Something I wish I could say to people almost on a daily basis...

I wish this actually turned out this way...

I am crazy in my own way, have soo many quirks about my personality, overthink just about every situation, am incredibly awkward with men, and am almost impossible to handle at times. BUT...that's me :-) If only i could say this all to a guy and have it end like this lol...







"I'm selfish, impatient, and insecure. I make mistakes. I am out of control and at times, hard to handle. But if you can't handle me at my worst, then you don't deserve me at my best."- Marilyn Monroe

kind of cheesy...

So I love this song although its kind of cheesy and corny unlike my usually cynical self. And this video I found with it just makes it super cheesy, but I love it! I have my moment of weakness/girliness from time to time lol

I've decided...

Today was my first day of pediatrics in Surprise, AZ. I wasn't sure how I was going to  like it but after today I've decided I LOVE LOVE LOVE the kids...but I can't stand their high maintenance moms. I have always loved kids, all ages, EVEN the criers. I know I'm not seasoned at all in medicine but I do have days where I absolutely hate adults.  I hate it when all my efforts to try to help are wasted on people that don't listen to you, only do more damage to themselves, and don't even care to get better! Granted, I understand that everyone deserves unconditional help, even at their lowest points.  But some days its incredibly hard to  help people that won't help themselves. So, today when I walked into my first patients room, a 5 yr old well child check, and he ran to me, hugged my leg and told me he loved me, I decided I love the kids.  It happened several times today and I was shocked how much I absolutely love being around them for this reason alone. Without knowing who I was, without ever seeing me before in their lives, they trust. They're so pure, they want to feel better, they don't hate you for trying to help them. That being said...I'm not such a fan of the moms. I just can't seem to grasp how you can actually dial 911 because you're child has a cough and spit up...really?!?! I can understand (to an extent) that motherhood is something amazing and your love for your baby makes you over worry, over react, etc...but does it make you an idiot? (sorry if that was insensitive) But is it really necessary to cry because your child sneezes 2 times in one day? (yes all these things happened today.)  On the other hand, there are the moms that bring their kid in because his eyes look "weird"...and he actually ends up being diagnosed with congenital glaucoma, also happened today.  And then there are the moms that refuse vaccines because they don't want their kids to have autism...I guess your risking measles is a better choice...."i read it on the internet..."   People are very strange and different and I will never understand why people do the things they do. Regardless of the crazy parents, the kids are worth it.

On a cooler note, I got to do a circumcision today! It was pretty cool except for the part where the dad almost passed out. I guess they feel it in a different way than I do lol.

So we'll see how tomorrow goes. I'm starting to like the idea of pediatric emergency medicine, that would be pretty sweet.

Vacation is over...back to my crazy normal life!

The 2 weeks I spent at home went by at a good pace this time. Usually I complain at how fast the break went by and that I wish i had more time. Maybe this break was just right because I actually let myself relax and not feel guilty. When I come home I find myself running every single day, making sure I see everyone so they don't get mad, doing something productive with school, etc. I just relaxed, still ran a lot (that i can't stop), and didn't feel guilty for sleeping in past 8am. Also, this break was different because of things that happened.  I ruined my brother's engine in his 3 month old car (it was an unavoidable accident, but still sucks a lot) and had a couple big disappointments with friends/family. I definitely enjoyed the break  and the chance to recharge but it was somewhat emotionally stressful. I learned some pretty good lessons about family and friends when I wasn't busy trying to fix the mess i made with the car, only I can find a way to lock up a BMW engine with water, awesome.

I also got to see some friends from college that I hadn't seen in 4 years. Went to two of my very close friends' wedding yesterday in Pensacola and had a great time. The wedding was awesome. I'm just really still getting used to the fact that most of my friends are married or engaged.  Is it really that time already? I'm going to be that 50 year old lady still swearing that I'm too young to get married haha. I especially love it when I ask my family what their new years resolutions are and they say "for you to meet a nice boy and get married"...nice. Maybe they don't understand the concept of new years resolutions.

It's also scary how fast 2009 went by! It was a good year for me, mostly because I got out of Kirksville and moved to Phoenix and because I'm finally doing what I love...in a hospital! I remember for so long thinking that rotations were way down the road for me. And now knowing that I have to start planning for residency, and finally being a doctor (although i may still feel like i know nothing) is pretty unreal. 2010 is going to be awesome and I really want to take advantage of my last year of "freedom" and travel for my rotations. Hopefully I can land a rotation in Colombia, Hawaii, and possibly NY.

