Music Monday: My Favorite "Import" Bands

     Since I had so much fun working on my last post about music, I decided to try to make it a regular thing.  So, here is the first installment of "Music Monday."  This week I thought I'd tell you all about my favorite bands from other countries.  These are in no particular order.  Enjoy!

1.  KEANE  
     A great British band I learned about a few years back from listening to 92.5 The River, an independent radio station out of Boston.  Since their 2004 debut album Hopes and Fears, they've been releasing a new album every 2 years or so, with Under the Iron Sea in 2006, Perfect Symmetry in 2008, and, most recently, Night Train in 2010.  I've seen these guys in concert once, shortly after lead singer Tom Chaplain's stint in rehab, and it was a great show.  My favorite songs by these guys include:
          - Somewhere Only We Know
          - Everybody's Changing
          - This Is The Last Time
          - Is It Any Wonder?
          - Leaving So Soon
          - Perfect Symmetry
          - Stop for a Minute

2. COLDPLAY  
     Unless you've been living under a rock, you've at least heard of these guys, even if you haven't heard them.  They, too, put on a good show.  They have several albums out, and another slated for release later on this year (the first single Every Teardrop is a Waterfall is in rotation on most top-40 stations at the moment).  A few favorites from Coldplay are:
          - The Scientist
          - In My Place
          - Sparks
          - What If
          - The Hardest Part (I am, admittedly, not a big music video watcher, so I had never seen this one before... bizarre... watch it, you'll see)
          - Lost!
          - Strawberry Swing

3. MR. HUDSON  
     A rather good-looking, bleach-blonde guy.  He initially was part of a group called Mr. Hudson and the Library, but has since gone solo.  I actually prefer his stuff with "the Library," it's a bit more melodic.  His solo work is influenced by Kanye and over-uses TruTone technology a bit, but still has a few good tracks to it.  He is reportedly working on a third album (second solo album) as we speak, so stay tuned... Some faves of mine are:
          - Ask the DJ
          - Take Us Somewhere New
          - One Specific Thing
          - Too Late Too Late
          - Bread and Roses
     And from his solo work:
          - Supernova
          - White Lies

4. FRIGHTENED RABBIT  
     This group hails from Scottland, and they currently have 3 albums out: Sing the Greys, The Midnight Organ Fight, and The Winter of Mixed Drinks.  All are good, but I think The Midnight Organ Fight is my favorite (probably because it was also the one I knew of first).  Overall favorites include:
          - Good Arms vs Bad Arms
          - Keep Yourself Warm (this video isn't very good - fan made- so put it on, and go do something else while you enjoy the music, PS it has dirty words... earmuffs, mom, earmuffs!)
          - Modern Leper
          - Old Old Fashioned
          -Swim Until You Can't See Land

5. OASIS   
     Yes, I know, (What's the Story) Morning Glory? came out when I was in 5th grade (that's 1994 for the rest of you), but I still love it to this day.  Old school Oasis (ie before the Gallagher brothers decided they hated each other had creative differences and went their separate ways... the first time) is classic, and frankly awesome.  See for yourself by listening to some of my faves:
          - She's Electric
          - Some Might Say
          - Don't Look Back in Anger
          - Champagne Supernova
          - Wonderwall

And of course no list of "imports" would be complete without.....

6.  THE BEATLES   
     I'm wearing a shirt with their picture on it right now as a matter of fact.  They are nothing short of iconic, and groundbreaking.  Their music is timeless, and if you don't love and appreciate them, I encourage you to listen to this selection (because to list all of my favorites would take up an obscene amount of time) of my favorite Beatles tunes:
          - Eleanor Rigby
          - Norwegian Wood (if you know my brother, ask him what he thinks this song is about... go on...)
          - While My Guitar Gentle Weeps
          - Imagine (OK, so it's just John Lennon... ha, just.... but he's still an import, so I say count it)
          - Nowhere Man
          - Paperback Writer
          - A Day In the Life (my Dad used to wake us up in the morning by turning on the light and singing "get up, get out of bed, drag a crow across your head".... a parody of a line in this song.... so talented, my Dad)

Honourable Mentions:
     1. The Kooks - try Mr. Maker, Always Where I Need to Be, and Do You Wanna
     2. The Kaiser Chiefs - try I Predict a Riot, Never Miss a Beat, Everyday I Love You Less and Less, and my personal fave: Ruby
     3. The Arctic Monkeys -try Fluorescent Adolescent, and Cornerstone
     4. Ra Ra Riot - try Can You Tell

Whew... that ought to keep you busy for a while!  Happy Listening

     

The Great Eggplant Experiment!

