Thursday, April 24, 2003
12:31 p.m.
no fucking way~!! it's so nice here.
and i got your package. thank you thank you thank you~!! there's nothing like getting a collection. no stress, no waiting, a warm fuzzy feeling of completeness ^__^
err, although the yarn and insect theme is...disturbing? i don't know. the pretty bug keychain is pretty, and the centipedes are of course very relevant (and somehow remind me of you two since they came out kinda enmeshed), but the yarn will prey on my mind. i just know it.

shelly was here yesterday, and got me gravi 1&2 (because we all know which parts i'm interested in) and a chin iisou pic, so i am generally in a happy place, which not even last night's on-call with the ritalin abuse and the psychotic depressions can touch ^__________^

and meta, i got my schedule, and it doesn't look like we have weekend on-calls at all. so unless my supervisor is some sort of psychotic sadist who does her own weekend calls, i'll be there~!!

Wednesday, April 23, 2003
12:01 a.m.
hm. psychiatry is continuing on, slowly, sloooowlyyyy...apparently crazy people are more afraid of SARS than the sane. time to re-examine concepts of sanity...nnnnnnnnnnnow.
tomorrow night i'm on-call, and this time i shall endeavour to actually bring an alarm clock and, umm, food.

yesterday i cleaned a winter's worth of pigeon shit off my balcony. with a toothbrush. yes, that's right. a toothbrush. i am sad and pathetic and too lazy to actually go out and buy a scrubbing brush.
therefore it is not surprising that i now have "poisoning pigeons in the park" by tom lehrer on continuous replay.
it just takes a smidgen
to poison a pigeon.
^___^

Monday, April 14, 2003
05:14 p.m.
i have noticed something odd about...me (yes, i am self-absorbed. so what?)
when i get an outline to follow for psych interviews, when people give me suggestions on how to improve - all that is good. very good. as long as i do the interview on my own. when i'm doing it in front of whoever gave me the tips, i have an absurd feeling that i'm somehow plagiarizing if i use that help. so i try to avoid that and instead impress my attendings by...ignoring their advice.
i think i need real problems. maybe that would make me quit having these weird fucked-up ones.

i know that you've quit blogging again, meta, but maybe you still read. how goes the hotel room and your imminent molestation (on-call schedule allowing; otherwise i'll just molest you some other time)?
and how is my precious esca? i have not heard from you in what seems to me, in my current sleep-deprived state, a very long time.

Thursday, April 10, 2003
10:47 p.m.
wooot~!! the boy got his co-op placement with the company he wanted. he will now make $$$ and move out, and apparently has plans to live with the she.
(although how her mother will handle it i don't know; the woman calls our house several times on any night the she is staying over, to...well, i don't actually know why she calls).

saw "bowling for columbine" with shelly. wah~!! so funny. americans ^O^
and shelly brought choco-dipped cumquats she made herself. i love shelly ^__^

all is well on the med front. although SARS screening protocols are annoyingly wreaking havoc with rounds and tutorials, actual clerkship is progressing well. had my first psych on-call this week, and it was pretty good. not busy because of SARS, but a good intro to what it's about.
funny thing about the difference between medicine and psych. in med, we tried to see the pts asap and clear the er. in psych, we usually let the pts "cool their heels" before we see them, sometimes for a few hrs.

Saturday, April 5, 2003
09:49 p.m.
well, we're being allowed back into the hospitals starting monday. good, i guess. was a nice holiday, but to balance out the glorious freedom, mother nature gave us an ice storm.
ah, universal balance...how it manages to fuck up a perfectly good week.

i have also started my descent into what will undoubtedly result in my future financial ruin - i'm buying on ebay. buying - nude figurines. kukukukukukukukukukukuku...

Tuesday, April 1, 2003
09:30 a.m.

SARS scare closed the hospitals to all students here. i am at home, twiddling my thumbs, awaiting further news.
residents can still go to hospitals, but not students. hopefully this won't last too long.
there is a rumor that the hospital i'm at this rotation has a SARS pt in the ICU. rumor only though.
for now...

a funny thing happened in the psych orientation meeting.
coordinater: "everybody has to take the final exam for this rotation. it's compulsory, you all must take it.
you don't have to pass it though."

Monday, March 31, 2003
04:49 p.m.

YAOI~!!!!!

in other news, witness the awesome power of borrowed authority:
me: "hi, this is the clinical clerk calling about patient x, could i talk to dr. so-and-so?"
evil secretary: "the doctor is busy now. maybe he'll call you back."

powered-up me: "hi, this is the clinical clerk, calling on behalf of insert name of attending here, could i talk to dr. so-and-so?"
evil secretary: "just a moment, i'll put you through."

