Saturday, February 26, 2011

Weekly Whine: What's in a name?

When I was a resident on a new rotation as a PGY2, our attending was orienting us to the therapy staff. She kept referring to me by my first name through the meeting, which is fine... I'd actually prefer if the therapists call me by my first name, since most of them are older and more experienced than I am anyway. But the weird thing was that she kept calling the other resident by his title.

For example, she would say something like, "If you feel the patient's medications need to be changed, you can page Dr. Lee or Fizzy."

I was baffled. Admittedly, the other resident was a PGY4 while I was just a PGY2, but we both had the same exact responsibilities on the ward. We were both licensed physicians. Neither one of us was boarded yet. He was five or six years older than me, but still just in his early thirties. So how come he was Dr. Lee and I was Fizzy?

And trust me, I do not have a difficult last name to remember or pronounce.

I just put it aside, thinking maybe the attending forgot my last name or something. But then the next day, another attending was going through the ward, introducing someone who was applying for a job. And he introduced us as: "This is Dr. Lee and this is Fizzy."

Strangely enough, these days I have the opposite problem. I want the staff on my unit to call me Fizzy and have told several of them so, but many of them persist in calling me Dr. Lastname. Or they called me Fizzy for a day, then went back to Dr. Lastname. It makes me really uncomfortable, for some reason, mostly because I'm the same age or younger than everyone and I feel like we're all on the same level. But after a few months of saying, "Call me Fizzy," I kind of gave up.

Conversely, I absolutely want all the patients to address me as Doctor, and it pisses me off incredibly when they ignore my introduction and immediately start addressing me by my first name.

Sunday, February 20, 2011

Residency match vs. hotness

So apparently, residency match is coming up in the next month.

EEK! Aren't you guys EXCITED????

In honor of the upcoming match, I did a little exercise involving the match list from my graduating med school class, inexplicably still saved on my hard drive:

I picked out the hottest 10 girls in my class and the hottest 10 guys, and I wrote down what each of them matched in. (I was bored. And possibly drunk.)

It was really easy to pick out the top 10 hottest girls in my class. Maybe female beauty is just more objective. Within a minute, I had a list and could have added a few more even.

I mulled over the top 10 guys for a long time, struggling to come up with 10 guys in my former class that I actually thought were attractive. It was hard because I didn't want my own personal preferences about the opposite sex to get in the way of this extremely important, objective exercise. I like nerdy, overweight guys with glasses. That's probably not any universal standard of male attractiveness though. Or, I don't know, maybe my class just had a lot of unattractive guys.

Anyway, these were the results:

Top 10 girls: General surgery, pediatrics, pediatrics, medicine, medicine, psychiatry, neurology, anesthesia, rad-onc.

Top 10 guys: Ortho, ortho, urology, plastics, dermatology, anesthesia, EM, general surgery, pediatrics, radiology

So from these lists, we can deduce that the hot guys did much better in the match than the hot girls, going for far more competitive specialties. So if you're a guy, it helps your career to be hotter. If you're a girl, not so much.

Although really, that's not the case at all. Looking at the general list, it seems like the guys just matched more competitively in general. The ortho matches were all guys, of course. So were all the urology matches. Even radiology was mostly guys. Derm, ophthalmology: all guys. The only competitive specialties that matched a good number of females were anesthesia and EM.

So in summary, being hotter probably wouldn't have helped me match in a more competitive specialty. Growing a penis might have.

Friday, February 18, 2011

Weekly Whine

Most days, I end up working though my "lunch break" at work. I have a lot to do and it's just easier to scarf down a sandwich while writing notes. Gets me home at a reasonable hour.

It doesn't bother me to have to work through lunch. As long as I get to eat, I'm happy. I get very cranky when my blood sugar drops.

What I don't like is the soundtrack I get to my lunch every day.

No, I don't have to listen to Justin Bieber or two people having sex, but I think both of these options might be preferable to what I do have to hear: In a conference room far, far away (but very much within earshot), there are people enjoying their lunch break.

OK, I don't begrudge anyone having a relaxed 30-45 minutes for lunch in which they're not furiously writing notes. But do they have to FLAUNT it so much? I'm sitting there alone in my office, eating a cold sandwich, and every few minutes I hear a burst of laughter. It's not just laughter either. It's the kind of hysterical sound that people only make if they're being tickled or possibly assaulted in some way.

Why are they laughing so much? And so hard? And so frequently? What is so damn funny? Who are these people and why are they so damn jolly??