When the little brother and I were in Europe this spring, we kept seeing Lebanese restaurants all. over. the. place.  Now, the US has its share of middle eastern and Mediterranean restaurants, but since we don't live in NYC or someplace really diverse like that (ahem... New Hampshire?), we had never seen, much less been to, a Lebanese restaurant.  So we decided we needed to check it out, and went to a Lebanese restaurant near our hotel in Paris.  For the most part, I have no idea what it was that we ate (other than knowing that my dishes were all vegetarian) with the exception of 3 dishes: hummus, tabbouleh and baba ghanouj.  I had never had baba ghanouj before, but it was delicious - like smooth, smokey hummus - and I quickly became obsessed.  Back stateside, I found a company called  that makes a really delicious baba ghanouj.  Unfortunately, their stuff can be hard to find in most grocery stores.  The always wonderful Wegman's has some stuff by Cedar's, but sadly no baba ghanouj.  Wegman's does, however, make their own baba ghanouj, but as I have mentioned in other posts, its second and third ingredients are mayonnaise and sour cream... gross!  I scoured the internet for a recipe, and a lot of them called for similar ingredients...but I ultimately found one for Hummus-Ghanouj which uses chickpeas as a main ingredient much like the baba ghanouj made by Cedar's and the authentic baba ghanouj we had at the Lebanese restaurant in Paris... so I decided to give it a try.
     Now, as much as I love vegetables, I am not a huge fan of eggplants.  They can be intimidating to cook, and if not done right are either too bitter, too tough or too slimy.  The first step of the baba ghanouj recipe called for roasted eggplant... um... I'm no weakling in the kitchen, but I was working with an alien food here... The recipe said to roast them in a skillet on the stove, but that seemed more like grilling to me, and I was worried that they would be done on the outside, but not all the way through, so I looked up how to roast an eggplant, and they came out looking like this:

Post-Roast... kind of reminds me of a pineapple...almost

Ok...good start, good start.  In the past I've had recipes that would have been made easier by a food processor, but were certainly workable without one, so I've never owned one (we never had one in the house growing up either).  For this recipe I really needed one, so off to Walmart I went.  They had a beautiful stainless steel KitchenAid one for $70, but as much as I love, love, love my KitchenAid stand mixer (thanks Mom and Dad!) and my KitchenAid microwave, there was no way I could justify spending that much on an appliance that I don't know how much I'll use.  So I settled a Black and Decker model for only $30 figuring "they're a respectable brand, it ought to work well enough."  Well, I was right - it does work pretty well - but it also causes hearing loss in the process!  That sucker is loud... like, left-my-ears-ringing-when-I-shut-it-off loud!

     The second ingredient in the recipe was Tahini - kind of a hunt to find, and honestly smelled pretty gross, but this apparently is one of those the whole is greater than the sum of its parts type recipes, and the end result was pretty tasty!

Ta-Da!  Doesn't look very appetizing, I suppose...

     Next time I'll probably go a bit lighter on the tahini than the recipe calls for, and I might try cooking the chickpeas a bit first to soften them up so the finished dish has a smoother texture; but not bad overall!
     But, the eggplant extravaganza doesn't stop there!  The only other context in which I have found I will eat eggplants is.... clearly.... eggplant parmesean.  As you can guess, smother anything in cheese and pair it with carbs, and I'm pretty much game!  There's an Italian restaurant/ sub shop around here that makes a delicious eggplant parm sub, and I've been craving it for a good week and a half now, but it's so unhealthy and I've been a bit busy with night float, that I haven't caved in to the craving yet.  But I did decide to compromise with myself, and try my hand at making eggplant parm at home.  This recipe is a little bit healthier - you bake the eggplant medallions instead of frying them.  I think this recipe is a keeper... although I think I'd use fewer eggplants next time - probably could've gotten away with using 1 large or 2 small eggplants, I ended up with a lot of wasted eggplant unfortunately.

