LeMons!

I'm driving in the next LeMons race in Houston! I'll be in the TetanusNeon, although the auto work I've been doing is on the sister car that-has-no-name. It too is a Neon - one year younger and three trim levels nicer. With all of the new drivers (including me), we needed a second car. We've divided the teams between the Tortoises and the Hares. I'm a tortoise. This split also nicely divides the short from the tall, which will be convenient during driver changes.

Very exciting. Check out www.tetanusneon.com for updates!

It's officially winter

I live in Houston, where it never seems to drop below 40F. So how would I know it's winter?

Easy kiddos - the hospital census! Right now is a truly bad time to be a sick child. The hospital is bursting at the seams. Half of the ER is taken up by children waiting on inpatient beds. Let me tell ya folks, that makes for some cranky people. Parents are cranky 'cause the rooms are small and only have a bed for the child. Children are cranky 'cause they're bored out of their ever-lovin' minds. Nurses are irritated 'cause the parents keep asking them for stuff. Doctors are cheesed for several reasons: 1) No ER doc actually wants anything to do with the floors. That's why they work in the ER. So essentially taking care of 'floor patients' in the ER bugs them. 2) The children waiting on floor beds occupy space that should be devoted to acute ER care. The more floor patients stuck in the ER, the more patients stuck in ER waiting. 3) Parents seem to think that MDs control bed availability. They're right - floor MDs control bed availability. Not the schmucks in the ER. So don't complain to ER nurses or docs. They (we) just start not to care after the fourth of fifth complaint.

Let me tell ya, sometimes at work I just wish Old Man Winter would sod off.

Muppets... that curse!

Check out a Jim Henson product I just came across - Puppet Up! Uncensored. It's improv, like Whose Line but with puppets. Nasty foul mouthed raunchy puppets. It made me giggle like a little girl on nitrous.

Trust me, I'm a doctor

And ya know what? I might have done this before.

Don't get me wrong, I'm certainly not infallible. Not even close. But generally, I don't make kids to unpleasant things just for the hell of it. I get my shits and giggles in other ways - like torturing small cats and beating the homeless. So if I want to shove a large tube down your child's nostril and into his belly, there's probably a reason.

I've decided that the whole concept of informed consent is bogus. How can I explain in 5 minutes what it took me 3 years to learn... to parents that didn't finish high school? I mean, really? Really? So I try, but it's all bullshit. I'll explain "risks" to parents, but even when I talk myself blue, they don't get it. These horrible things could happen to YOUR child. But guess, what? I'm kinda glad no one ever gets it. 'Cause then I get consent and I can do what I think is right for the kid.

The really annoying thing: the parents don't object to the riskier shit, but go crazy when I want to do something simple. Sedation carrying the risk of respiratory depression? Sure! NGT*? Hell no! Grr...

* NGT = nasogastric tube, which is a tube running down the nose and into the stomach. NGT are commonly placed to decompress the stomach or to introduce medication to the stomach that the patient is refusing, like charcoal of GoLytely. NGT are low risk when placed by someone well trained, uncomfortable but not painful, and TOTALLY useful.

Absence

I've been absent for quite some time. Excuses are many, but legit reasons are few. Basically, this blog suffered from a combination of laziness and depression.

So... so.

I've got the biggest test of my life approaching on Monday the 27th. All I do, except sleep, eat, poop and fuck, is study. Granted, if hubby had his way the fucking portion of the program would last for hours every day. The fucking would also get in the way of his own projects - most notably the tetanus neon. My husband, racerman. So sexy!

Blogging from Steamboat!

So my husband scheduled a fishing trip. This is a good thing, since the last time he tried to go fishing, bad things happened. Unfortunately, the trip ened up being on one of the rare weekends I have off.

So I went skiing. Hah! Take that!

But really, I wanted him to fish, but I didn't want to be left floating around in Houston. So, since I had 4 days left on my Steamboat lift pass, I found a way up here to SKI!!! The skiing forcast, however, didn't look too exceptional; only a 30% chance of fresh snow, (relatively) high temperatures... nothing special. But there was snow last night, snow today, and there will probably be snow tomorrow.

Now my worry isn't so much about bad skiing, but bad driving over the pass. Such is life!

