I
am
so
tired.

I'm on track to work 90 hours this week. I still meet the 80-hour workweek average (80 hours per week averaged over 4 weeks), so there's no official complaining allowed (80 last week, 90 this week, and probably 50-60 next week averages to about 70/week). I already complained last week when we were being held past 5 pm to do scut work. I don't mind being held past 5 pm if I'm in an awesome surgery, or if I'm actually seeing patients and contributing to patient care, but to hold us through pm rounds just so we can "run ahead of the team and pull charts and open them to the correct pages" is total bullshit. So I spoke up. And the residents got pissed. And I was fearing for my clinical grade, even though everyone told me that I was the best person to speak up and stick my neck out, because the dean knows me and will listen to my side of the story if I end up with bad evaluations. I was all set to drop the issue to save my grade (and that's how the abuse is propagated!), but luckily, an attending (and past clerkship director) happened to stick his nose into the situation completely on his own, and took it upon himself to speak with the residents. So now, every day at 5 pm, the three of us not on call are told unceremoniously to "have a nice evening." I will, thank you very much. Never mind that my evenings consist of vegging on the couch for 30 minutes to an hour trying to regain my sanity and checking email, then finding dinner, then wasting some more time until about 9 pm, when I take a shower and slowly get ready for bed. Asleep by 10:30 at the latest. Yeah, that's a great evening. You'll note that no studying is being accomplished because my brain is in a constant state of mush.

I've officially decided that I can't do general surgery. Yeah, surgery is cool, but you can be a surgeon without being a general surgeon. Never mind that the residency is pure hell and I don't think I (or my future marriage) could take it. The bottom line is, I'm really not passionate about gallbladders or thyroids or bowels. So general surgery is out.

Did you know fall premieres are this week? I didn't. At least, not until someone else pointed it out. Do I even remember back to May, when I was totally following Grey's Anatomy, ER, Scrubs, and probably some other shows? Nope. Thank goodness for DVR and the ability to catch up on all my TV watching in October, when surgery finally ends (October 12, to be exact. Let the countdown begin.)

Yum

I had the good fortune today of being post-call after a pretty easy call day at Norton's. My two surgeries with the department chair yesterday morning went surprisingly well (from a pimping standpoint, anyway; one of the surgeries itself was pretty horrendous), I was done with my duties at 10 pm, and got a full 6 hours of sleep on a pretty comfortable bed (by call room standards). Home by 8 am, another 3.5 hours of sleep, and I had a full day ahead of me to do whatever I wanted.

Plus, tomorrow is my "weekend" day off (each student gets one per weekend, as mandated by the clerkship director), so I had two days in a row to do whatever I wanted with!

I ignored the pile of dirty clothes waiting to be washed, the even larger pile of clean clothes waited to be folded and put away, and the general disaster area that is our apartment and instead I went out to eat and go shopping. Pure bliss.

For lunch I tried Pho Binh Minh, a Vietnamese hole in the wall that's been open for almost a year down in the South End. I've heard good things about it, and they were all true. I had the best bowl of pho tai I've had in Louisville. Delicious! I'll definitely be going back.

After a full afternoon of shopping, I went to Oriental House for dinner. I've been there before, and while they have an "authentic Chinese menu" (translated into English, thank goodness!) that's pretty good, they never before had my #1 comfort food dish, shrimp dumpling noodle soup. But today when I walked in, I noticed a little piece of paper taped on the wall and I actually could read the handwritten Chinese that said they now have shrimp dumpling noodle soup and wonton noodle soup. That was a huge victory for my Chinese skills, first of all. Second of all, the noodles were delicious. It was no Sang Kee, but it was BY FAR the best Chinese food I've had in Louisville. (Surprisingly, for all the great restaurants this city has, from every cuisine/ethnicity you can think of, we do not have good Chinese restaurants.) I need to go back with more people so I can order more dishes and have a real meal. In fact, tonight's experience made me wonder about a Chinese wedding banquet... it's something to think about, anyway.

Yay for finding comfort food! When I'm in a hungry-and-tired mood, I always want either 水餃麵, pho, or Qdoba/Chipotle. I also often want this one sandwich I had when I lived in Taiwan, from Finga's Italian Deli (run by a New Zealander in Taichung), that I am pretty sure I will never have the opportunity to eat ever again. So sad. At least I can now satisfy choices 1-3 whenever I need to.