In the pan... all layered up like lasagna

Plated with whole wheat pasta

     Most people like to enjoy beer or wine while cooking.  Apparently I am an 80-year-old midwestern man, because I was drinking sarsaparilla.  It's made by an organic, fair trade company in Maine, and they sold it at my medical school, but I found this pack in TJ Maxx here in Pennsylvania!

    

      As I was wandering around Wegman's trying to find where they might have stashed the tahini, I found some delicious treats in their international foods section.  I had been looking in this section for weeks trying to find these crunchy, chocolate-filled koala's that my friend Clara had introduced me to and hadn't had any luck.  Turns out they were probably there the whole time, they were just out of my (short) line of sight.

The koala on the left looks angry... I ate him first...

     I also found a new (to me at least) type of candy bar from Cadbury, that I obviously had to try!

     The inside tasted like a combination of honey and maple sugar candy - I had to eat it over 3 sittings because it was too sweet.... I know, imagine me thinking anything was too sweet!!  It was decent, but I'm not so sure I'll be rushing right out to buy another anytime soon.  I think I'll wait for what Cadbury does best: Creme Eggs!!

     Last, but not least, in the organic section (where I ultimately found the tahini) I found little packets of peanut butter-honey... I bought one thinking it might go nicely with some free graham crackers at the hospital as a midnight snack, yum!

Bonus: it's 93% organic!

Halfway Done with Night Float... this time around

     Finishing out this last week of night float means I am officially halfway done with night float... this time around, anyway.  I will have another 4 weeks of night float later on in the year, and more night float over the next 2 years as well.  I have to say, as hectic as the nights can sometimes be, I am really enjoying night float!  The trickiest part is trying to adjust to working all night and sleeping all day.  This is easier for a single, childless person like me than it is for some of my colleagues who work all night (catching a couple of hours of sleep at best if we are lucky) and then go home and maybe nap for a few hours before getting up to spend time with their significant other and child(ren) before heading back into the hospital for their next shift.  Some families come and eat dinner in our resident's lounge so they get to spend a little bit more time together during waking, daylight hours, which is really nice!  As much as I would love to be married and have kiddos of my own, not having to worry about anyone other than myself on my off hours is definitely an advantage during this rotation!
     Last Wednesday I left work at 7:00AM and had an appointment to get my car inspected at 8... by the time it was done and I was home, showered and in bed it was 11AM, and I had to get up at 4 in order to get ready and make it to work on time... needless to say Wednesday night I was pretty tired.  So imagine my delight when things quieted down around 4AM and I was able to catch a few hours of sleep before I had to get up for sign-out at 6:30!  Ahhh, that was a lesson learned rather quickly.  While it felt great to lay down and get some rest, it totally threw off my finely balanced sleep schedule!  When I got home and in bed by 8AM Thursday morning, I quickly fell back asleep... only to wake up in a panic thinking "oh no, I'm late for work, people are counting on me!"... I looked at my clock, only to realize it was only 12:30 in the afternoon, and I still had 3 more hours to sleep.... by the time my adrenaline level returned to normal I probably only had about 2.5 more hours to sleep.  Moral of this story - no matter how quiet it gets, I won't be sleeping on night float anymore!
     It's still strange to me that it's even acceptable to sleep while at work... or even watch TV for that matter (even though the only thing on at 3AM is infomercial after infomercial).  It also seems like there's some sort of time warp... I'm only at work for 14 hours on average, then I head home and it feels like there should be time to do more than just shower, sleep, and get up/ ready again, but if I want to get 8 hours of sleep (and trust me, my co-workers and patients want me to) then that really is all I have time for.  I'm just thankful I have time to sleep that much.  It does end up meaning that a lot of things get put off until the weekend (vacuuming, reading, catching up on TV, cooking, emptying the dishwasher).
     This week involved a couple more c-sections, evaluating more women to rule out labor, admitting on average 2-3 people per night, and seeing fake patients in the office to get used to using the EMR system.  We admitted three patients on Friday night and I'm anxious to go back to work tomorrow and see how things went over the weekend - one person had a pretty serious illness, one had a mysterious illness, and one had a whole lot of things wrong with him.... I'm interested to get updates on all of them!
     While on night float, my office hours are Monday afternoons, which means that tomorrow afternoon I have patients in the office prior to working overnight in the hospital.  Last week they were fake patients... this week they are very very real....eek!  I think I might be more anxious about this than about a lot of my other new responsibilities as a doctor (other than OB stuff, perhaps).  I've seen probably hundreds of patients in the office as a medical student, but that was as a medical student, where I could comfortably say "you know, I'm not sure about that, but I'll mention it to Dr. so-and-so and see what he thinks."  But now, I'm going to be put on the spot!  Patients can and will ask you all sorts of weird things... some cousin's boyfriend's accountant's son had X condition and now they think their kid will too... or they read about Y treatment on the internet and are convinced they need to try it.  I don't want to give them a wrong answer and seem stupid in front of the preceptor afterwards (preceptor = the attending doctor we run our assessment and plan by before letting the patient leave the office), but more than that patients sometimes seem to have an uncanny ability to remember really random shit you tell them and take it as the gospel truth (except, of course, the patients who forget what you're saying as you're saying it).  I have two fairly straightforward appointments booked for tomorrow - an adolescent physical, and a diabetes follow-up...fingers crossed no one asks me anything I don't know how to answer!  Also, here's hoping I can work with the EMR system without seeming like a bumbling idiot or like a rude jackass for not making enough eye contact while internally cursing the system/ willing the computer not to  start smoking!

