000-05:00

The following post might be offensive to any devout sports fan.

This year I did not fill out a NCAA bracket.

Oh, it gets worse than that.

This year I have not watched a single NCAA basketball game.

Wait for it...

This year I do not even know who is in the Elite Eight, Final Four, or whatever level the tournament is at now.

Toad Strangler

2008-04-01T10:02:00.000-05:00

As the weather warms up to the level of palpable humidity that defines Mississippi summers, my goal is to start talking the Loo for her daily walks early in the morning before the heat sets up shop. This plan seems perfect, except for the early morning part. Needless to say, I won't be winning any "Early Bird Gets the Worm" awards anytime soon. This morning, however, was the exception. The alarm went off, and 5:30am, I'm out the door with Lanie in tow (or maybe more accurately with myself in tow, but let's not get stuck on specifics.)

The first thing I noticed was the occasional distant flash of lightning followed by low rumbles of thunder. "No big deal," I thought. "Lanie needs to learn to handle thunder anyway." And she was fine. Then, it started to sprinkle. So, we stopped in the middle of the road while I evaluated the situation.

Lightning. Rain. Metal choke collar.

We needed to head back home. No sooner than this thought had taken shape in my mind, the bottom dropped out. Every ounce of rain the meteorologists have been teasing us with for the last week fell out of the sky. The Loo hates the rain, and I'm fairly certain had I let go of her leash she would have headed straight home, but the fear of her just heading to the first carport and refusing to budge loomed in front of me. So, we jogged home, soaked to the bone.

I think maybe that was divine intervention telling me this early morning thing should be kept for the birds.

Makes Me Smile...

2008-03-30T10:18:00.000-05:00

A man in Topeka , Kansas decided to write a book about Churches around the country. He started by flying to San Francisco and started working east from there.

Going to a very large church, he began taking photographs and making notes. He spotted a golden telephone on the vestibule wall and was intrigued with a sign, which read "Calls: $10,000 a minute."

Seeking out the pastor he asked about the phone and the sign. The pastor answered that this golden phone is, in fact, a direct line to heaven and if he pays the price he can talk directly to God.

The man thanked the pastor and continued on his way.

As he continued to visit churches in Seattle , Dallas , St. Louis , Chicago , Milwaukee , and around the United States , he found more phones, with the same sign, and the same answer from each
pastor.

Finally, he arrived in Alabama . Upon entering a Church in Tuscaloosa he saw the usual golden telephone.

But THIS time, the sign read "Calls: .35 cents."

Fascinated, he asked to talk to the pastor, "Brother Jones, I have been in cities all across the country and in each church I have found this golden telephone and have been told it is a direct line to Heaven and that I could talk to God, but in the other churches the cost was $10,000 a minute. Your sign reads only .35 cents a call. Why?"

The preacher, smiling benignly, replied: "Son, you're in Tuscaloosa, Alabama now, home of the University of Alabama, Crimson Tide Football, The Million Dollar Band, Bob Baumhower's Wings, and Dreamland Ribs. You're in God's Country. It's a local call."

M3 Schedule

2008-03-29T13:43:00.000-05:00

It's finally that time of year when the administration has decided that we don't have nearly enough stress and things to worry about. It's time to make our our schedule for third year.

Now, this is a very complicated process. It is not as simple as signing up for the classes you want. There are 8 pre-set schedule options that one hundred plus medical students are vieing for, and names are chosen randomly for selection order. So a strategy must be chosen wisely. Do you rank the schedules in order of the most appealing to you? Do you try to plan around an upcoming event? Or do you try to swing being on the same rotations as your friends?

Any upperclassman has a bagful of tips, tricks, and advice to offer, but I truly think my sister gave the best. She told me, "Eh, don't worry about it. It's a crapshoot. You probably won't get what you want anyway, and you'll just have to make it work." (Not a direct quote, or she'd be suing Tim Gunn for her catch phrase...)

Saving Lives

2008-03-27T13:35:00.000-05:00

When I began medical school, I referred to any time spent doing related activities (studying, going to clinic, attending class, studying more) as "saving lives."

"Wish I could go out tonight, but I've got to go save lives."

"Yep, meeting with my preceptor this afternoon to save some lives."

The closer third year approaches, my attitude on this phrase is changing. First off, I'm not saving lives. Nowhere close. For example, yesterday in two hours with my preceptor I touched one patient. I did an eye exam on a normal 14yo AAM. Not only did I not even pretend to save that boy's life, I didn't even address his chief complaint.

Mostly though, I'm starting to see that in my contact with patients now and in my next year, saving lives is not my goal. I just don't want to kill anyone. If I actually manage to help somone, bonus, but I'm just hoping not to be the reason their heart/kidneys/lungs stop working.

So next time someone asks my what I'm doing, I am prepared to say "Trying not to kill anyone."

Pott-ah Parties

2008-03-25T11:08:00.000-05:00

Last week The Cutest Boy in the World was introduced to the world of Muggles, Quidditch, and all things Potter when we watched the first of the series, Socerer's Stone. He is addicted. In the past four days we've watched the next three movies. And tonight, we are joining the Canizaro's to watch the final released film, The Order of the Phoenix. His Hogwarts mania doesn't end there. He is already making plans for the sixth movie release and reading the entire collection of books. I've created a monster.... A basilisk maybe? Or a Norwegian Horntail?

Revenge of the Nerd

2008-03-23T11:20:00.000-05:00

I am a nerd. While most medical students were using last weeks as a mental and physical rest, ignoring all things medical, I went to the Our Body: The Universe Within exhibit in Mobile. This is where the proverbial "they" take real human cadavers and preserve them with polymers, allowing the public to view the inner workings of the human body.

Most visitors to the exhibit were in awe of the fact that the entire exhibit was composed of real people; I was amazed that "they" somehow managed to label the infraspinatus muscle incorrectly. Most people were grossed out by the sections of a body, showing you the relationship between the different organs; I was intrigued by the massive splenomegaly in that particular person.

In general, the exhibit was fantastic. It reaffirmed my love for medicine, the wonders of the human body, and my nerd status.

Still Breathing

2008-03-04T07:25:00.000-06:00

Just wanted to quickly report that the Loo made it through the weather and the drugs safely. It was morbidly funny to watch her stumbling around, eyes all droopy, and barely able to lift her own head like she had had too much too drink at the office party. But this morning she seems to be coming back to normal, if not a touch groggy. Of course, I do need to sign her up for an AA meeting.