But anyway, normalcy starts again tomorrow bright and early with screaming kids. (Pediatrics rotation starts tomorrow). I really love kids but I don't know how I feel about being their doctor, we'll see. It will either leave me wanting to have kids soon or never wanting kids...either way, it should be interesting.

The highlights of my surgery rotation at Maricopa Medical Center aka "da copa"

I've been meaning to post this but I always forget!

So for the past year I've kept a little notebook of thoughts/quotes/ideas/tricks that I learn on each rotation. I write down things, not really notes, but things that I learn from and go back to. Whether its a new enema recipe that I hear an old doc talk about that works every time for ileus or constipation(yes this is cool to me), or a moment that I really don't want to forget, or just some funny quotes from patients, I write it down because I want to look back years from now and hopefully bring back some humility. I want to know that even if i gear towards being a "know it all" doc or even somewhat cynical, i still can remind myself that I was not so savy once and to not lose sight of the little things that really matter and where I really started. Ok so anyway, this post is just to share some of those quotes that i wrote down....

In the ER:

Chief complaint- testicular pain/infection
Pt with testicular abscess: "Doc I'm pretty sure one of my hoe's gave me the shit!"
Me: "We're talking about your testicle right?"


Chief complaint- possible small bowel obstruction
Me: "Do you have any history of high blood sugar or do you take insulin?"
Pt who is barely awake: "no, i've never been sick"
Pt's brother: " She's been great, her sugar was a solid 379 this morning, like it always is"
Me: "........."

Chief complaint- rectal bleeding
Me: "has this ever happened to you before?"
Pt who is clearly is too high to remain awake: "oh no, i'm very healthy, not one health problem"
Me: "hmm, what color was the blood?"
Pt, awake again: "oh here, i saved a clot for you so you could see it!!" [shoves tissue with blood clot in my face]
Me: [trying not to vomit] "that's ok, i really don't need to see it....."
[I stepped out after doing her physical and read in her chart that she has HEP C, she's MRSA+, and positive for every illicit drug on the planet almost. Nope, not one health problem!!]


On the Med Surg Floor:

Chief complaint: leg abscess
Pt who made it through the ER fast because she was demanding surgery on her leg abscess: "Hey doc i just need you guys to go in and drain my site, it's infected again, and it's my only site left"
Chief resident: "Site? you mean your shin?"
Pt: "yea if you don't do it tonight I'll go through withdrawals again, that's how I wound up in the ER, and I really don't like shooting up in my neck"
Chief resident: "ok well thanks for your honesty!"

S/P diverting loop colostomy
Me: "how are you doing this morning? how is that colostomy coming along?"
Pt with Stage IV colon cancer: "well, if i have to have to wake up to talk to people about my shit at 5am, I'd rather it be with pretty girls like you, at least I know if this doesn't scare you away, I still have hope"
Me: "It takes more than some shit in a bag to scare me away..."
Pt: "well I've got a lot of shit..."
[he was my favorite patient] :-)


S/P perineal reconstruction with abdominal flap and total proctocolectomy aka a huge operation and she almost died
Pt, 3 days out of surgery: "I'm going to be fine, don't worry"
Me [almost in tears that she is comforting me, came to tell her it was my last day of the rotation and I wouldn't see her again]: "It's my last day with you, but you have the best doctors taking care of you and you're going to do great"
Pt: "thank you for taking care of me, never give up, I love you"
Me: [balling my eyes out like an idiot]


Presentation in weekly Morbidity and Mortality conference [ this is where interns and residents present cases that had a negative outcome due to a preventable reason and they get torn a new one by the attendings, very scary]
Dr. O: [presents a case about a pt who had a tear in his esophagus repaired, and then had to return to the ED because the repair failed and tore open again] "the failure of the repair was due to the patients diet immediately post operatively"
Dr. G (an intern, not the sharpest tool in the shed): "actually, It wasn't Dr. O's fault, it was mine. I gave the pt a sandwich the following morning and asked him if it hurt. He said no, so I thought it was fine."
Attending Physicians: [first silence....then the lions unleashed and attacked poor Dr. G]
Dr. G: "...but it wasn't the whole sandwich, he just had a couple bites!!!"
*note to everyone- if you have a hole in your esophagus and then have it surgically repaired...DON'T EAT A SANDWICH THE NEXT MORNING!!!
*note to self- do not yell back at  your attendings when they are yelling at you during M&M...they WILL kill you. And if they don't, your fellow residents will.