What I'm Listening To

     This post is inspired by my aunt... when I was home I would always make her copies of my "Current Favorites" playlist... now that I'm 9 hours away, this list will have to suffice:

1. L.A. by New Vo Riche
2. Dust Bowl Dance by Mumford and Sons
3. Windows Are Rolled Down by Amos Lee
4. Anna Begins by Counting Crows (an "oldie but goodie" as my 2nd grade teacher would've said)
5. What You Know by Two Door Cinema Club
6. Helena Beat by Foster the People
7. Till the World Ends by Britney Spears (a guilty pleasure, don't judge!)
8.  Rolling in the Deep by Adele
9. Tighten Up by The Black Keys
10. On the Floor by Jennifer Lopez (another guilty pleasure, I like the lambada music sampled in this song)
11. In Every Direction by Junip
12. Wooden Ships by Crosby, Stills and Nash (try as I might to resist because my parents liked them, CSN is one of my all-time favorite bands... for those of you who need an education in the outstandingness that is CSN (and sometimes Y), might I suggest their "greatest hits" album as a good place to start.  You can find it here: CSN Greatest Hits)
13. Sway by Bic Runga (she has a beautiful voice and this song takes me back to highschool... for better or for worse)
14. .357 by New Vo Riche
15. Something Good Can Work by Two Door Cinema Club (their music is so much fun you can't help but want to dance)
16. Calgary by Bon Iver (sophomore album = just as good as the debut)
17. You Are a Tourist by Death Cab for Cutie

There are so many more songs out there that I think are fantastic and not to be overlooked, but this is just a sampling of what I've been listening to lately.  Writing this post was a lot of fun, so I think there will probably have to be more music-oriented posts in the future!  Enjoy!

Perfect Saturday

     Yesterday I was determined to make the most of one of my precious days off, and I think I did just that!  I got home from work at 8AM, and headed off to the farmer's market with two of my friends/ fellow residents.  We ate some delicious crepes for breakfast... this crepe thing is becoming a weekly habit!  I got banana and nutella again (they were out of pears this week, or I would've had a pear and smoked gouda crepe), one of my friends got peaches and cream, and the other got spinach, mushroom and gouda.... so many delicious options to chose from, and you can only get them once a week.  Actually, it's probably a good thing that the farmer's market is only once a week or I'd be super overweight, and I'm sure they're not good for my cholesterol either!
     After breakfast we wandered around and picked up some delicious things.  I got a tomato and an onion from one of the Amish stalls, and used it to make this:

Guacamole!  The picture doesn't do it justice...

     I had been craving some homemade guacamole all week, and fresh produce from the farmer's market was just the incentive I needed to actually make it.  Guacamole is something I learned how to make from my good friend and former roommate, Clara - and if I do say so myself I make pretty darn good guacamole, so thanks Clara!

