Wednesday, June 29, 2005


So tonight is my last nightriding shift for the month at the local community hospital. Of course, that means things had to get eventful. As you might have guessed from previous posts, the night is usually pretty quiet. Most patients have problems that really coulda waited until the light of day, but somehow fever and earaches just MUST been seen EMERGENTLY 'cause it is an EMERGENCY.

Not so with this patient. This one came in fighting to breathe - respiratory distress with grunting and decreasing mental status, to be medical about it. So the baby is sick as snot, and is getting all of the attention. Which is fine, nay, appropriate.

Unfortunately, this pisses off some of the other patients. Actually, not the patients, but the patients' parents. "Why isn't my child being seen - isn't s/he an emergency as well? Why does that patient get all of the attention? Huh? My baby is CLEARLY more important BLAH BLAH BLAH." All of this while the child is sitting comfortably eating Cheetos.

Right about now is when I want to scream, "Be fucking happy that your kid isn't dying. 'Cause guess what, that other one IS! Not metaphorically, not in a symbolic sorta way, but in a right-now-lets-intubate-and-maybe-start-pressors-and-give-blood-products kinda way. You know, the stuff you do right before starting fuckin' CPR."

But I don't. Why? 'Cause we're all better doctors, and better people, than that. People get frustrated. People get tired and I'm sure that a child who has been screaming for 72 hours grates on the last nerve like a monkey on crack. So I can understand being irate.

And just as an aside, who the fuck calls 911 for a crying 12 month old? No fever, not sick looking, got better with Motrin, totally consolable. By the time EMS arrived, Mom reported that the child was back to normal. Isn't that about the time that you call EMS back and tell 'em to forget about coming?

Oh well.

Tuesday, June 28, 2005

drunk dial

so hard to resist...

what a good thing when tempation is averted!


Sunday, June 26, 2005


I'm sorry, there are just some things I can't fix in the pediatric ER.

If your family is wicked dysfunctional... DON'T GO TO THE EC AT 3AM! Are you suicidal? Are you homicidal? Psychotic? No? I can't do anything for you! Actually, I lie - I can help you get an appointment with the friendly neighborhood psychiatric clinic. And yes, if I help you make the appointment, you will get seen sooner than your average schmoe. But really, that's it.

But damn, don't expect me to fix 16-fuckin-years of dysfunction in one 2 hour ER visit.

It might seem like I dislike psychiatry. Not true. I like my psyche-delving friends. However, I hate ER psychiatry - 'cause I can only do two things. Number one - send you to the local mental hospital. Number two - send you home with nothing. Very few people meet criteria for door number one, so most people leave more upset than when they got here.

Lovely, no?

I'd much rather see (yet another) kid with gastro. Puke - generally fixable. Family dysfunction - generally not.

Saturday, June 25, 2005

Been a while...

Sorry about that. Life got in the way of blogging, and hey, just 'cause I vowed to use this forum to write more, doesn't mean I'm gonna. ;)

Last night I tried to be a good doctor and generally ended up pissing everybody, including myself, off. This community hospital EC always seems to work that way. Resources are limited, patients want more than I can give, staff members don't like doing anything at all out of the ordinary and everything takes way way way too long. I sorted things out. I made a plan. Who knows if anyone gives a shit. The patient (and her parents) certainly didn't seem to care. The fact that it was fuckin' four in the morning didn't help any, either.

On a lighter note - go Red Sox! They have been winning and, wouldn't ya know, the Orioles have been losing. We're now on top of the AL East. I know we haven't even gotten to the All-Star break, but hey! I believe. I think we could perhaps make like the Patriots and get two in a row...

And please, can we take a second and revel in the badness of the New York Yankees? Doesn't it just warm the very cockles of your heart? Jeter is frustrated. Steinbrenner is blowing a gasket. Heaven on earth, I tell ya. Now if only the Pedro would start to slump, my baseball life would be nearly perfecto.

Monday, June 20, 2005


I'm convinced that the gut has a 'second brain'. Oodles and oodles of neurons live in and around the gut for the sole purpose to ensuring that our sustenance gets where it is supposed to go. However, they also cause trouble. People can get 'abdominal migraines.'