Friday, March 28, 2003
03:53 p.m.
last day.
last day, no new intakes, one last discharge.
feelin' good, already missing the place. everyone is so niiiiiiiice ;__;

yesterday one attending gave a dinner party for us at his place, with all the other attendings (minus the one on-call). so great. it was actually lots of fun and not a bit awkward, which is surprising. i suppose this just underscores how great these people are.

ah well. we'll see if psych can beat this rotation (ha ha. no it can't).

and i've secured my 1st carms letter~!! go me~!!

Monday, March 24, 2003
08:22 p.m.
chibi fighting robots~!!
finally, i have broken down and after a long and successful period of willful ignorance and disinterest, have gone to one of those competitions in which the boy pits his little robot against other little robots in a little ring.
"whatever", i thought, "if i get bored i'll wander off and watch more interesting things than little boys playing with little robots."

and was i bored? hell no~!! i sat there cheering and booing little robots for hours like one suffering from some rare dementing illness. i want a little robot too. i even have a name for it~!!

sadly the boy, his mind distracted by the general non-workingness of his more "prestigious" autonomous robots (and possibly by his acute state of insomnia) managed to lose the final, getting 2nd place. the she got 3rd after letting the boy take control of her robot in the tie round of the final (oh she, did you not see he wasn't concentrating? you were doing so well yourself~!!).

oh well, 2nd and 3rd is nothing to sneer at, and there's always other competitions. where *I* shall dominate~!!! kukukukukukukukukukukukukuku...


back at the hospital, 3 new pts were ruthlessly thrown my way, and another one to pick up starting tomorrow. so i'm back at 7.
*sigh* why do i even bother trying to clear house on the weekend if this is my thanks?
one. last. week.

Saturday, March 15, 2003
07:59 p.m.
ah. what a sucky day it is. and it's eerie and quiet now, and the pager hangs on my belt like an albatross, promising to pull me in as soon as i step off hospital property.
i'm paranoid that way.

i'm paranoid in lots of other ways too. for example, as i sit here in my dark lonely room i imagine my attending was actually criticizing my general slowness when he mentioned in his friendly fashion how many pts he saw today. he did oh-so-many consults and i did...2 new ones and an admit from rcu i think.
one needed to see a surgeon urgently because the red cross people might have scalded his DM neuropathic feet, turning them into septic lobsters. there appears to be some kind of internal surgeon conflict going on of which i am only peripherally aware, so the surgeon on call refused to see him and referred him to - the surgeon not on call, who...ummm, wasn't around, being that he's not on call. so i and the intrepid nurses, not wishing to see our names in the newspaper if this case goes legal, found a friendly surgeon if a far-off hospital and had him transferred off our hands.
but the paperwork, the calling and begging for a surgical bed, the sheer bureaucracy of it was mind-boggling.

looking back on my day like this, it doesn't seem like too little. a new pt, an rcu pt who needed all his admission orders and such, and the admit/transfer, plus all my regular pts and one of my classmate's. doesn't seem like enough to not allow me to eat anything between 8am and 5pm, but i got a bit flustered and involved in that damnable transfer.
is my attending critical? i don't really think so. he has a better rapport with my classmate because they both hail from the same far-off place, and naturally i'm also intermittently paranoid about my classmate (enough to spy on his evals, i should really work on this paranoia thing), but he's always nice and friendly and willing to teach. hm.
i guess the problem lies with me.

in other news, i've put in my first foley 2 days ago. sadly, the pt in question was too far gone to appreciate my efforts.
unlike my classmate, who, having done 3 of them, guided me through the procedure.
ugh.
i feel guilty now. i suck. i also think i can get free psych help.

Tuesday, March 11, 2003
04:22 p.m.
*droooooooooooool*
today, as if to make it up to me for the clusterbomb of pts ( "as if" of course, nobody actually gave my headache a 2nd thought ^_~), one attending brought in chocolate mousse cake, and the other supplied huge strawberries with chocolate fondue.
and i, being weak of mind and easily swayed by the good and chocolatey things in life, am once again in a happy mood. today being a fairly pt-light day helped too, and once i tracked down the chart of that pt who wasn't mine and dictated on him, i was left to my own devices and pts, all of whom are pretty stable and generally improving.

and i see meta's back again. was one of the projects your group thing with the uncooperative members?
there was an uncooperative pt here last week. he was placed in restraints and pumped to the gills with psychotropics. that made him cooperative fairly quickly ^__^

Monday, March 10, 2003
10:39 p.m.
ugh. i was having a perfectly good monday (if mondays can ever be good, which they can not), having discharged one patient and being left with but one under my tender care. thus i slinked from floor to floor, seeking to avoid work in the form of new consults, making it past lunch and nearly to dinner.

then - BAM~!!!
2 (count 'em), 2 new admissions, and one pt admitted yesterday who never had a proper consult dictated (because, of course, the attendings don't bother with that). so, for all it counts, 3 pts shoved onto me around dinnertime, which is why i'm still here at nearly 2300 after finally finishing my last dictation.

make that second-last, but the remaining one is a discharge of a pt who was never mine, and consequently i know nothing of his history or course in hospital. nevertheless, i must dictate his discharge sometime tomorrow when i get my hands on his chart because (all together now): the attendings don't bother.

and how is the world of the interphalangeal space, dearest?