Funniest clip ever

A Love Letter to the Dumb Drunk Guy

Dear Mr. Drunk Guy-

There are many things I love about you: your cheerful exuberance, your golden shiny bling and your happy go lucky lack of coordination. I also admire your understanding of acceleration, momentum and physics. Most memorable is your ability to know that if you step out in front of my moving vehicle, I'll have just barely enough time to stop before running your black ass over.

I love you way you fall over the tono cover of my convertable, eager to cuss me out. I love the way your friends yell at me. I love the way you totally ignored my screams as I yelled at you to get the fuck out of the way of the moving car!

Yargh.

The Toe Nail Striketh

The day I've been waiting for has finally arrived: my black toenail nastiness has finally separated from my toe. I took my sock off after working overnight and realized I had a 5mm gap between my lovely painted toenail and my nailbed. So, being the masochistic wench that I am, I pulled on the separated nail.

And it popped right off.

No pain. No wiggling. Just off.

Underneath was an ethereally pink, soft, new neo-nail. It doesn't look like a regular toenail. Yet. It shows signs of true naildom: it's firmer than the surrounding skin, obviously made of keratin, and ingrown, just like the last one.

So there it is folks. By reading my blog the reader can now know how long a nail needs to go from black toe to new nail. Hallejulah!

The Kennedys serve stale danishes

At least according to the Daily Show.

And how pissed am I at the new Cloverfield ads? Hugely. I've wanted to see this movie since the first trailers 9 months ago. The trailers were great; I had no idea if a huge swarm of alien bugs had invaded Manhattan or if the film depicted a super-stealthy remake of Godzilla. I loved the idea of a movie about the random folks caught up in a summer action movie plot. What would I have done if, during a roof top BBQ, I saw Godzilla stomping around? Besides freak, that is. I guess I would grab my bike, as much water as I could carry, and hope my husband was hot on my heels.

And the cats? F*ck them, they'll probably do better than I would! Crafty, demonic critters that they are...

Anyway, the new ads imply that a Godzilla like creature has invaded NYC. TMI! I liked the uncertainty of the first ads, and I wish the ad execs had never changed their strategy towards full disclosure. Dunderheads.

Thwarted at every turn

Today, I wanted to be super-duper productive. This was not to be. Here was the plan:
- wake up at 9a.
- get to Audi dealership and have our radio reset out of safety mode*
- go to therapy at noon.
- eat.
- pick up accumulated vacation mail from the USPS.
- apply for passport.
- shop for books.

What happened?

- woke up at 1030a.
- therapy was canceled... but I didn't know that since my phone has been discharged for 48 hours (whoops!)
- the passport office is only open until 1p. I showed up at 2:30, just 'cause I'm a genius. And because I'd cleverly hidden my passport in my old purse, instead of in the desk drawer where it's supposed to be. But I did get purdy passport photos!
- the Audi dealership didn't have a mechanic available to reset the radio. I had to make an appointment for 9a Friday. Suckitude.
- food didn't happen until 330p.
- too lazy for the bookstore.
- mail pick up occurred.

Basically, I feel like I've been chasing my tail all day like a particularly dumb golden retriever.
On the up side, I did get mail and fantastic shots for my next passport. On the down side, I will actually have to stand in line for passport renewal. Undamaged, less than 15 year old passport renewal apps can go through the mail. Unfortunately, mine has been in my back pocket, sweat upon, dunked in the ocean and just generally abused into such dilapidation that I'm sure the Department of State (that's who passport checks get addressed to, not the 'State Department' FYI) would call it 'damaged'. So I have to talk to a human. Argh!

What the heck is up with Blogger?

So I logged into Blogger today and the interface is all messed up. It looks like a bad website from Netscape 2.0.

Interface aside, it's time to get back to the business of daily posting. The other night Harry (of messed up shoulder fame) was brave enough to bring his new girlfriend 'round for dinner the other night. This is the first time she's been around the Boyz and I since they met at a bar. Granted, we were with Harry when he met her and none of us thought that their bar-tastic near-hook up would lead anywhere, but that just shows you what we know. I remember rather liking her during that first encounter... but I was drinking and I'm friendly that way.

During the dinner the other night, I still liked her... and I was sober. She's younger. She's a professional dancer. But she's smart and she's not "on the pole." Between yoga and real, honest to God dancing gigs she makes a decent living. How about that? And she went to a women's college, so that's another factor in her favor.