I get nausea. Whenever something bad happens, or I get super worried about something my stomach goes crazy. Those of you who know me, know that I can knock down small buildings when I belch, but this is worse. I don't get belchy, I just get queasy.

I've been nauseous for two weeks now, and I'm not having fun. So everyone think soothing thoughts toward my belly.

The husband will thank you!

Friday, June 17, 2005

Ouch! I'm it!

Have you ever?

1. Snuck out of the house........ yes - I was 16 and my 70+ year old deaf grandmother was 'watching' me while my parents were on vacation. Needless to say, he wasn't worth the effort.

2.Gotten lost in your city......... Not lost like I can't get home, lost. Lost like I can't find where I'm going? Yes.

3. Seen a shooting star.......... It's hard not to in Iceland, where I went on vacation.

4. Been to any other countries besides Canada.... Yes. (though why Canada?) I have been to Austria, Czech Republic, Hungary, Germany, Denmark, Iceland, France, Switzerland, Italy, Mexico, England, Ireland, Scotland, Iceland, Norway, Spain.

5. Had a serious surgery........ Nope, but I've seen quite a few.

6) Gone out in public in your pajamas....... Wasn't that one of the whole points of college?

7) Kissed a stranger........... Nah, but I have hope.

8) Hugged a stranger......... Do patients count?

9) Been in a fist fight........ A fight? Not so much. Kicked someone in the nuts? Sure.

10)Been arrested.......... Does getting harrassed for suspected shoplifting count?

11) Laughed and had milk/coke come out of your nose...... Often. Beer, too.

12)Pushed all the buttons on an elevator........ Only people under three are allowed to do this, and then only once.

13) Swore at your parents......... Yup, and they swore back. And then we kissed and made up, so it is all good.

14)Been in love....... Yes

15)Been close to love....... Yes - isn't this automatic given that I've been in love? Doncha have to get close to love before you can get to love?

16) Been to a casino......... Yes

17) Been skydiving.......... Hell NO. Never, never, never, never, never.

18)Skinny dipped........... Yeah. So has my hubby. He was the hero of the lake, saving gorgeous lesbians left and right. (More on that in another post...)

19)Skipped school........... Yes. Again, wasn't that one of the major points of college?

20) Seen a therapist........ Heck yeah. Therapy is good.

21) Done the splits........... Briefly, I was a gymnast. The splits stuck with me longer than most of the other gymnastic type skills.

22) Played spin the bottle........... Again, the college thing.

23) Gotten stitches.......... In my lip. Very freaky to watch the needle go into and out of my face without feeling it. Gotta love lidocaine.

24) Drank a whole gallon of milk in one hour.......... Yuck, no.

25) Bitten someone........... Heck yeah! Must mark mate...

26) Been to Niagara Falls........ No, sadly.

27) Gotten the chicken pox....... Nope, thank God. I love them vaccines!!

28) Kissed a member of the same sex....... Yah, well, when spin the bottle is played with a mixed croud, same sex kissing is fairly guaranteed.

29) Crashed into a friend's car........ Nope. Not even my husband's.

30) Been to Japan......... I really want to see Mt. Fuji, but I haven'y gotten there yet.

31) Ridden in a taxi............ Yes - who hasn't?

32) Been dumped........... Yes, but not since I was 18, when I started dating my husband.

33) Shoplifted............Um, yes. I was being harassed on suspicion of shoplifting, and um, well, I was. Oops...

34) Been fired............. Nope.

35) Had a crush on someone of the same sex......... Yes. Again, a college right of passage.

36) Had feelings for someone who didn't have them back........... Yup. He was dreamy and moody.

37) Gone on a blind date............. No.

38) Lied to a friend............... Nothing more than a white lie. If someone calls and wakes you up from sleep and you really don't want to be up, but you know that s/he is calling from a million time zones away, are you really gonna say "yes" when s/he asks if they woke you up from sleep?

39) Had a crush on a teacher............ No.

40) Celebrated Mardi-Gras in New Orleans........... No.

41) Slept with a co-worker............ No

42) Seen someone die............ Yes. it sucked.

43)Had a close friend die........... No

44) Been to Africa............ No

45) Driven over 400 miles in one day........... Yes. Who wrote these questions? New Yorkers?

46)Been to Mexico.......... Yes.

47) Been to India............. No

48) Been on a plane............ Yeah - I hate take off and landing, but I get over it.