Holy #$!%, We're Engaged!
Because I don't blog enough as it is. No new content yet, but I will put all future wedding planning posts there.

Pittsburgh Trip Pics

From 3 weeks ago, when we went to Pittsburgh for a baseball game.

Small Victories

I found XS scrub tops at the hospital -- dark ones to boot! No XS bottoms yet, but I'll survive in the meantime.

I diagnosed my first murmur! I thought it was diastolic (I know, pretty rare, but this baby had all sorts of other problems, so a diastolic murmur wasn't unbelievable), but that kid's heart was beating so fast it was hard to tell. I still give myself points for hearing it all on my own, even if it did end up being systolic! Now, writing "RRR, no M/G/R" on my notes actually means something.

I was stopped at a red light the other day with my window down and a bunch of guys in the car next to me tried to get my attention and motion to get my phone number. "Sorry," I called back as I flashed my left hand, "I'm taken!" And then drove off. What possessed me to do that, I have no idea. But it was awesome.

Other Awesome Things:
We haven't made any other progress in wedding planning, but I may have found a dress. My mom and sister came to visit last week and we went dress shopping, and we may have found the one! I'm going to go back and try it on in a couple months, and in the meantime, I'm doing online price comparisons for it. No pictures yet (I wouldn't want to jinx anything in case you don't like it), but maybe I'll do a post of the dresses we didn't like at some point.

I had a night of trauma call last night, and it was really fun. We got a guy shot seven times while getting out of his car (don't worry, he's alive), and I ended up elbow deep in his abdomen holding pressure on a kidney laceration surrounded by peristalsing bowels while the residents worked on his injuries. It was so cool.

This isn't really an Awesome Thing, but it's not really an Un-Awesome Thing either: I think I really like surgery. It's a really scary thing to admit out loud, but there you go. It totally fits with my personality (read: bossy), but the residency SUCKS. Figures. Damn these life choices.

Cummings's Anatomy

I know you've all been dying to know: Is life as a surgical student as glamorous as that of a surgical intern on Grey's Anatomy???

Maybe you already knew the answer, but just in case, let's do a comparison.

The on-call room
Grey's Anatomy: The site of numerous romantic trysts between various medical house officers and attendings. Presumably kept clean. Presumably has comfortable beds. Presumably never used for sleep because everyone apparently goes home at 5 pm every day.

Real Life: The site of, at best, a few hours of sleep in the middle of the night when you've been awake for over 20 hours. A small twin bed with a plastic mattress like your old college dorm had, unmade since whoever the last person was on call slept there, with the flattest pillow in the world. A small bedside table holds a lamp, a cup of someone else's pocket flotsam (pens, etc), and an alarm clock that doesn't work. A small TV in the corner is there if you want it, but you don't have any extra energy or time to watch TV. Our medical student call room at the children's hospital is sandwiched between the men's locker room and the bathroom that is shared with the resident's call room. I can lock the door to the bathroom, but not the one to the men's locker room, so anyone in the locker room who knows the code can enter my call room. That makes for a very sound, secure sleep, let me tell you. And as for the romantic trysts, I wouldn't dare have one in that room even if money WAS involved. Not that money would normally sweeten any deal when it comes to such activities...

Sleep

Grey's Anatomy: The surgery interns apparently get a lot of sleep. I think this reflects poorly on the educational quality of the Seattle Grace training program, since it is quite obvious that the best learning opportunities are the ones that present themselves in the middle of the night when your brain and body are no longer functioning.

Real Life: Our interns are on call every 3rd night or so, meaning they show up at 4 am on Day 1 to round on the patients, stay through the day and night handling floor work and surgical cases (usually with no sleep), round again the next morning, take care of any loose ends, and leave around 9 or 10 am (hopefully) on Day 2. The rest of Day 2 is off ("post-call") and then on Day 3 they're back at 4 am and work until 6 pm or so if all goes well. On Day 4 the cycle starts over. We students have it slightly easier. I take call every 4th night, and hopefully sneak away around 1 or 2 am to catch a few precious hours of sleep in the aforementioned call room. We don't start until 5 am (A HUGE thank-you goes out to my awesome chief resident for not making us pre-round before the residents!), and on regular days leave around 5 pm.