     At the same stall they also had bunches of flowers for sale for only $3.50, so I picked one up to brighten my room since I don't get to see much of the outside world these days.

Please excuse the oh-so-fancy container they're in...

     I don't know much about flowers, all I know is they're pretty.  I didn't own any vases, so I just put them in a Holy Cross travel mug for the time being... classy, I know, but I rectified this later on in the day!

    At another stall I also picked up a loaf of broccoli bread.... weird, right?  I'm not a huge broccoli fan - I'll eat it because it's good for me, and I like cream of broccoli soup, but it's not something I'd willingly buy for myself and cook at home.  But make pretty much anything into a carbohydrate and I'll eat it... and if it's homemade, all the better!

Mmmmm....vegetable-y!

     I tried some, and it's actually really good.  It's sort of a dense bread, wheaty and doesn't really taste much like broccoli.  The stand I bought it from had many different types of bread, so I have a feeling I'll be trying them all at some point or another... they had a pretty excellent looking ciabatta bread....mmmmmm!

     By the time I got home I was pretty beat, so I crawled into bed and slept until about 5:30.  

     If you know anything about me, you know that Target is one of my favorite places - it has clothes, food, accessories, electronics, home goods - so since I got paid on Friday and had a gift certificate from my friend Lindsay, I headed off to Target!  Let's just say that I got there at 7:15, and by the time I left the sun had gone down...  I bought the first printer I've owned in over 4 years!  It's also a scanner and a copier, and though it's made by HP it was only $100, not bad!  I also got some cute shoes on clearance, picked up some vitamins, grabbed a birthday card, and a few other things...ahhh Target, I love you! 

     Since starting work I've realized that I really need a clock in my bathroom so that I can keep track of time while I'm getting ready (AKA so I don't end up rushing around like a crazy person with 3 minutes left to get my ass out the door on time).  Target to the rescue!  I bought a clock radio that is also an iPod/ iPhone dock... and it only set me back $30!  Score!

     After Target I headed to one of my other favorite places... Wegman's!  We don't have these "back home," and I sooooo wish we did, because they are incredible.  New Englanders: picture Whole Paycheck Foods, only reasonably priced, and with consistently fresh produce, and oven-fresh creative baked goods, bulk bins of pay-by-weight candy, grains, and nuts, and a huge serve-yourself buffet of Indian, Chinese, and American food.... heaven inside four walls!  The little brother gave me a gift certificate to Wegman's for my birthday, and I put it to good use getting the rest of the ingredients I needed for guacamole, as well as stuff to make Muddy Buddies:

Once again, photos don't do it justice!

     This is something I discovered thanks to my lovely friend Lindsay, and it is addictive (unfortunately enough for my waistline)!  I made a double batch when I got home, and I'll be bringing one of them to work with me on Monday... get ready folks!

     The rest of my night consisted of making said guacamole and muddy buddies, doing laundry and organizing a bit, and catching up on last week's episode of Weeds (thank you, DVR!)...nothing super exciting, but it was relaxing which is just what I needed.  Tomorrow I'll have to make an effort to hit the gym!  At the moment though it's off to bed - freshly washed sheets and a fluffed up feather mattress = heaven!

Night Float - Week One is Done!