49) Seen the Rocky Horror Picture Show............. Sweet transvestite....

50) Thrown up in a bar.......... In the restroom, yes. Actually while at the bar, no.

51) Purposely set a part of myself on fire............ Hair, yes. Anything fleshy? No.

52) Eaten sushi.......... As often as possible.

53) Been skiing/snowboarding............. Skiing since I was 3.5 years old. I snowboarded for a couple years and just decided to stick with skiing. I don't have enough time to split my snowsports.

54) Lost a child............. On the job, well, yes. Kids die at work. My own child? Don't have any yet.

55) Gone to college/university............ Yes

56) Graduated college/university............. Yes.

57) Fired a gun.................Yes and I am a very poor shot.

58) Purposely hurt yourself................. I've going skiing on an injured knee, so you could say I kept on hurting myself. But damn, I was having too much fun.

59) Taken painkillers............... Oh yeah.

60) Been intimate with someone of the same gender............... No.

I tag Eileenie-weenie.

Wednesday, June 15, 2005

Heck of a weekend

So I didn't get to N'awlins.

Circumstances beyond my control, but let's not talk about that. Let's talk about how Chipotle is trying to kill me.

This is an old story, but it is just too damn good not to write about. One day I go to work in the large children's hospital ER. I plan to work my 12 hours and then get the hell out and go home. That day I was assigned to the 'Mega-Bay', which is not a 20 story android costal inlet but the area in the ER where patients who are sick and hurt, but not really that sick or hurt, go to be seen and treated. (Note: if the child is really sick, hurt or actively trying to die s/he goes to a different Bay where things move much more quickly. But ya gotta really be trying to die.) About halfway through, my stomach demands attention and sustenance, so I obligingly take myself over to Chipotle and get a barbacoa burrito. Back in the ER, I'm done with lunch and sitting in 'Mega-Bay' doing the ever-present and freaking endless paperwork. Suddenly, I feel flushed, light headed and sweaty. More scarily, my collar feels tight and I can't quite breathe right.

Ack! So my fellow resident takes me up to that other Bay I was talking about (you know, the one with the really sick kids?) and suddenly I'm a patient. I got an IV. I got Epi (epinephrine) three times. I got steroids. I got 2 liters of IV fluids. I had an anaphylactic reaction to freaking Chipotle. I also got better... eventually.

The incident has made me famous in the ER. Which is both good and bad. Now I get more teasing, smiles and winks, but the staff knows me. So when I want something, it happens a little faster than before.

And heck, even just a little fame is fun. I can say, "Oh yeah, I'm the anaphylactic resident," and people immediately know who I am, how far along in my training I've gotten and what NOT to feed me.

It's good to be the King.

Thursday, June 09, 2005


Yay! So this weekend I get to go to New Orleans with my bestest friend, her boyfriend/sex buddy and my husband. Happy happy day.

I like N'awlins. It's such a vibrant city; opulence and poverty mixing willy-nilly with high culture that's stumbling over the bodies of sloshed drunks. My first trip to New Orleans was probably the best. I conned my parents into thinking that I was going to spend spring break down in the Crescent City with some friends from college. Instead, I spent a week in decadent sin with my boyfriend. He was 6 years older than I, and my underage status put a serious crimp in his drinking style. I had finally made the advanced age of 19 - just over the legal drinking age in Orleans county. So we spent the week drinking in public and just generally mooning around the city in luuuuuuuv.

My best New Orleans story starts with my second or third trip. The American Academy of Pediatrics held the national meeting in N'awlins last year and my residency program was nice enough to send me, free of charge. A whole passel of us went. On our first night there, some of the other residents and I met up with some of the attendings (senior faculty doctors) and proceded to go out drinking. Toward the end of the night, after several large drinks called hand-grenades, one of the other interns and I decided to go to Larry Flint's strip club. First of all, you would think a freaking group of doctors would know better than have drinks named after a device designed to maim and destroy. Secondly, we were with our bosses. People who would be trying to teach us the art of keeping people alive and sane. Does that sound like the kind of crowd receptive to ladies of the night? Even though the ladies did dance vertically instead of horizontally, come on! The strip club idea? Not so bright. But, it seemed like fun at the time. So we went. Not only did the two of us go, we dragged one of the most innocent, sweet, and damn near demure interns with us. The good news is that the attendings don't hold our misbehavior against us. The bad news is that at least three of the most prominent attendings in our pediatric program associate three of us with stripping and two of us with corrupting the innocent.