It drives me freaking nuts.

I feel like a grinch talking about this. But it's really hard to have to listen to people in another room laughing hysterically for thirty minutes a day every day. It's sort of like if I was on a diet and I had to watch people eating decadent chocolate every day while I munched on carrot sticks.

It's gotten to the point where I try to avoid my office during the 12-1 time period, so I don't have to listen to them. But that's the best hour to eat lunch! This is just so unfair.

Wednesday, February 16, 2011

Tales From Intern Year: The Haircut

The story I got:

Mr. Hoff (not his real name) is a 40 year old guy who woke up to go to work in the morning. The next thing he knew, it was the next day... he woke up covered in coca cola and apple juice, on the floor of his room. He's never had any incidents like this before.

I walked into the room and he was a young-looking guy with a kind of strange shaved haircut. The sides of his head were completely shaved but the top was kind of long... it actually sort of looked like a Vanilla Ice haircut. I asked him what had happened and he said he wasn't sure. Nothing like that had ever happened to him before.

"Do you have any memory at all of the last day?" I asked him.

"No, no memory at all," he said. "I just woke up... and I musta got something to drink, cuz... I woke up all covered in coke and juice. Also, I gave myself this haircut."

"You don't remember shaving your hair?"

"Nope, not at all."

"Have you ever shaved your head before?"

"No way... I didn't even think I could."

It was impossible to get a good idea of what had happened to him because he had absolutely no concept of time. He had been to the emergency room at another hospital for a brief loss of consciousness, but he wasn't sure if it had happened days ago or weeks ago. I started doing a mini-mental, but I knew it would be way too painful to do the whole thing, so I just started it....

Me: "Mr. Hoff, can you tell me what day it is?"

Him: "It's Monday, March 17."

Me: "No, actually, it's Tuesday, March 18."

Him: "No way! Really?"

Me: "Yes."

Him: "Are you sure?"

Me: "Yes, I'm sure."

Him: "I thought it was Monday. Wow, are you sure?"

Me: (starting to doubt myself a little) "Uh, yes."

Him: "Wow..."

Me: "Can you tell me what this is?" (points to my watch)

Him: "I don't have my glasses."

Me: "This thing on my wrist."

Him: "Oh. A watch."

Me: "Good. Can you tell me who the President of the US is?"

Him: "An asshole."

Me: "Uh... what's his name?"

Him: "George W. Bush."

When I asked him to spell the word WORLD backwards, he just said "D.........." then he gave up.

His urine tox was positive for a bunch of things he admitted to having taken (medications), but we still couldn't figure out what was going on. The attending didn't know what to make of it, but he sure had a lot of questions about Mr. Hoff's haircut:

Attending: "So were you thinking of giving yourself a haircut?"

Mr. Hoff: "No, not at all."

Attending: "Is this a haircut you've ever had before?"

Mr. Hoff: "Well, maybe years ago. But not in a long time."

Attending: "Is this the kind of haircut you would have wanted?"

Mr. Hoff: "No, no... not at all."

Attending: "Have you ever given yourself a haircut before?"

Dr. Hoff: "No, never. I didn't even think I could."

Attending: "It actually looks pretty professionally done... are you sure you did it yourself?"

Mr. Hoff: "Yeah, I mean... there's hair all over my bathroom."

By the end, I was seriously wondering if my attending was going to ask Mr. Hoff to do his hair too.

Monday, February 14, 2011

Happy Anti-Valentine's Day!

When I was in my first year of med school, a couple of my friends and I decided that we were sick of Valentine's Day and how it made single people feel crappy about themselves. So we decided to celebrate Anti-Valentine's Day. This holiday would express feelings that weren't specifically of love, but weren't of hate either.

We went out to the back of the university hospital and we climbed through a dumpster and selected "presents" for all our friends. We then taped little messages on each of the presents that expressed the sentiments of Anti-Valentine's Day. I can't rememeber, but I'm assuming we were drunk at the time.

Here were a few examples of presents:

Amazingly, we were not expelled.

Sunday, February 13, 2011

Pre-Valentine's Day Romance

A conversation I had with my attending right before my second wedding anniversary:

Attending: "The first wedding anniversary is the paper anniversary. So for our first anniversary, my husband made a little scavenger hunt with clues going to all my different presents."

Me: "For my first anniversary, my husband had mono, passed out, and I had to take him to the hospital in the middle of the night."

Attending: "So he's not really the romantic type?"