I've actually adjusted disturbingly well to this schedule. I am now perfectly capable of falling asleep instantaneously whenever the opportunity arises, and functioning fairly well on very little sleep at all. For instance, last night I got 3.5 hours of sleep, woke up at 4:30 am, and ran on adrenaline, coffee, and Coke until 3:15 pm, when I hit the wall. For me, hitting the wall consists of feeling horrendously nauseous. I snuck away for a refreshing 45 minutes of sleep and have been going strong since, although as we speak the nausea has returned and my thighs feel like jello (sleep deprivation sign #2).

Cooking and Cleaning

Grey's Anatomy: Izzie appears to have ample time to bake on a regular basis. Granted, some of that baking was while she was taking a mental health vacation from her surgery training, but she bakes fairly regularly anyway. It appears that the interns bring homemade lunches to work on a fairly regular basis. Presumably, they cook dinner and eat real meals. The intern house looks well taken care of, clean and tidy.

Real Life: I am normally a frequent cooker. I like cooking; it's relaxing, and I enjoy trying out new recipes. Right now, though, I cannot even venture a guess as to the last time I cooked anything. There might have been a ramen noodle last week, but I'm not sure. Breakfast is found in the main physicians' lounge (fairly well stocked, actually: yogurt, cereal, bagels, muffins, donuts, fruit, coffee) or the surgery physicians' lounge (donuts, bagels, coffee). Lunch is often in the Norton's physicians' lounge (free, but tastes like your typical cafeteria food; as a poor, non-picky student who's only worked here for two weeks, I am not yet sick of it, but most of the residents are), or at McDonald's (conveniently located on the first floor of the childrens' hospital; public health be damned!). Dinner, if I must hang around for dinner, is usually ordered in: pizza, Chinese, Qdoba, etc. I'm not spending a ton of money, since a lot of it is free, so that is the only saving grace for my non-cooking lifestyle. Dinner, if I'm home for it, is usually either take-out or eat-out, since I have no energy to cook and we haven't gone grocery shopping for more than staples in forever. As for cleaning, since I mostly wear scrubs, I've stopped doing laundry. We had a pile of clean clothes occupying our lounge chair for nearly a week, and it would still be there if my mom hadn't come visit and folded everything; now I have a pile of folded clothes in a corner of my bedroom that I guarantee will sit there until October 12, when this rotation ends.

Surgery
Grey's Anatomy: All of Seattle Grace's cases are mind-blowingly amazing. Or at least, they don't seem to have very many mundane cases.

Real Life: Every day, there are at least 2 I&Ds (incision and drainages) of abscesses (think large, pus-filled pimple on a non-face part of the body), another 2 line placements, removals, or replacements (like central lines, catheters for chemo access, etc), and another two hernia repairs. It sucks to think these attendings have trained for so long just to be popping huge pimples. But it's great for me, because it's one of the few procedures I'm allowed to do -- and anyone who knows of my great love for popping regular pimples can certainly imagine how cathartic it is to stick a scalpel into a huge abscess and squeeze out all that nice, disgusting, white pus. MRSA: public health disaster, Holly's best friend she never knew about.

Grey's Anatomy: Did you know they scrub all wrong? They are always shown talking to each other while they scrub, but you can see their mouths moving (I tried to find a screenshot but couldn't; check it out yourself when the next season starts). Why can you see their mouths moving? Because they're not wearing face masks. Boo.

Real Life: In order to cross into the OR area, you must be wearing a head covering. You're probably familiar with the cool surgeons' caps I'm talking about:
Here is Dr. Richard Webber wearing a cool surgeon's cap. McDreamy presumably sports one under his neurosurgery loupes as well. You can see the OR nurse wearing an oh-so-stylish bouffant-style disposable head covering.