I hope Harry keeps her, at least for a while. I think she's good people.

Steamboat rules

And so do my friends. But first, let me address a reader concern: The Injury Report.

The worst injury award goes to Harry. He busted the hell out of his shoulder. I think he's torn his rotator cuff and needs pretty extensive physical therapy. He heard it 'pop' twice and I found some point tenderness over a muscular insertion point. Oops.

The award for the most satisfying fall goes to Tim. The dude is a skiing and teaching God, but yet skiing with me was challenging enough to push him into actually losing a ski. Yes! I felt like a mountain Goddess... for about two seconds until I too ate shit.

The award for the injury with the most impact on my personal life goes to hubbie. He lashed his neck something fierce on one of his last runs, and he's still in pain two days later. Guess I should schedule a message for the man.


I, however, win the award for the grossest injury. Ski boots need to be snug to perform correctly. So my boots are size 7. My shoe size is nine. Can you sense the problem? Anyway, I ended up with a litany of podiatric problems:

• bleeding blisters on my shins bilaterally
• ankle blisters (no blood though, very wimpy)
• cracked nails

But the best foot injury of all was (is) definitely my left great toe. Somehow the pressure on my boot caused a whopping subungual hematoma, aka blood blister. It involved the whole nail, but oddly enough was only painful of ski day #2. Then it just kinda went numb. Is that bad? Today, two days after my last ski day, the hematoma finally popped. I've been oozing nasty bloody serum-like stuff on my sock all day. Yum yum yum! But my nail is no longer blue and I can see the pink of my nailbed again. So that's good.

***Note: While looking for images for subungual hematomas, I found this really cool article on skiers toe. That's what I have baby... and I should have used a drill bit days ago. I was waiting until I got back to the ER and could use a professional grade cautery tool. Oh well.

I saw this on I can has cheezburger. So good.

Growing up

Yes, I know, I'm a doctor. And yes, I'm even done with residency. So that should mean I'm all growed up, right?

Problem: I don't feel grown up.

I did, however, move much closer to grown-up status the other day. I bought a planner. I used to use one of these things back in college to keep my classes and papers straight. I got out of the habit in residency, 'cause I had no control over my schedule whatsoever. I just showed up in the morning and went where I was pointed. No thinking necessary.

Now I have a crazy schedule involving night shifts, meetings and research demands... not to mention a husband and social life. I was so disorganized Prez Bush's brain looked tidy in comparison. So I finally caved and got a good old fashioned paper planner.

And I feel pretty good about it. :)

Nursing woes

I wish my nurses today would just freaking work together. We had a triage nurse basically refuse to escort (or find someone to escort) the patient from triage to the OBS unit. This is a problem, 'cause getting to OBS, and not Fast Track, can be kind of tricky. And, when the patient ends up in Fast Track by accident, it delays care by hours and hours. When she refused the first time, my OBS nurse very correctly called down to triage to address the problem. No heat from her side - she just wanted to make sure it didn't happen again.

The triage nurse threw a hissy fit. And ya know what? The second patient she sent up got lost too. Not as lost, and not for nearly as long (we suspected triage might do something dumb again), but still. I really shouldn't have to get involved in this sh!t. If the nurse manager hadn't been on vacation this week, I wouldn't have had to stick my nose into the situation. Grr...

Upcoming vacation!

I know I missed my last Saturday post (yesterday) and I'm hereby announcing that I'm likely gonna miss next Saturday as well. Why, you ask? I'm going on vacation! Where, you ask? My favorite place on earth, Steamboat Springs Colorado. And it's been snowing for two weeks straight - powder powder powder time, baby.

I'm a pretty good skier. I like to think I'm as good as anyone could be given:
- three weeks a year on skis from 3 years - 12 years
- two weeks a year from 12 - 18 years old
- one week a year most, but not all, years thereafter.

I can get down anything. I enjoy getting down most everything. But I'm only graceful about 70% of the time. I haven't been in Steamboat during a true powder dump since I was 18. I can't wait I can't wait I can't wait. With my luck, though, the snow will stop two days prior to my arrival and a warm snap will arrive one day before I get there.

Grr.

Cross yer fingers for snow, baby!

Godf*ckingdamnbastardtraffic@ssholes!

Goal: To enjoy the company of my friends at a birthday party, leave early enough to get home in time to have a final beer, wind down a little by myself AND get 6.5 - 7 hours of sleep.

