Going Back Back to Cali Cali

Dan and I are headed to Sacramende!

Just accepted a fellowship position at UC Davis Medical Center.  I'll be part-time faculty there ... which means Tahoe and the Bay are waiting for us to visit....

Dan's flying out to SacTown this coming weekend to do some job & house hunting.

I'm so excited!  Last Midwestern winter.  Ever!!!

OCTOBER = TERRIBLE

7.5 months to go.
I hope somebody hires me this month.

residency: 1/3 to go

JULY = TERRIBLE

11 months to go.

Interns are coming ...

... and I need to get my act together.
Things to accomplish by the end of July:
curriculum vitae
letter of intent
list of fellowship programs to apply to
critical care projects
follow-ups, procedure logger
vacation requests

and to be a nicer wife.

wild animal vacation

Dan and I ditched the dogs and ran away to Orlando for a week to have a real honeymoon.  It felt GREAT.

Hyatt Regency Grand Cypress.  Resort with own golf course, waterfalls everywhere, enormous free form pool with multiple waterslides and hot tubs, stables filled with horses for riding, a lake for paddleboats and bike trails, fantastic restaurants with pool views, uncaged parrots in beautiful perches in the lobby, Lambos parked outside, ridiculous.

First resort up: SeaWorld!

The manatee is the dumbest animal I have ever had to learn about.

There were also polar bear (sleeping) narwhal (looks like a penis) and ENORMOUS WALRUSES (walrusi?)  We rode roller coasters and petted sea animals and ate everything.

Next day -- Disney World's Animal Kingdom

everybody was asleep.  Pumbaa.

Sleepy lion.

Animal Kingdom was a blur, the dinosaur ride sounded lame but was amazing, and the Yeti ride was even better.  Mostly what I remember were all the tired parents yelling at their self-absorbed, sticky, hot and tired children.  Some memorable quotes overheard being yelled at children:

"I am DONE with you!"

"NO MORE CANDY FOR YOU!"

"Next time you TELL MOMMY!"

"Honey stop spitting on your brother"

Some quotes overheard being yelled at parents:

"I get spanked ALL THE TIME!"

"I HATE YOU I HATE YOU I WANT MICKEY MOUSE"

"WHYYYYYYYYYYYY" ... and also tons of indiscriminate crying.

Next day: SeaWorld Aquatica!

I loved riding slides through the dolphin exhibit!  I took pictures in between water rides and stuff but I deleted them all after seeing all the fat sunburned people covering up whatever I was trying to take a picture of.  SeaWorld Aquatica is NOT a sexy place.  It is gross.  And when you are on a staircase, standing below and behind, up-close and personal with someone else's wet butt, it is super not sexy.  Glad I brought boardshorts, nobody got to stare at mine.

Also, SeaWorld Aquatica sells funnel fries, which is a tiny funnel cake in stick form, so that you can pick up the "fries" and dip them in ice cream.  EXCELLENT

In between all the theme parks was sitting in the hotel hot tub, ordering gourmet room service (sushi!) and visiting Downtown Disney.  DisneyWorld is enormous and evil.  They have creative and clever ways to squeeze every last drop of money out of you... it works.  I came home with too many trinkets and a clever dinosaur Tshirt.  Also my husband bought me presents!

Back from Park City

I love my attendings.  Went to UT for a week to do some riding and some learning (theoretically).  Never attended conference, rode everyday with the other residents who came along, crashed on the floor (closet floor) of the cabin the attendings rented out, drank their booze and ate their fancy food everynight.  Heard all the "olden days" DRH horror stories, watched old men play Euchre, played ski videos and analyzed Telemundo.  Shared one bathroom with 11 men.  Rode the Park City alpine coaster in between runs.  Packed pow & sunshine days 1-3, wet pow on day 4.  Flight home on day 5.

It's nice to be home again.

We're Dying!

this poor little blog has gotten abandoned when second year really started kicking my butt.  Intern year was much easier.  Second year is probably a lot more fun but now I'm hyperaware of how much stuff I have to know and do before third year and graduation can happen.  Everything is going by too fast.  And I'm not meeting the mental benchmarks I set for myself -- I still feel horribly PGY-1.

In the meantime, Detroit is experiencing an explosion of Emergency Department visits.  We have an insane 30-minute rule here in my hospital system -- you get seen by a doc in 30 minutes or less.  Doesn't mean you're treated and done, but at least you get eyeballed and put in the patient care area, as to minimize the notorious ED waiting room incidents that get reported by the media.

I have no idea what the people of Detroit think about this.  I DO know this is not a popular rule among the staff.  Our triage RNs are great at sorting out sick (dying) from not sick (has a cold and feels terrible) -- why ask them to shuffle all these people into our overcrowded ED before we even have space for them?  When your section of the ED is full and more patients keep getting sent back, I end up doing my physical exam on a fully dressed patient in the hallway (running out of beds is easy, running out of chairs is no picnic, but running out of standing room is the true indicator of a bad day).

Truthfully, sometimes a busy waiting room encourages the walking wounded to call their primary care doc, find another urgent care (rather than our Level I Trauma Center), or tough out their symptoms for a little longer.  But when every sniffle and sneeze gets put through, I'm now having to walk around and over some angry grumpy sick people (hey I understand -- the flu SUCKS and feels TERRIBLE) in order to pay attention to my dying people.  And I really hate coding patients in front of other patients -- this has been happening a lot lately.  The ICU has been at maximum capacity for the last month and sometimes the ED has as many as 12 ICU patients boarded and waiting for beds.  So I'm doing vent management and hourly ABGs for folks in between pelvic examinations for hysterical 19 yr old G4P3s who peed on a stick and it came back positive.  FML.

I'm worried that patient care is being compromised.  The ED is understaffed for this kind of volume.   Our overflow module is now open regularly.  Our fast track and intern module both open early.  People are being asked to come work extra hours.   TOTALLY NUTS.  And on a side note, my academic education is being compromised.  The only thing I'm getting better at is printing out discharge paperwork quickly.  It's not that I see too many people (usually 3 an hour) -- it's that I'm dealing with patients left over from previous shifts, and really complicated ones at that.  A lot of my time is spent doing stuff for folks who've been in the ED 30 hours.

And on the home front, both dogs are still alive, but Dan and I are dying from some mega-flu.  Guess our flu shots didn't cover mega-flu.  I got it first, from being cocky and finishing the dessert of a colleague who is working PICU and was having respiratory sx.  I went down hard and Dan pretty much laughed at my attempts at contact precautions and separate towels and sheets etc.

Now he's down.  And he's the kind of person who rarely goes completely down.  We're both off this weekend and had plans for a real date, but the idea of getting out of bed makes me want to barf.  I think I'm on the mend (witness me actually posting something on this poor dead blog) and Dan has some time to go.

In-service exam next week.  Not a lot of studying going on here, just rehydration and eating ibuprofen and trying to breathe out of my nose.  After in-service, brief trip to UT for conference and powder.  Dan's ironically headed to CO to present his research, but has no intentions of skiing.  I cannot believe we are married.  Grateful but stunned.  I begged him to let me pick up some ski pants and a jacket (at least) so that he can always change his mind and rent some equipment out there, but he declined.  I'm almost to the point of buying him some stuff anyway and hiding it in his luggage.