In this aspect, Grey's gets it right. The surgeons are always shown wearing their custom surgeon's caps. The female interns are usually shown wearing a similar style of cap (see Cristina above), although most of them probably actually have hair too long for such a cap; I'll have to watch more closely next season to be sure. Of course they wouldn't show glamorous Meredith in a lunch lady's cap, but that's what we all wear. Anyway, I was talking about face masks. To actually walk into an OR, you have to have your mouth covered. And you should probably have eye protection as well (you never know when pus is going to come flying at you!). But you have to put your mask on before you scrub, because once you've scrubbed, you're only sterile from your chest to your waist, and only in the front. You would not be able to tie a mask around your head once you've scrubbed your hands, so you have to put the mask on first.

That's it for this installment of TV vs Life. I've been writing this in bits and pieces over the last couple of weeks, but today I am post-call (I got an amazing 5 hours of sleep at the hospital last night, and another 3 this morning once I got home!) and plan to make the most of it. Anyone in the mood for... cleaning and studying?

The Story and the Ring

So the reason I haven't posted any pictures of the ring or told The Engagement Story yet is that my life is horrendously busy and I haven't had time. But I was granted time off today to go to a wedding of Eric's coworker (wedding #5 of 6 for 2007), and we don't have to leave until after lunch, so I got to sleep in as late as I wanted this morning -- which meant I was wide awake at 8:30 with time to blog. Yuck. But, it's still a significant difference from 4:30...

I had been working on a little graphic presentation of sorts that illustrated The Engagement Story as well as the ring, but something about it just isn't right. It's one thing for me to tell you the story, but illustrations make it maybe just a little too intrusive. So here's the story in word form:

On Saturday, August 11, I had finished my last night of overnight Labor and Delivery shifts, so I slept all day. When I woke up at 5 pm, we went out to dinner as we normally do, opting to try a new restaurant, the Come Back Inn (and yes, we will!). Eric suggested we go to the 9:30 set at the Jazz Factory, but since it was only 6 pm, we had some time to kill, so I suggested ice cream first. Then Eric suggested getting a glass of wine at home. So far, nothing out of the ordinary. Yes, the apartment had been cleaned extensively when I got home Saturday morning, but I thought maybe Eric had just finally realized that our apartment was a disaster area (haha, wishful thinking). Yes, Eric was opening my car door for me, but he often does this -- although that night, he was opening the door EVERY single time I got in.

So we get home, open a bottle of wine, and sit down on the couch. Eric brings up a writing exercise we once undertook in college: We would each write one sentence of a story, then switch, and see where our sentences took us. He asked if I might want to try that again, and I agreed to it. So Eric started off with a nice introduction about two fictional people named Holly and Eric who lived in Louisville. And then I took the pen. We shouldn't forget that I had just finished two weeks of delivering babies, one of which was all over-night shifts, so my brain was completely addled. I derailed that story quicker than you could imagine with a sentence about kittens who drink beer. Eric, always perserverant, brought the tale back on track, and I continued to derail it, until all of a sudden I realized that it was sort of odd that Eric's sentences were so much more on the serious/romantic side than the crazy/silly side. Then I started to get some palpitations. The apartment is clean... He kept opening doors for me... But of course, I had to pee. Dammit. In the bathroom, I kept having palpitations. No, I'm just being silly. There's no way he's going to propose. I was pretty nervous as I walked back into the living room, not sure if I was going to be entering a different scene -- like a dark room with candles or something (no, I wasn't in the bathroom that long) -- but everything looked normal. Whew. Then Eric handed me the journal we were writing in, with his next sentence. "Eric finally thought of his next sentence, and it went like this: And then, without further ado, it happened." I looked up. And then WHAT happened? I was sufficiently nervous and the grammar was sufficiently unusual that I was confused. And I still didn't want to believe it. So I turned to Eric and said, "And then WHAT happened?" And Eric said some sweet things, pulled a ring box out of his pocket, and got down on one knee.

After some tears and me saying "Yes!" we opened a bottle of champagne, grabbed our cell phones, and started calling people with the good news. Then we opened another bottle of champagne for more phone calls. And then, around 11 pm, we invited all our friends out to Proof on Main for celebratory drinks, where I had another three cocktails, the aforementioned Capri Martini.

So that's the story. It's a good one, I must say :)

And here's the ring. This is the best picture I can get -- my crappy camera can't handle the sparkle very well, so I can't really get the stone in focus.

It's pretty sweet :)

We're planning for a May 2009 wedding. Details to come!