What got in my way... Oh, that would be signage. Or rather, the lack thereof. There are about three ways to get back from my friend's house. Why so many options? He lives in bumfuck. Yes, it's a very nice section of bumfuck. And yes, it's a very nice house in a very nice section of bumfuck, but it's still bumfuck! And when you're so far away, there are almost always multiple routes. (Yes Karla, I'm talking about your brother. Seriously, does he really need to live 25.6 miles from the Montrose?)

One route - the northern one - would have been fine. That's the route the lovely Tom Tom gave us on the way out. Given how well things went, and given that the trip back was sans husband, I thought using the Tom Tom directions a second time would be swell.

Yeah, well, it would have been if the Tom Tom had been consistent. But nooooooooooo on the way back it sent me south. Which, since I was sans husband, I didn't realize until I was well on my way. Without the sun, I'm helpless at finding north.

So the Tom Tom sent me south to 10 and HW-6. Straight into construction. Bumper to bumper traffic at 1030p on a Friday. Grumpy much? Yeah, that would be me.

MacGyver!

I've somehow conned my husband into watching DVDs of the second season of MacGyver with me. It's great. Although season three is better. But whatever! I'm getting my young and mulleted Richard Dean Anderson fix.

On another note - I've rediscovered the StudentDoctor.net forums. The emergency medicine forum in particular is hilarious. Some of the threads are boooooring. I really couldn't care about the residency match anymore. Nor do I care about 3rd year (medschool) clerkships. But the 'Things I Learn From My Patients" threads, part one and two, are great. So are the haikus.

Just go check it out.

Hair

I finally got my hair cut. It's now shoulder length.

Tomorrow, we'll see how well I like it.

Chaos

Doctors never get sick. At least that's the illusion. The best part is we, as physicians, buy into this one ourselves. And even though I intellectually disagree with the ironman mentality... I discovered today that I'm definitely a card-carrying member of the MD hardass society.

One of the other doctors in my emergency medicine group called in sick today. She couldn't work her shift. She said. And even though I didn't talk to her, I did overhear conversations between her and my boss.

She wasn't that sick. She wasn't going to the ER, or her doctor, or whatever. She just wasn't going to work.

Meanwhile, the rest of us were scrambling to cover the ER. I was covering two areas... and one of the two areas decided to turn into a burning cesspit of sickness. Patient number 1 had a hemoglobin level of 4; which would be one third of normal. One third of normal isn't good. She was a kind of pale I hadn't seen in a while. Patient number 2 had a gi-normus mass on her right neck involving her airway. Oh, and by the way, the child had an oxygen saturation of 85% (normal = 100%) because the stupid thing had started to grow.

Fabulous!

Now, on a good day, I like taking care of sick people. That is, after all, the whole point of becoming a doctor. But when I'm being pulled in five million different directions and I'm taking care of patients in two totally different geographic locations... at that point I'd really like to just be taking care of simple stuff, thanks. Airway impingement? Not so much.

The good news is that everyone made it out of the ER okay; the ICU players went to the ICU, the floor patients went to the floor, and everyone else stayed in the waiting room. 'Cause they weren't sick enough to get seen while I was there. So they made it out of the ER without being seen to go to their PRIMARY CARE DOCTOR tomorrow. Which was where they belonged, thankssomuch.

Scrub hierarchy

There is a scrub hierarchy that only those in medicine knows. Furthermore, I'm not sure that non-doctors fully understand all of the class connotations of the scrub pyramid.

Lowest on the pyramid are the sales reps. These dudes try to mimic doctor scrubs, but always get the color wrong. Furthermore, their scrubs always fit too well, which is an immediate give-away.

Next are the orderlies, also known as PCAs. PCA stands for patient care associate. They basically take vital signs, clean up the messes, weigh poopy diapers and do other unpleasant tasks. Identifiable by their store bought scrubs and lack of stethoscopes, these poor folks are the bottom of the medical staffing structure.

I'm going to skip over respiratory techs and radiology techs. Their uniform is a lot like the PCA outfit, with slightly more medical knowledge. Which, of course, makes them more dangerous.