Wednesday, March 5, 2003
05:43 p.m.
blah blah blah 25 year old patient blah blah reacts to deep pain blah blah list 8 reasons why she's unconscious.

such was the internal medicine final written exam. 15 questions like that. and the above example is possibly the easiest because let's face it, one can b.s. a lot of reasons for people being unconscious.
15 scenarios actually, each with 2-4 questions. in 2 hrs. i feel...shocked. and extremely sleep-deprived.

blah blah what treatment would you use? be specific, give exact dosages.
what do they think i carry a pocket drug reference for, to do bicep curls?

to have the "final exam" in week 2 1/2 of a 6-week rotation. how supremely unfair.
(naturally i would not be complaining if i thought i'd aced it. naturally. but hey, it's a pretty valid complaint)

and so, a day of feeling crappy and vaguely outraged. and also somewhat disappointed with myself. i should have known more.
what this counts for in the final eval, no-one knows. at my med school, probably not much. but it counts for one hell of a crappy day, and that's enough.

Monday, March 3, 2003
05:10 p.m.
post-on-call weekend. wasn't all that bad, except of course on sat. damn you, other hospital, and your re-direct~!!

new attending came on this week and started discharging pts left right and center. love new attending ^__^
2 of mine went today, and 2 more will, ccac and hematology willing, go tomorrow. ccac is homecare, which will assess one of them for the general ability to live alone.
hematology is following our leukopenia dude. the man's got no neutrophils. well, he today has the very minimal number needed to fight off infections, barely.
so, not to get ourselves into trouble if he comes in dead after discharge, we're going to let hematology make the call. heh heh. take that, hematology~!!!

was watching parts of "patch adams" on sat (abandoning my plans for a 10 hr sleep) and came onto the part where they talked about transferance. basically claiming the reason pts are referred to by disease and not name is so the docs don't get attached to them and feel their pain or somesuch. i say:
1 - you try looking after 50 patients (the # currently being carried by the attending) whose # remains pretty constant but who actually change with daily admissions and discharges and tell me you remember their *names*, and
2 - "attached"??? hell, kick them all outta here for all i care, then maybe i'll get some rest.

medicine: draining all empathy out of my, one pt at a time.
warning, above statement assumes prior existence of empathy. level of empathy may vary.

Friday, February 28, 2003
05:19 p.m.
today was weird noneventful day. was practically done by 2pm, and tried hard to avoid new consults by rushing from floor to floor and checking blood sugars on my pts multiple times. but i don't think there were any new ones anyways.
i eventually went down to the er to find my classmate and fellow toiler in the trenches, only to learn that he'd written his pt sign-off and disappeared for home. at the same time realized i still had the 3rd-year student's book (the one i told you about), and she of course was long gone.

however, while in the er i managed to heroically head off another ctu consult by remarking that a pt there was just in last week, was seen by us and worked up for cardiac, and maybe gi should take a look at him now.
like i need to listen to him whine. i get enough of that from...myself.

medical students - working on constructive new ways to avoid or otherwise get rid of pts.

Tuesday, February 25, 2003
10:50 p.m.
^__^ well, i didn't think you were dead. just in some sort of...coma?
and i am doing way better now. this week's attending is much calmer and willing to actually sit down with me and go over the orders. but i'm on-call again tonight, my patient load shot up from 3 to 8, i'm way behind on my dictation and you just know something's wrong when your 1st reaction to learning that your pneumonia patient is having a heart attack is "thank god, now icu will take him off my hands".

eh. this is nothing. i'll still have to survive my marathon fri-sat-sun on-call this weekend. *inappropriate giggle*
i don't feel like going home to sleep. the pts in er get sleep meds. why don't i get sleep meds?