So those are just a few of the quotes/moments from my rotation that I wrote down. It wore me out, made me cry, made me feel like I was dumber than a pre-schooler at times, and made me feel stronger than I ever imagined other times. It really is crazy how far we've come but even more crazy is how much more ground we still have to cover. I don't think it ever ends. Actually, I hope the learning and pushing limits never ends. Oh yea, and saving lives is pretty dang cool too...

I look at people's butts before 5am...

So it's been a while since I've written anything in my blog. I've been really busy! General Surgery at Maricopa Medical Center in downtown Phoenix takes up about 16 out of my 24 hrs in the day. Although I have to wake up at 2:45AM every day, drag myself out of bed, smell cauterized flesh and colostomy bags before breakfast, endure heartburn from endless coffee and no food until about 3pm...i'm loving the rotation! At first I was really unsure if I would enjoy it at all because I really didn't think I would enjoy surgery. I'm always cold, i can't stand for long periods of time, and I lose interest in a case after 2 hours, maybe that's just my ADD. But to be honest, it's been great. I love the satisfaction that you, the surgeon, are the one that does the final intervention. And it's not that I like the whole "I'm God" feeling at all, i think i have an aspect of my personality that wants to fix things...and as a surgeon, you do exactly that with your hands. But at the same time, I don't know that I like surgery enough to want to endure the residency/lifestyle. If I did do surgery, trauma surgery would probably be where I'd go, but that's just insane (which I am at times), but i'm still leaning towards ER, just ER.

So far i've learned so much on this rotation. Def learned stuff about medicine itself, but mostly I've learned about dealing with people. This is hospital is so big and busy all the time, people in the OR just move at a faster pace i think, well my team does. In the midst of all the bustling and million things that need to be done I've found myself easily forgetting about the patient itself. People are always paging, calling, ordering, yelling, etc. They always tell us in school to have compassion, sensitivity, always treat the patient how you would treat family. And i've always just thought "oh yea well duh, i'm not a jerk, i'm never going to forget to have compassion, etc etc etc..." But in the past 3 weeks alone i've had to catch myself and actively think to do all of those things they tell us in school. I find myself in the OR trying to get op notes, admit orders, set up the meds so fast so I can be more efficient and move on to the next case without delay. That's fine and all, but today I realized that i was just falling into a routine. A routine that really didn't include, make sure patient isn't afraid, and look for the little things that make a big difference (warm blankets, reassurance right before/after anesthesia, etc). When i'm in lecture its easy to say I'll do all of those things. But when you're in the OR and in that environment, I can see how people easily lose that aspect of medicine. I'm going to try my best to realize that now is the time to form the right habits and that no specialty is too busy to do the right thing and go that extra mile for the people we take care of.

On a more inspiring note, I almost cried today in front of a patient. Ms. AC is a 55 yo lady who weighs about 80lbs, has crohns disease with active colitis, the beginnings of colon cancer, and severe perirectal fissures and abscesses. She's in so much pain that she can barely move when I see her at 4am everyday. She gets food by IV in addition to normal diet because she's so malnourished. Her eyes are sunken and her arms and hands are just bones with red nail polish. She is a very sick lady, but also one of the sweetest people I've met in a long time. She will most likely need her colon removed along with the region of skin and muscle around her rectum and will need subsequent reconstruction of her anal canal, and chemotherapy, which may only make her worse. She has a very rough road ahead of her. All that being said, I went to see her today in the evening before I left to explain the surgery plan. I explained the entire extreme plan, the risks, possible consequences which, to me, makes me cringe just thinking about the recovery and overall outsome.  And after I got done telling her what seemed to be like torture, all she said was this "vayamos todos adelante, nunca para atras".  It means "let us move forward, never backwards".  Even after I told her that she mght die from the surgery and treatment to try to save her life, she just smiled and still was positive. She then said "I could cry, but for what?" I felt the tears sort of welling up in my eyes as I just looked at what almost looked like a skeleton smiling back at me. I was thinking "i hope that I one day have as much strength as this lady". It's remarkable how some people are resilient beyond belief and no matter what, remain hopeful and strong throughout. They're the ones I really love to serve everyday. And then you get those people that don't appreciate anything you do, only complain, and make decisions to worsen their condition everyday. I don't think I'll even understand it and it really frustrates me. But if for every 20 frustrating patients, there's just 1 patient like Ms. AC, that's good enough for me.

So, my surgery rotation is awesome overall. I'm amazed my the dynamics of personalities, perspectives on life, and just plain old social skills that some people lack. But more than anything, I'm learning that no matter how big, how smart, how awesome I think I am, I will never be above doing the little things, i guess it's that extra mile that really matters in the end.

Bed time for me...i have bellies to push on and colostomies to check in the morning!!!