Nurses are the easiest creature to identify in the medical world. They always buy cutsy futsy scrubs. Frequently, their scrubs have been pressed. Never, every are their scrubs hospital green. Never, ever are their scrubs stained. Frequently, their scrubs have extra pockets, especially in the pants. Sometimes, those nurses even spring for elastic waistbands.

Just for contrast, MDs never buy their scrubs. We feel that we've paid the hospital enough in time and sweat that free scrub tops and bottoms are the least it owes us. Extra pockets? Who needs them! We've got the white coat. Elastic waistbands are for wussies, and cutsie pattern would make us look like nurses.

Basically, no culturally literate, self respecting doctor will ever find him or herself in store bought scrubs. If it ain't hospital style stolen, it ain't worth it!

Hockey!

Hockey is a sport I thoroughly enjoy but don't really understand. I've had the basics explained to me, but I just get all confuzzled while I'm watching the game. It doesn't help that I've had the most exposure to American Hockey League and college hockey - basically the equivalent to triple and double A baseball. Which makes the hockey... sloppy. Hockey is an imprecise sport to begin with, so development league games are messy like a two year old eating chocolate cream pie.

My local team is the Aeros. We've been to one game so far this season, and we're going to a second this afternoon. I like watching them play, but sometimes I feel like the venue doesn't actually want us there. Aeros fans only get Bud Lite and similar; Rockets fans get a choice of barley-based libations. Yes, I know, Rockets games bring the venue much much more money. I don't care! I don't go to Rockets games. I want my bock beer, damn it! None of the nicer food joints are open for Aeros games, just burgers and such. Sometimes I think they would close some of the bathrooms if they could get away with it. Stoopid Toyota Center. Stoopid South for not supporting hockey. Pbbt!

Wild-card Games

What the fuck happened to Rothlisberger? Three interceptions in the first half? Is he out of his mind? So the Steelers are losing; as I write this, the halftime show is blathering away. Is there any use to the post-season halftime show? I don't think so. Every day during the playoffs, there are at most 2 games. I don't really need to hear 20 minutes of recap. Nor do I need to hear recap of the game I'm already watching.

Halftime shows are just annoying. I'd rather watch a marching band or maybe some pretty cheerleaders. Even Janet Jackson's boob is preferable.

Really, it's still yesterday

Or at least as far as I'm concerned - I haven't been to bed yet.

Today I treated the PWT Award Winner. These poor white trash folks really just never had any chance. Great grandma had a face that had been around the block so many times that 'roadmap' was an understatement. Grandma was MIA. Mom was, at the MOST, 16 years old. However, the award winner for the family was Dad. Or better stated, the baby daddy - since all he did was donate the sperm.

Babydaddy, like the child, has seizures... maybe. According to the Mom, "The dad says he has seizures, but his dad (ie Dad's dad) says that he only has fits when he's doing cocaine."

Oh snap, now that's a good family tree. This kid is already done for - PWT, a Dad with substance abuse issues, and a mother that probably won't finish high school. Good luck and good night!

Don't drop yer baby

I'm just saying. 'Cause if you do, I'll call CPS on your ass. Especially if the 'dropping the baby' story doesn't match with the two skull fractures, one older than the other. Again, I'm just saying.

In other news, hubbie and I are finally sitting down to do something we haven't done in days and days and days: watch our DVR! Mythbusters is at our fingertips, along with Bionic Woman, Torchwood, Dirty Jobs, Good Eats, Eureka and Top Gear. So far, we've tackled a Bionic Woman and we're midway through Mythbustuers.

Holidays

Mad props to folks who can blog every day through the holidays. I have proven that I can't. We had a crazy good time, though. Our annual New Year's Eve bash was a success. Most of the guests did, in fact, show up in formal wear. Our food came off well, even if the filet mignon was saltier than I'd usually like. We didn't run out of booze, which had been an initial fear. Best of all, even though I got drunk, I didn't get totally sloppy, pass out or puke. Go me!

Usually, when we through a party, I do well through the first 2/3rds of the night... but then during the last hours of the party I usually lose all control, slam the drinky-drinks and get shit-faced. Shit-faced then leads to passing out, which leads to hubbie staying up until all of the guests leave followed by shafting him with most of the cleaning. Not very cool.

This year, I stayed up until the fat lady sang. One number: 5. The party lasted until 5am. Holy crap! According to hubbie, most of our parties last that long. People, that's 11 hours of party. Yeesh. Who knew we were such animals?