A.W.O.L.

I went a little nuts today. It is no surprise to anyone that I have been a little stressed out by this whole lack of a job come July thing. I have been trying the whole brave face thing, but my better demons definitely did not win today. I blame a slow day at work. We only had one case this morning, so my entire day was finished by 9 am. I should have finished a couple of chapters that I am writing, studied for my boards or read the stack of articles on my desk. Instead, I sat down at my desk and freaked out.

I made the mistake of looking at a calendar to see when I was next on call. I then realized that in 3 short days it would be March. In my head, I had plans to be filing for privileges at whatever hospital I had decided to grace with my presence. Instead, I still don't even have a solid lead on a job much less offers. I honestly felt that my head was going to explode.

As a diversion measure, I decided to call and schedule a massage. I had promised myself one as a diet reward. When I went to set a date, I asked when was the next available appointment. I was hoping for an opening this weekend. Imagine my shock when she said they had an unexpected opening today at 12:45. I didn't think twice - I took it.

Then I got really nuts. I left the hospital. I didn't talk to anybody, make sure things were covered, and nothing was going on with patients. I just left. Absent Without Official Leave. I did keep my phone with me, but usually would have put a lot more effort into being available and making sure everyone knew where I was.

It was exactly what I needed. I can actually shrug my shoulders again without a searing pain in my head (I carry my stress between my shoulder blades.) After the massage, I decided to continue the destressing with a little retail therapy. As I am still on a budget, and have no job, I only ended up with two purses on great sales, but I had a very nice time. I looked at two really adorable denim skirts that were very tempting. However, the idea of having to tell Kris that I bought another denim skirt was scarier than their prices so I left them both at the store.

All in all it was a nice break with reality. Now back to the drawing board for the job search.

Flashbacks!

There is one book almost guaranteed to make any person that has ever been to medical school pale. It is West's Respiratory Physiology. And yes, it is as boring as it sounds. It is also incredibly complicated and way over the head of almost any medical student that doesn't have a Physics degree. I recall too vividly the hours I spent trying to understand that book. I even had two versions, the "real" book and the essentials (basically the Cliff notes version). I couldn't make heads nor tails of either.

As we all know, respiratory physiology is somewhat important in my line of work. I have thought about rereading West's over the years, but the sinking feeling in the pit of my stomach wouldn't allow me to pick it up. However, I have a lecture tomorrow on Pulmonary Physiology. Therefore, I decided to conquer my fears and make peace with West's. Ten years have passed, and I like to think that I have matured and learned a lot in those years, but I still don't get this book. I mean really, wouldn't English have been a better language in which to write it? Okay, I will not let this book win - back to the beginning.

Sick and Single

Despite my occasional grumblings to the contrary (see Valentine's day), I actually still enjoy being single. I think to be a good girlfriend, wife and/or mother requires a certain amount of selflessness. The ability to inconvenience yourself for the convenience of others - all the time. I am not even close to there. I am not even in the same zip code. I hope to be there some day, but I am able to recognize that I am not yet. A part of me still secretly becomes frustrated when my friends can't "come out and play" at the last minute. Stories of spouses being late from work, dinner needing to be prepared and children needing around the clock supervision confound me. Don't get me wrong, I understand the irony. I have the worst job on the planet for making plans, but who is surprised that I want my cake and the ability to eat it too.

That being said (and hopefully not alienating all of my friends) - I HATE being single and sick. The odd thing - I am not looking for someone to "take care of me." I get quite pathetic and grumpy when I am sick and should best be left to my own devices. I hate being sick and single because there is no one to call the ambulance. Perhaps it is knowing too much, over thinking, or I concede I am just nuts, but every time I am sick at some point I convince myself that I am dying. I actually go so far as to figure out how it is going to happen. My imagination can then picture my decaying body alone in my apartment for days before anyone even realizes that I am dead. (I admit a certain inclination for dramatization.) The only thing missing is the cats (sorry - still don't like cats even if they would work well for the scene.)

Needless to say, I am feeling better. At least no longer convinced that I am dying. Back at work today although because I am truly feeling better or was becoming bored out of my mind at home I can't honestly say.