Me: "Not really."

Attending: "Is he planning something special for your second anniversary?"

Me: "I'll just be happy if I don't have to take him to the hospital."

Saturday, February 12, 2011

Weekly Whine

Man, I love doing this Weekly Whine. I could do this every day and never run out of things to complain about. Every hour, maybe.

Today I'm going to relate a story from my intern year that I'm still pissed off about, all these years later:

Midway through my intern year, I had a co-intern on wards named Dana. By some fluke, Dana ended up with a larger census than me at some point. This happens from time to time, despite the fact that we admitted roughly the same number of patients (in fact, I think I had admitted more).

On a short call day, I had two patients and Dana had four. There were two patients to distribute on short call, so being the nice, kind, giving, caring person I was, I immediately volunteered to take the patient who was more complicated and whose orders hadn't been written yet. But as it turned out, that more complicated patient got discharged the same day (who knew??). And I discharged another patient while Dana kept all of hers.

Therefore, through no fault of my own, on pre-call day, Dana had five patients and I had one.

While we were in the elevator that day, Dana turned to me and said, "You know, I'm really disappointed in you. You should have offered to take both short call patients yesterday. That's what I would have done."

I was SHOCKED. I had been working my ass off like everyone else and the second my service got a little lighter, I was supposed to VOLUNTEER to take on more work? It wasn't like my resident or attending had asked me to take both patients and I refused. And how the hell was I supposed to know my sicker patient would get discharged while hers would stay?

But of course, I felt really bad about it. I apologized and then Dana apologized, and said she was just stressed out and residency was turning her into a bitch.

Still, things were kind of awkward after that.

Anyway, fast forward to several months later, the last wards rotation of my intern year:

My co-intern this time was a pretty little transitional intern named Stephanie, who was going into dermatology. (As you know, all the best people end up doing dermatology, right? Because you can totally match in that without being a super competitive gunner.) Anyway, I was "warned" about Stephanie months before, but she seemed SO sweet that I was looking forward to having a rotation with her. Stupid me.

I could spend a few more paragraphs whining about Stephanie's many issues, but I'll spare you. Let's fast forward again to the relevant issue: our program had started a new system where the interns would split the long call. One of us would admit for half the night (the early person) and one for the other half (the late person).

This system didn't work so well for me and Stephanie. Through some trickery and fancy city talk, she managed to make me the late person on every single weekend call, which is worse because you don't cap on weekends. When I attempted to complain, she made me feel like I was being a bitch so I quickly backed down (me = wuss). But really, the main reason it didn't work well was because Stephanie was "slow as ass" (my senior resident's words, not mine, but I thought it was very eloquent and repeated it frequently).

Anyway, on our second call, I was the early intern and capped at five admissions. She admitted two. Post-call, I had nine patients and she had three.

This was a little uneven, so my attending and resident suggested we even things out on the short call. It was totally their idea, you guys! Not mine! But Stephanie didn't like it one bit when they told her.

When the attending and resident were out of sight, Stephanie pulled me aside and said she "needed to talk to" me.

I won't get into specifics, but the gist of the conversation was: "I was really excited to start this last medicine rotation but now you've ruined it."

It was a little funny, because she disguised the whole thing as a conversation about how I was very negative about the rotation and how she felt I complained too much (definitely true, but who doesn't??), but what it really came down to was that she wanted us to take the same number of patients on short call the next day. She kept saying, "What's the difference?" If there's no difference, then why was she complaining about it?

I told her that the attending wanted it this way, the resident wanted it this way, and even the new resident starting on Thursday heard about the situation and wanted it this way. Also, I had clinic all afternoon and she didn't (transitional interns didn't have clinics). Even with more admissions than me, she would probably go home well before me.

But she insisted on going through all the patients and pointing out that if there were three admissions and I took none, there was a very slight chance she might have one more patient than me the next day.

I found the whole thing really ironic. It was the complete opposite of the situation with Dana, yet again I was the one getting yelled at. Except in this situation, Stephanie was not only not selflessly volunteering to help even out the distribution, she was actually refusing when the resident asked her.

So basically, this was the situation:

If I had less patients and I didn't offer to take extra patients, the other intern got angry at me.

If I had more patients and the other intern had to take extra patients, the other intern got angry at me.

See how interns treat each other? I was pretty disgusted with her and disgusted with my life.

Anyway, the upshot was, I thought it over, discussed it with another intern, and decided to be the bigger person and split the short call admissions.