Friday, February 21, 2003
06:45 p.m.
i thought i'd just continue my last entry, but i want to leave it as is. i was on-call, it was my 1st solo consult in internal medicine. this diary is here for a reason.

but to continue my thoughts, the other students are more experienced. the 3rd year student's obviously been through this before, and my classmate has done in-hospital electives while most of mine were at clinics. i'm catching on, but with only the two of them here and no residents, it's obvious i'm the one who needs most explaining admin-wise.
at least if there were more people, i could spread my questions around and avoid looking like an idiot.

i was in quite an unhappy state following my last entry. i was upset at knowing so little, but really more upset that the others knew more. i was afraid of being seen as stupid by my attending. when the page came, i went down to the er practically chanting you can't screw this up, you can't fail under my breath. when it came time to dictate (for the 1st time in my life) the admission, without anyone present to really answer my questions about the format, nevermind the patient, i was seriously torn between smashing the chart against the wall or bursting out in tears.

i really hope this will prove to be my worst moment. i felt so completely useless and lost, and my attending seemed to feel i should be able to handle the admission without him even being in the same building with the patient.

in any case, i snailed my way through dictation with much frustration and endless pausing. i did some more today. i'm getting better, i'm getting the hang of it now, i think. my pts are getting discharged so fast i can't keep up with the d/c summaries. i've just been told i need to include punctuation on my dictations and await my first efforts with amused trepidation. but i still remember how close i was to crying over the fucking paperwork nobody bothered to show me.

and on an unrelated note, i've once again lost your #, my dear. at home now, for the weekend (yes, we changed on-calls. i'll be covering next weekend). call me?

Wednesday, February 19, 2003
06:26 p.m.
well, i'm at my internal rotation. and for the 1st time since starting med school, i feel truly and completely out of my depth.

current week's attending seems to think we know all about hospital procedures involving consults, admissions and discharges without being told anything. to make matters worse, the other two students on the rotation do seem to know much more, one being a 3rd-year almost-resident at the end of her clerkship, the other being my clessmate (paged. tbc)

Sunday, February 16, 2003
04:30 p.m.
chibis are gone.
am wandering aimlessly around, packing, with the feeling that i'm forgetting something absolutely vital. have started making lists. find it odd to walk into bedroom and see space where chibi cage was.
apparently my parents reorganized the entire tv room and took all the clothes out of the closet there, to avoid smells-like-chibi syndrome. i am amused. so much work on my account.

esca's armpit of a city ate my bankbook yesterday ;__;
yes, i will immortalize this occurrence on the blog and refer to it in bitterness. i need bitterness. it makes me warm.

i will be on my way to elective in...1 1/2 hrs. i'm sure i'm forgetting to do something.

Friday, February 14, 2003
08:17 p.m.
clie~!! i have clie~!!
can your clie kiss my clie and transfer precious clie germs?
i shall arrive in the armpit somewhat before 11 am. i was there today, and i even hinted strongly that i'd like to be released for lunch to try and find you, but alas, nothing came of it.

i got the pics developed too. i was...quite surprised. i thought i'd laugh my head off. but your bfie is actually very very sexy ^__^

well, geriatrics is over, and i think i learned a lot about dementia. that's something, seeing that it was a hodge-podge of 2 weeks, 4 preceptors, and 5 hospitals. not too bad, but really, really all over the place.
ah well, can't wait for my thrice-daily hospital cafeteria meals.

Wednesday, February 12, 2003
06:10 p.m.
allo, dear layout-making one. i shall send pic post-haste *drool*

am in a semi-unreasonably crappy mood. we had our case presentations today, which were supposed to be 5-10 min. my partner and i did that, and we were the only ones. the rest were all 20 + min, many closer to 30, and most not case presentations at all but rather mini-lectures on broad topics.
does nobody read instructions anymore?
what really pissed me off was that the tutor present never mentioned the time thing. i don't think it should be up to me to remind my peers that they've fucked up, especially if the tutor doesn't seem to find anything amiss. and naturally it is far too late to run my errands, which must be done by the time i depart for my rotation...meaning i have 2 weekdays left.
but that's what happens when you let crap like today's go 2 hrs overtime.
however, i also recognize that my current state of anger is somewhat out of proportion with this incident. i haven't slept too well lately because of stress, and knowing how much needs to be done outside actual clerkship work before i leave isn't helping. when am i supposed to do it if i'm in the hospital during business hours? *tears out hair*

i will go watch tv mindlessly to dull my rage. or my brain, as long as it's dulled.

by the way, dear, i'll be visiting the armpit this fri. we'll be geriatricsing across the road from the hospital and i thought i could stay overnight then, but sadly i need this fri afternoon here to finish everything. ah, if it wasn't for those over-long presentations...do feel free to hate them as i do.

ps: IM, pah, i can do them with my eyes closed. i AM the injection queen~!!!

Tuesday, February 11, 2003
11:44 p.m.
ooohhh la la...the generous armpit has provided her with a house~!!! a 3-bedroom one. me so jealous ;__;

geriatrics churns on, and it's getting more stressful. today we made a mad dash from one hospital to another to another, and still need to come back to one of them really early tomorrow to read more chart.
i think i meant to write something personal and diary-like today, but my head hurts and i'm sleepy and i still haven't finished my presentation for tomorrow. i don't feel "personal".

Monday, February 3, 2003
04:37 p.m.
ok, so i'm bored.

Which Saiyuki character would sleep with you?