Felled by the flu

It started yesterday afternoon. I had been sitting on the couch for most of the day watching television. I had a whole list of things I needed to be doing, but couldn't get the energy to do any of them. I was wrapped up in several blankets and had the temperature turned up to 75 degrees, but still couldn't get warm. Then, the fevers started. Next the body aches. By this morning, even my toenails hurt. It felt as if I had been run over by a bus.

As much as it kills me to admit it, I am fairly certain that I have the flu. I had it once before (my fourth year of medical school). Since that time, I have been very careful to get my flu shot each year. If you have never had the flu, I can't say that I recommend it. It mostly feels like an enormous effort is needed to just breathe. The shot has worked until this year. Ironically, this is one of the "good" years - where the shot actually covers the flu strains that are out there. So much for modern medicine.

Cupid

Did I ever mention that I am not a huge fan of strange child like creatures that walk around with bows and arrows? I mean - that can't be safe. What about the whole putting an eye out thing? What type of message are we sending to children? Okay, perhaps I am just a bit bitter today - Valentine's day - that I am spending alone in a cold city with no one to snuggle up against. Will hopefully be better tomorrow.

Nuts!

I have always been a big nuts person. Notice that I did not say that I have always been a bit nutty, although that point is probably debatable. I love nuts of any kind. My favorite is probably cashews, but it doesn't top the list by much. I even recently learned that I even like Chestnuts (which I personally don't think technically qualify as a nut, but I digress). I had never given it much thought until the recent peanut recall.

I had only caught snippets of the recall. A short snippet on CNN or on the computer. However, Monday as I sat down at my desk to have a snack, I became more interested. I tend to keep protein bars in my desk for snacks and quick meals when I am having a busy day. I have a low boredom threshold as we all know so I tend to keep a variety. As I pulled out my Luna "Nutz over Chocolate" bar Monday, I had a brief thought about the peanut call. I am not sure why, but am so glad I did. I decided that it would be smart to make sure that my "healthy" snack wasn't going to give me Salmonella.

Good thing that I looked. Not only was that brand part of the recall, the particular lot that I had was thought to be potentially contaminated. So much for my snack. I then proceeded to look through my work stash. Every single bar that I had in my desk contained nuts and was on the list! Since I have been eating on these bars for a while, a part of me rationalized that they were probably okay. Then saneness took over and I tossed them all in the trash - better safe than infected. When I got home yesterday post call, I decided to go through my pantry and throw out anything that was "on the list". I had quite a few items. Turns out I am a sucker for anything with a nut flavor. Just happy that I didn't end up getting sick. Time to try the Lemon Zest bars.

Genetics?

I enjoyed genetics in school. It all seems relatively simple. You have two parents that each contribute one gene to each trait. On the surface, it even seems to work. My brown eyed dad and blue eyed mom have one child with brown eyes and one with blue. Of course, my sister somehow got my dad's long eyelashes to go with my mom's blue eyes, but I'm not too bitter. It would seem that we should all be a perfect combination of our parents. I may have gotten my dad's eyes and the "Baxter" round face, but anyone that has ever seen pics of my mom at my age will agree that all the rest of my features come from her. I also am 4 inches shorter than my nearest in height parent - where are the genetics there. And don't even get me started on how my friends Kris and Bassam have a blue-eyed son or a red haired daughter!

This whole genetic rumination started today in the gym. I have decided that I have a congenital absence of deltoids. I have pretty good upper body strength. It is a combination of having to position patients at work, and preferring upper body workouts over lower body ones (what seriously depraved person invented the squat?). However, I have never had strong deltoids. I can complete full sets of curls with 15lb weights, bench press 50 lbs, but I am still doing 5lb military presses and struggling. We won't even discuss my poor lateral raises. Is it possible that I was born without the requisite triad of muscles that make up ones shoulder? I watch TV and salivate over Kelly Ripa's delts and one of my favorite movie scenes is the dance in American President - Annette Benning's shoulders are to die for. It is even more frustrating to read everywhere about how the deltoids are the "easiest" upper body to build. On what planet?

Sorry, but I am no longer convinced that Gregory Mendel guy had a clue.

Catch Up

Sorry - don't worry I didn't freak out about the 10 year thing and go crazy. (Okay, I did kind of freak out, but that isn't why I haven't blogged, and I would argue that I went crazy years ago. ) Life just got a lot busy, and I have been spending time learning lessons.