     I was definitely a slacker on posting this past week, but I'll make up for it now!
     For those who don't know, Night Float is a system that many residencies have in order to decrease the amount of call residents have to take during the week.  Different family medicine programs do it differently: some have you do a week of night float once during a four week rotation of inpatient medicine, OB/GYN, and pediatrics...my particular program has one resident from each year (intern, second year and third year) work from 5PM to 6:30AM Monday through Thursday... same three residents each of those nights... and then the intern (that'd be me... intern = first year resident) also works from 5PM Friday to 6AM Saturday with two upper level residents who are on call that night.  This way, no other residents have to be on call during the week, and the night float residents don't have any duties during the day (other than one half-day of clinic) - in other words we don't go to things like morning report or noon conference.  This is so we can sleep during the day and not violate work-hour rules - as an intern, I'm not allowed to work more than 16 hours in a row, and I must have at least 10 hours off between shifts.
     The way my program structures it is that the third year resident on night float is in charge of inpatient adults, the second year resident is in charge of OB/GYN and inpatient pediatrics, and the intern does duties for both the adult inpatient and OB/GYN services.  In addition, the third year takes calls regarding patients in nursing homes covered by our residency, the first year takes calls regarding patients in the hospital as well as every other call that comes in from the answering service for our office and the offices of our preceptors as well as the prenatal center.  The second year takes the other half of those calls.
     Typically my nights have involved getting calls about patients labs, changes in their condition, needs for different orders, doing admissions, and going to any codes, deliveries and neonatal resuscitation there might be.  I also evaluate patients who come in to labor and delivery who think they're in labor/ their water has broken/ they're bleeding, etc. and I return calls from outpatients who have some medical question or another.
     There has definitely been a steep learning curve, and a lot of new responsibilities and systems to get used to, but I always have an upper year to consult with even the stupidest questions (to any upper years reading this: thanks for not outwardly judging me, even if you are rolling your eyes/ laughing on the inside).  But, at the same time, it's pretty awesome!  Not many people can say that they start their day off by delivering a baby.  And admitting patients to the hospital can sometimes involve doing a little detective work, which is always interesting.  And the patients themselves have some crazy stories, which can definitely be very entertaining!
     At this point I think I'm most comfortable doing admissions - I've been trying to step up my game in the transition from med student to resident and challenge myself to think critically and form assessments and make plans.  This is easier to do with admissions since I usually have the time to calmly sit and think (not to mention my senior resident guiding/ prompting me).  It's not so easy to do when nurses call from the floor at 3AM and say "Mrs. X's blood glucose is 250," or "Mr. Z's sodium is 125," or "So and so is in pain,"...or when a patient calls in and says "I'm having _____ (fill in the blank: contractions/bleeding/ discharge,etc) at _____ (fill in the blank again: 38/27/34) weeks...oh and I have this complicating factor, what should I do?" Thank God for upper level residents for those calls!  That's when I go into sponge mode and try to soak up as much learning as I can since I don't have enough experience at this point in time to always know what to tell people!
     I think one of my weaker areas is OB.  My OB/GYN rotation was almost two years ago, and since we were guinea pigs at the site I did my third year rotations we didn't always get called for deliveries, and patients weren't used to having medical students around, so it wasn't always easy to get to do cervical checks, or to see tons of vaginal deliveries, etc.  So now that I'm here and determining how far dilated/ effaced/ what station a woman is at during labor is kind of a new thing for me, and let me tell those of you who have never had the occasion to do one: cervical checks are hard!!  I'm sure some day - maybe 6 months from now, maybe 3 years from now - I will look back and read this again and struggle to remember the day when I thought of cervical checks as anything other than second nature, but for the time being I'm still in the everything-feels-the-same-in-here phase.... it's all warm and wet, and sometimes if I'm lucky I can actually find the cervix and take a stab (no pun intended!) at how dilated they are, etc.  It's going to take practice, practice, and more practice.  Meanwhile I'm sure my patients these first few months will be thinking "thank the good Lord and all that's holy for epidurals!"
     My OB-related responsibilities while I'm on night float are always my most challenging for several reasons: I lack experience in OB, and I'm always keeping in mind that deliveries can be dangerous, and I have not just one patient, but two.  There are a lot of factors to consider when working with pregnant patients both in labor and not: blood type, GBS status, how far along they are in their pregnancy....and so much more!
   
     Overall this first week of night float was a success (at least I think so!  hopefully the second and third years I worked with would agree and aren't out there thinking "wtf, who let this girl graduate from medical school!?").  I keep forgetting what day it is and that when I get home from a shift just because I've been awake and working and it's light out doesn't mean the rest of the world has: mail hasn't come, garbage men haven't been by, e-mails won't have been answered, phone calls won't have been returned.  And vice versa... while I'm sleeping the day away, a whole lot of stuff is going on!
     In medical school I used to lie in bed in the morning thinking "I'm exhausted and I don't want to go to work today," pretty much every day of most rotations (don't judge me!)... so far at least that is different now.  Yes, I still wake up thinking "It's time to get up already?!  But I just fell asleep!"  Only now I think "work is going to be really cool tonight and I'm going to learn so much."  I think that's partly to do with the fact that I'm more invested in my patients and partly because I love the people I'm working with and the program I'm at.
     Here's to a relaxing weekend off and a great second week of night float!