I left a message on Stephanie's pager, saying that I would do this. I ran into her the next morning and we had the following conversation:

Me: "Did you get the message I left for you?"

Stephanie: "Yes, I did."

Me: "Okay, so that's better for you, right?"

Stephanie: "Well, let's see how many we get."

No "thank you very much." Just a very snooty "let's see how many we get." Would it kill anyone to say thank you? How difficult is it?

Well, at least my resident thanked me. I get the feeling that she had received quite an earful from Stephanie as well.

Thursday, February 10, 2011

Photographic evidence

This wall in our residency clinic never had papers removed from it. Ever. I think the Declaration of Independence might be up there somewhere.

I tried to find the oldest paper I could on the wall. This was one from 2000. (Photo taken in 2009.)

Ooh, one from the early 90s:

Kurt Cobain was still alive when that was put up on the wall. Think about it.

Monday, February 7, 2011

Tales From Intern Year: Scavengers

Residents are total scavengers.

Example #1:

One day during my intern year, I was craving caramel popcorn. The cafeteria was only selling massive bags of popcorn, so after I ate a couple of handfuls, I had most of the bag still left. I decided to leave the open bag on the table in the resident's lounge.

I kind of meant for people to take what they wanted, but I figured nobody was going to eat from a random open bag of popcorn. Boy was I wrong. By noon, when I came back to the lounge, most of the popcorn had been eaten. Then when I came back again at three, not only was all the popcorn eaten but even the bag was gone (presumably devoured).

Example #2:

When I was on call in the ICU, someone brought some giant cookies into the ICU physician break room in the morning. I got hungry at some point later in the day, so I broke off a piece of the one remaining giant cookie and ate it. The next time I came into the classroom, a little bit more of the cookie was missing (someone else must have eaten some). I ate a little more too. Each time I came into the classroom, a little more of the cookie would be missing and I'd eat a little more.

So I was sharing that cookie with someone. I just don't know who. And this didn't bother me in the slightest.

Saturday, February 5, 2011

Weekly Whine

Hi, welcome to what seems to be becoming my weekly whine. This is where I complain about something and then everyone gets inexplicably offended because omg someone complained about something on a blog.

This week I am complaining about my cleaning woman. Yes, I'm complaining about a woman who comes and cleans my apartment. Also, my diamond shoes are too tight and all these hundred dollar bills won't fit in my wallet, but those are topics for another entry. Anyway, this woman made a strong showing on her first day with us by cleaning the wrong apartment. Granted, she's the first cleaning woman I've ever employed, so I don't know if my standards are too high or something, but this woman has been a bimonthly source of stress for me for the following reasons:

1) We agreed to pay her $75 per session at the onset. After she finally cleaned our apartment the first time, she told me that it was going to be $100 for that session. I told her that she couldn't just decide how much she was going to charge us after it was over. Finally, she said if we paid her $100 for that first session, she'd charge us $70 from then on. Made no sense to me, but I agreed.

2) A few sessions later, she left us a note, saying she "tried to make it work, but she just couldn't find a way" to clean our apartment for $70, and she had to charge $75.

3) She refuses to clean our oven or microwave without an extra charge. She also doesn't do laundry.

4) A couple of months ago, she said she "couldn't possibly" take out our garbage anymore. I told her I was going to fire her (because, seriously, wtf?) and she changed her mind and somehow found a way.

5) She won't clean our dishes. This I think bothers me the most of all, because I throw all the dishes in the dishwasher before she comes, so there's generally just maybe two pots that aren't cleaned. She puts them in the sink and doesn't clean them. They would probably take about two minutes to clean, which is why there's something blatantly obnoxious about the fact that she refuses to do it.

6) This isn't her fault but I hate the fact that you have to pre-clean before a cleaning woman comes. I end up spending the entire night before picking up toys and getting the apartment clean so that she can clean. Probably the biggest utility of having a cleaning woman is that it forces me to clean.

7) Related to #6, she often reschedules on us. I don't mind so much, especially if she has a good reason, such as that six feet of snow just got dumped on the midwest, but sometimes her reasons are less predictable, and I wish she'd tell me the day before, so I didn't go through and tidy the whole apartment the night before so she could clean.

8) We suspect she may have broken one of our electronic devices by dropping it and not telling us.

9) She left me a note once, saying that she babysits, which is almost laughable, considering I barely trust her to clean.

Anyway, I think that covers it. Yet we keep her on because I just don't want to scrub the toilets.