Lesson: Snow has good and bad points. Allow me to explain. It had snowed here several times already - at least by my definition. You have to remember that back in Georgia snow flurries if only seen briefly by a street lamp constitute a snow storm. The 3 or 4 snow "dustings" that we had gotten here already certainly qualified as snow in my book - at least they did. Wednesday last week, my definition changed. The word started spreading late Tuesday. Snow was coming - the real kind. Not exactly sure what to expect, I set my alarm clock early so that I would have extra time.

When I woke up that Wednesday the entire world was white. We had received 6-8 inches of snow - OVERNIGHT!. Needless to say this was an entirely new experience for me. I had unfortunately parked my car the night before on the roof of my parking deck, so I got to start by pushing snow off my car. After a treacherous drive in - Georgia drivers should not be allowed on Philly streets in snow - we had a fairly busy day. I had expected none of our patients to show. The roads were much clearer for the drive home, and then it got COLD. We didn't see a day out of the 20's until this past Tuesday. The snow melted a little and then overnight we got 2-4 more inches.

Freshly fallen snow is quite beautiful, and there is something breathtaking about looking out over a city or old university covered in snow. It also is warmer when it snows. The really cold weather seems to come right before or after. Besides the obvious driving issues, snow just gets very messy. Grey slush on the streets and sidewalks is not attractive. Snow bluffs covered in debris also not attractive.

Lesson: High School Students are "special". I was on call last Thursday (as I am this Thursday), and it was a truly horrific night. Up the entire night save about twenty minutes with patients trying to actively die. As part of my new volunteering kick, I had agreed to speak to a group of high school students in a Medical Occupations class on Friday. I went with one of our OR nurses who happened to have a daughter in the class. Not to pat myself of the back or anything, but I do fairly well sans sleep up to a point. The students came very close to that point.

The first part of the class was harmless enough. We simply introduced ourselves, and talked a little bit about what we do and how we came about doing it. Then we opened the room up to questions. Most of them were pretty predictable and standard, but there was one girl who was way out in left field. Her first question to me (I guess as a warm up) was about my accent. I had already admitted to being from Georgia, and had even commented that this was my first "real" winter. Her question was how did I turn my accent on and off and when did I decide to do so. Huh?

I wasn't even sure how to answer, and then they got worse. I had been asked about how I decided to become a surgeon. I told a story of "my" first case as a medical student. It was a butt abscess in an HIV patient, but I loved it. The question that I was then asked by the left fielder - "Do you think that it makes you disturbed to like to cut people?" This was then followed by a question regarding dealing with the "arrogance of surgeons." I gave laughing answers, and then made a point to ignore her hand for the rest of the time. Give me homeless people any day over high school students.

Lesson: Money is not everything. Bet you never thought you would hear me say that statement. Last weekend I had the opportunity to pick up a couple of NP shifts in the cardiac surgery ICU. I thought, how hard can that be? They write a few orders, pull a few tubes and transfer patients to the floor. . . plus it payed $100/hr. The plan was 6 hours on Saturday and 4-6 hours on Sunday. Reality was 11 hrs on Saturday and 13 hrs on Sunday.

Turns out when you moonlight in your own facility, they don't buy the whole "I'm just the NP" argument. We also had a unit that the wheels had fallen off of. They had 5 cardiac rooms running last Friday night with emergencies. They all were still incredibly sick on Saturday and a whole new group got sick on Sunday. I have never worked harder in my life, and that includes during my internship. I made a ton of dough, but it was no where close to worth it. I may feel differently when I actually see the money and have had more time to recover, but I am not certain.

Lesson: Be careful what you ask for. I had complained recently that we weren't doing enough cases. Well, this week fixed my little red wagon. I have pretty much gone home each night, crawled into bed and woke up 6 hours later to come back in to work. I am post call tomorrow and have the weekend off. I currently plan to sleep for a good portion of it. Time not asleep may very well see me on the couch imitating a potato. I will happily guarantee that nothing productive will come from this weekend.

Well, I think that is the majority of my lessons. I am long winded as usual, but what else is new. I will leave you with this really cool quote I found in a magazine recently.

"Finish each day and be done with it. You have done what you could. Some absurdities have crept in; forget them as soon as you can. Tomorrow is a new day. You shall begin it serenely and with . . high a spirit."