Birthday Love

     I know I'm a little behind the times, but it's been a busy week, so... better late than never!  Last Friday was my birthday, and so many of my family and friends (both new and old) helped to make it special.  I just wanted to say a quick, public Thank You to everyone who sent cards, texts, facebook messages, food, and good vibes my way!!  I really appreciate all the love!

Birthday cards brightening up my dresser

     One of the best things I received for my birthday was a drawing made by my cousin.... it's incredibly awesome, check it out:

She's quite the artist, yes?!

     So cool... there's a birthday cake to the left of the flower, but for some reason my camera kept cutting it off every time I tried to get it in the shot, sigh.... I'm no good with technology.

     I didn't do a whole lot on the day, as I mentioned in my last post I was working the overnight shift, but I got to eat some tasty food made by friends, and I got to hear from so many of you... and that's all I needed to have a great birthday.  Thanks everyone!

Out with the Old, In with the New

     I've been having a little squirrel problem.  I bought a bird feeder when I moved in down here, and the squirrels (one morbidly obese one in particular) have decided that it is, in fact, a squirrel feeder.

The "old" decidedly not squirrel proof feeder

      I never used to understand why my mom would get so irritated at the squirrels on her bird feeders.  I figured they were just as hungry as the birds and deserved the food just as much.  Well, now I think I might finally understand.  Those cute little bastards drain the feeder so fast I can't keep up!  Not to mention they seem to paw through the food until they find what they want and scatter the rest all over my porch... along with some "gifts" in return.  How thoughtful.  So today, I decided to try and do something about this little problem.
     I woke up at 4 this afternoon, and decided to make a quick run to Walmart to grab a few things before they closed.  While there I picked up what I hope will be a more bird-exclusive feeder.

     My iphone photo doesn't really show great detail, but basically it has a wire cage around the center column where the food is.  The cage has perches on it, and if anything heavier than a bird sits on it, the strategically placed decorative leaves slide down over the openings.  Hopefully it'll work, and the birdseed in it will last for longer than a day.
     As I mentioned in my last post I picked up a new hanging basket at the farmer's market yesterday to replace my sad old dying one.  It's just a simple basket of white impatiens, but at least they're alive... for now!

     Happy 4th of July everyone, I'll be celebrating by sleeping until 4 or so and then heading into the hospital at 6PM for another crack at this whole doctor thing!  Enjoy the festivities, but be safe - just remember that a lot of hospitals are crawling with brand new docs this time of year!


UPDATE: The squirrel not only figured out how to get food out of the new feeder, the little bastard broke the damn thing!  So much for that idea...back to the drawing board.

Night One... Check!

