User: jerseyjess Date: 2009-12-24 23:27 Subject: Hineni Security: Public Mood: tired

I saw A Serious Man tonight, mostly because it was the last night the movie was playing in the Millburn theatre and my baby brother said he could get all of us in for free. (He's working at the movies again this break) I'm pretty sure this is the first time I've seen a movie in theaters since...uh...maybe Be Kind Rewind, which I saw with Vom so it was in January of my second year of med school, or something like that. i can't remember seeing anything in the theater after that--I don't watch TV so I don't get to see previews so I don't know what's coming out and normally I don't feel like paying the $10+ for 2 hours of entertainment...so I only go when someone else is paying and as you can tell, people don't seem to feel like paying for my movies too much. But it does make me feel like a pretty crappy film major if this is my first cinema-movie in 2 years.

Anyway, we all really liked it. If you're not Jewish, you probably won't enjoy it, but the whole theater seemed to enjoy it which is probably because who else would go see a movie about Jews on Christmas Eve? I get the feeling most non-Jews wouldn't get most of it because they didn't really explain any of the Jewish sayings or rituals or anything like that. I was fine with that but I can see how most people wouldn't be a huge fan. My dad said it was pretty understandable that the movie didn't have widespread appeal. Also, the opening scene is in Yiddish. It's subtitled, but it's funnier if you understand the Yiddish. (I got parts of it. Not very much, my parents got more of it)

I don't get it though, the main character was a prof and my sister is a prof and my sister seems to get treated like gold. I'm using her laptop and she yelled at me to not close the lid because she had to keep it nice because her department wasn't giving her a new one until June. Her department pays for her printer paper and her ink cartridges and all that jazz. They send her away on trips. They tell her not to worry about teaching and that her number 1 priority should be her research. Once she gets tenure, her salary is going to go up to around 6 figures. So why is it the guy in the movie was constantly getting berated by his department, his students were making his life miserable, he didn't have money...It was kind of a depressing movie, especially the end. My dad compared it to the story of Job. Parts of it were funny but I left the theater feeling a little blue, truth be told. I mean, the guy really never got a break and the ending was pretty bleak, right as things started to look up, they went down in flames. It was like he was always trying and got nowhere and nothing he did mattered or was good enough. That being said, I guess part of me kind of wishes more people knew what it was like to never be good enough. i think it's one of those things that separates med students from most other people and probably why med students date other med students--no one else understands what it's like to get up every day and try your hardest and know that nothing you do will ever be good enough, you will never get anything completely right, and you will always be surrounded by people who are smarter than you and make sure you remember that. And then you try to complain about it to someone and they don't understand and they think you're whining. It's hard to explain.

I'm completely off-topic right now so I'm going to close by saying it was a good movie and I think the Jews reading this would enjoy it because even though I found it overall pretty depressing, it had a lot of humor sprinkled in. And a lot of Jews-only jokes. Those are always nice. And the Coen brothers rarely disappoint. So that's something.

User: jerseyjess Date: 2009-12-23 14:33 Subject: Hexagonal Security: Public Mood: bored

Mmmm...nothing interesting is doing so here is a brief recap of the past year: (AKA the first line of the first entry of every month unless that entry was a meme or a cartoon or something like that in which case I went with the first line of the entry that actually had something to do with me...)

January:
Happy Birthday to my baby brother!

February:
I spent the day in Pediatric Cardiology Clinic today which meant it was me and the Chief of Pediatric Cardiology at my school

March:
Today I spent from 9AM until 10:38AM hoping that my attending would not invite me to go to the rotary club with him.

April:
Mmmmm...I'm vaguely hungover but it's all good, I don't have to do anything until tomorrow at which point I have to start doing internal medicine.

May:
I had my first session of physical therapy on Friday with Lee the PT.

June:
I'm pretty sure that at some point during the day myself and the other 3 students on this rotation all said some variation of "this month is going to suck."

July:
I'm back in jersey and i've been eating like a hog ever since I got here

August:
It's been a brutal few days that involved a 16 hour greyhound bus back to NYC, finding my new 6th floor walk-up studio apt in NYC, coming back to my parents' house in NJ for the night, driving up to Boston with my bro, spending the night with Phuntmuffin in Boston, Yevgenia and Adam's wedding, spending the next night on a bus back to NYC, getting to my apt after 3AM, and having my first day at NYU today starting at 7AM.

September:
Blerph, I just submitted my residency application.

October:
I am dog-tired, to use an expression I learned from an old National Geographic.

November:
I woke up yesterday morning and it was totally dark in the room and I had no idea where I was.

December:
Dr. Dermafem: OK jess, if the patient is taking 2 pills a day, then how many pills would you give them for a month?

So many memories...

I feel like we can draw a bunch of conclusions from these snippets:
1. I only talk about myself (seriously, almost all of them start with "I")
2. I'm not particularly good at opening sentences (because really, do any of these make you want to continue reading?)
3. I am tired a lot (to quote someone at work, "I can't remember the last time I wasn't at least kind of tired")
4. I spend a lot of time either being confused, tired. or dreading the future. That's not a good thing.

Oh well. Maybe 2010 will be more exciting. If nothing else, it's the year I finally graduate so yay for that.