Not the reputation a respectable professional usually wants.

Oh well, the hell with respectable.

Wednesday, June 08, 2005

"General Medicine"

The community hospital has a clinic designed to provide EC follow up for those without insurance. It's called the "General Medicine Clinic", gen med for short. The clinic also serves as the urgent care center for children seen at the hospital's pediatric clinic.

Most residents hate doing time in gen med. I love it. I just want to give cookies out to each mother that actually calls, gets a sick visit and then shows up to clinic. Each general medicine visit is an avoided ER visit. Got the crud? Come on in! We'd love to see you - just for the love of God don't take the snot to the ER. The cost to the health care system is so much greater in the ER, and a general medicine visit solves most problems. Really, no lie!

I also get to hang around all of these really smart subspecialists and basically evesdrop on all of these cool conversations. Yes, occasionally I do like to learn.

Saturday, June 04, 2005

Blarghity blargh blargh

I managed to finish nightriding without killing anyone, which definitely is a plus in my book.

But now comes part two - flopping back to days. The kind people in scheduling decided that my 'day off' started at 8a today - the end of my overnight shift. So I get to go into work tomorrow, 24 hours later, at 8am. What's more, I don't get any freaking extra sleep this week, no day to sleep in!!! Fuckers.

I like my job, really I do. Pediatrics is fun. Kids are fun. Parents aren't always crazy. When kids go from sick to well because of something I did, that's nifty. I mean, how cool is that? Lil ole me can fix someone! Not all the time, and not even most of the time. But damn, when it happens I feel good.

Right now, however, all I really wanna do is have a day to sleep until noon. And yes, I will have some cheese with my whine.

Friday, June 03, 2005

Snoozing the night

Nightriding can be super scary - the potential for badness is just so huge. What if someone comes in really really trying to die? But the reality is usually much more boring. Hours and hours of sitting, waiting for patients. And then when they come, they just don't need ER care. Our ER population usually needs a regular pediatrician much much MUCH more than an ER doc.

After all, healthcare dollars are really well spent on diagnosing a cold at 3am! Snot should not equal ER care. Snot should go to a clinic, during the day, with a doctor that can follow said cold and make sure it isn't allergic rhnitis, sinusitis, etc. And what kind of cracked-out mother takes her child to the ER for a stinking diaper rash? Oh yeah, our kind of cracked-out mother. (I suppose I should be thankful that I am able to use 'cracked-out' as a figurative term. For whatever reason, we don't see a lot of drug abusing mothers on a regular basis. Either that or we just flat-out miss them.)

The hospital also does its maintenance work at night - which is scary in its own way. At 3am, when just two petite female doctors are running the ER with two petite female nurses, hordes of huge burly repairmen come bustling through being burly and scary. I always think to myself that those men could take us all out and no one would be the wiser for several hours.

Of course, this doesn't stop me from trying to grab a nap whenever I can. Personal safety is way less important than sleep. (Ask any resident, they'll agree!)

Thursday, June 02, 2005

Riding the night

For the next three days, my life goes topsy-turvy. Why? I'm the nightrider. I'm half of an expert team holding down the fort in the pediatric EC at a community hospital all night long. The really fucking scary part about nightriding is that the supervision is miniscule and backup nonexistent. At night in this particular EC, there is no attending (ie liscenced) physician - only residents. That's right - absolutely no one with actual pediatric board certification can be found. Just two residents. And why would you want anyone training in pediatric emergency medicine in an emergency room, that's crazy talk! Residents are good enought!

Not to mention, nightriding totally destroys my circadian rhythm. My skin goes crazy. My mood plummets. My fish starve. Working from 8p - 8a isn't very compatible with most of life's little details, like getting to the bank. Sure, I could go after work, but by then I'm delusional, grumpy and nearly homocidal. Not a good combo when visiting a bank. I've also got to find time to get my car registered and I think I would have seizure if I had to visit the DMV after a night at the EC. STAT benzos, please, the doctor is seizing.

Yargh. See you on the flip side, people.