     I survived my first night of night float...and as far as I know, so did all of my patients!  All-in-all it wasn't too bad, thanks to the support and patience of the two upper level residents who were stuck with me I was working with.
     We got sign-out from the day teams at 5:30ish, and were able to eat some dinner before getting any calls.  Sign-out is where the teams caring for the patients on one shift tell the incoming shift all about why that patient is in the hospital and what the management plan is for them, they let the incoming shift know about any potential calls they might get about the patient/ any issues they are anticipating, and things they need to check up on (labs, etc.).
     One of the residents that I was working with last night typically brings in a homemade dinner when he's on call to share with the team - I've had his wife's cooking before and it is excellent, so I was super excited to learn that she had made one of my favorite meals....so delicious!  Also, since it was my birthday, one of my great friends baked me a nutella pound cake!  It was outstanding!
     Eventually it was time to get down to business, and we headed to the ED to admit a patient for chest pain.  I definitely felt a little rusty, and it can be hard to focus in the ED on a Friday night - it is SO noisy down there! - but overall the history and physical portion went OK.  Because of the noise level we headed upstairs to finish our notes.  I entered the entire set of orders with my senior resident's help - my first time using a computer order entry system - and those of you who know me and my track record with technology (computers in particular) will know what a miracle it was that the computer didn't burst into flames just for the mere fact that I was in the room!  I was able to find the right things to order, and customize them to what we needed, and get them signed without incident... but I later found out that this is not always the case (more on that later).
     I tackled another first last night as well - my first dictation of an admission history and physical - I think it went OK, but we'll wait and see how it turns out once it comes back from transcription!  That'll be the real test.
     Afterwards, we went around and took care of a few items on our to do list such as following-up on a patient's blood glucose reading after their dinner, and personally checking a patient's heart rate to make sure their beta blocker dose was sufficient.
     We then went back to the residents' lounge where I answered a few pages about questions on our patients from the nurses taking care of them.  One nurse called to say that one of our patients had a headache and wanted to know if she could give him some Tylenol.  I checked to make sure that he didn't have any conditions or medications that would make it unsafe to give him Tylenol, and double checked with my upper level to make sure she agreed (I know, I know, it's Tylenol for God's sake!) and then put in the order.  About 20 minutes later I got a call from the nurse again saying that I had put in an order for rectal Tylenol and was that what I really wanted?  Whoops - damn you computers, messing me up yet again (I suppose it's revenge for all the computers that haven't lasted longer than 2 years under my ownership).  Go ahead and laugh at me, I laughed at myself, and I'm sure all the nurses on that unit were (and probably still are) laughing at me too!
     Later on I evaluated a lady to see if she was in labor (she wasn't) and then sent her home.  Around 2:30 all three of us kind of hit a wall and decided to try and get some rest...that didn't last long.  We got a couple of pages about labs, and then around 3AM I got a 911 page from labor and delivery.  Nothing, and I mean nothing, will get your adrenaline running at 3AM like a 911 page from L+D.
     Last we knew there was no one in labor on L+D (our patient or otherwise), so we bolted upstairs to see what was going on.  A lady had come in in active labor, but was a patient at another health system so we had no information about her, and she didn't really know much herself other than that she had had several previous C-sections.  Not exactly a candidate for a vaginal delivery so we called in the on-call OB/GYN and I got to scrub in to be first-assist on my first emergency C-section.  There are a lot of details that I'm not at liberty to share on here in order to protect the privacy of the mom and the baby, but suffice it to say that if a patient could have a condition to make delivery high-risk for both mom and baby - this lady had them all.
     I am not ordinarily a fan of being in the OR, and scrubbing in on such an emergent case on my first night as an intern (and at 4:30 AM no less) definitely had me feeling the heat!  We got baby out, and I was so focused on my job at hand that I didn't even notice if it was a boy or girl!  It had been a long time since I'd seen a delivery of any sort - c-section or vaginal - and it was really amazing to be one of the first people in the world to see a brand new face for the first time, I had forgotten how cool that feels.
     By the time the surgery was completely over and we had finished up on labor and delivery, it was almost 6 AM, and time to sign out to the day team (sign out on weekend mornings is at 6 AM, and on week days it's at 6:30AM).  I was so exhausted at that point, I'm sure it's going to be hard to do that 5 nights in a row - but hopefully not all nights will have such a dramatic last half!
     I went home and took a shower, and forced myself to stay awake until the farmer's market opened at 8:00 and went and got myself a delicious banana and nutella crepe and a new hanging plant for my porch (the old one wasn't looking so hot).  I got home and gratefully collapsed into bed at 9AM, and didn't wake up again until 5:30.  It's definitely disorienting to flip my schedule completely around and become a night-owl.  Even now at 1:30 in the morning, my body is confused - my mind knows that I've only been up for 8 hours, but because it's dark outside (except for the lightning from the thunderstorm that keeps making my lights flicker) I feel like I should be in bed.  Also, since so much of my waking hours for this rotation are when most other people are asleep, there's not much for me to do except watch TV and read - kind of boring and isolating, but at least my gym is open 24 hours a day, 7 days a week (not that I'm going anywhere in this storm)!  I feel like things could go two ways on this rotation - either I'm going to gain a bunch of weight because I'm eating catch-as-catch-can and probably not going to go to the gym as often as I would  normally, or I'm going to lose a bunch of weight because without being on a normal meal schedule I'm only eating when I feel hungry, not because the clock tells me I should.
     I'll keep you posted on that, and on whatever else this rotation brings - the hospital can either be eerily quiet at night, or (like last night) completely insane!