User: gitster Date: 2009-12-23 11:18 Subject: Web+DB #54 Security: Public

前に日本に行ったときに小飼さんと対談してきたのが3ページ程の記事になっているWeb+DB Pressの54号を編集部さんより送っていただいた。

今号も特集は盛り沢山だ。

ゆーすけべーさんの「思いつきをすぐにカタチに!」をまず見る。コードサンプルと本文記述のバランスが良い。

あちこちへの外部リファレンスが多くて、よく読まずにただ「見た」だけではフォローし切れない記事かも知れんが、そういう流し読みだけでも雰囲気は伝わってきて面白い。ぎゃくに、外部リファレンスも追っかけてしっかり読み込んだ読者は、応用の効く「企画開発のコツ」をつかめることだろう(とエラそうに言うが、ボクはまだそういう読み方をしてないので、「ことだろう」にとどめておく)。

User: jerseyjess Date: 2009-12-21 11:55 Subject: And after all Security: Public Mood: apathetic

I'm back in the jerz and mim and harold and i are all going out for lunch with Unc once he gets here. Mom left us an email to tell us this, which makes my family sound significantly more dysfunctional than we actually are.

Anyway, I got back to Ohio on Saturday night, except technically it was Sunday morning, my flight didn't get in until a little after 1AM so I didn't get back to my apartment until around 3AM-ish because it was snowy and I had to drive slower. On the flight I had the window seat and the guy with the aisle seat wouldn't shut up. First he told us all about how someone had stolen his cell phone. Then he told us all about his ex-fiancee. Then he talked about how he used to be in construction. I got lucky though--the guy in the middle seat did me a huge favor and started talking to AisleGuy so that little miss window seat could take a nap. When I was getting off the plane at the end MiddleSeatGuy said to me "happy holidays" and I said "thanks, you too" and he said "and I hope I was able to keep you from having some conversations that you didn't want to have" and I thanked him for that as well, so I guess I wasn't all that subtle about the fact that I didn't care. I don't care about too much after midnight. I'm gonna be an awesome doctorb.

Then my brother came up and we drove from T-do to the jerz yesterday, I'm pleased to report that we're still friends. We made really good time because the turnpike was all cleared off so we didn't have to worry about that, plus my baby brother drives like a maniac. I'm pretty sure he didn't go below 85 the whole way there. I think the speed limit was 65 most of the time. We also didn't stop for anything but gas although at one point we bought pretzels at a gas station. So we got on the road around 10 and made it to jersey around 6, which is pretty phenomenal if you think about it. And we didn't kill each other. That's a good thing too.

So...I guess that's about all the news from over here, I'm probably going to slow down on the posting for a little while since I don't predict anything will really be doing, unless you want me to write about running in the snow and watching Law&Order. I have a while off, BTW. I have 2 weeks of vacation now and then I'm taking 4 weeks of "flex time," which means i don't have to do anything. I'm supposed to be using it for interviews although all my interviews are Fridays and Saturdays so really, I probably could have snuck another rotation in but I have 8 weeks of flex time and I can't think of any other time that I'm going to really want to use them so I'm taking off the month of January and the month of May. Should be OK.

That's it from over here.

User: gitster Date: 2009-12-20 20:54 Subject: gitsterの近況 Security: Public Tags: git

前に日本に行った時に小飼さんと対談して来たのが出ている技術評論社さんのWEB+DB Press 54号がそろそろ世間に出たようだ。喋ったことの三分の一位しか出ていないような自分の記事はともかく、目次を見ると他の特集記事はとても面白そうで楽しみである。

9月に出した「入門Git」は有難いことに評判も良いようで、また重版となる。時々、思い出したように読み返してみて気付いた点をまとめてあるノートから、また、誤植訂正分だけを抜き出して出版社に送らればならぬ。

ユーザ・コミュニティへのクリスマス・プレゼントとして十分安定した1.6.6リリースを出すべく、望むらくは最後のRCとなる1.6.6-rc4を出した。特に問題なければ、これがそのまま1.6.6の正式リリースとなって欲しいものである。

User: jerseyjess Date: 2009-12-18 16:13 Subject: JaxJess Security: Public Mood: content

Mmmm...I"m currently in the Jacksonville Airport and they've decided to give everyone free wireless this month, which is more than I can say for the hotel I was in last night. Anyway, it's also around 70 degrees here, which is pretty freaking awesome. Granted, it was rainy this morning, but it was 70 freaking degrees!

Yesterday though was really great--I got to go for a run outside, in shorts and a tee-shirt, and I even put on sunblock! (Partly because melanoma is the leading killer of women aged 26--34 and partly because I didn't want to have to do an interview with a peeling pink nose) And really, that was all I wanted--a nice run in the warm sun. My derm partner told me that I was going to finish running and it would be around 1PM and I would wonder about what they were doing in derm clinic. I can honestly say, that did not happen. The only skin I cared about at 1PM was my own. (seriously, I'm a little scared of melanoma these days. I've seen patients younger than me who had it and whereas everyone I saw was lucky and managed to get it excised before it metastasized, Dr. Dermafem had a lot of patients who were my age and dying of metastatic melanoma. She didn't let me in those rooms with her. I was OK with that.)

Anyway, I felt so much better after getting a little bit of sun. Maybe this is something I should do more often--disappear in the middle of the winter and go someplace warm for 36 hours and be someplace where you can stand outside for longer than 5 minutes. Granted, it's kind of an expensive way to get your kicks, but hot damn, I was feeling better 2 hours after landing. I was supposed to go to Arizona in March for my lifepartner's wedding, but then she decided to move her wedding back to October, so that's out. Maybe it'll be warm when I hit up Augusta, Georgia in early January. But yeah, it's weird to open a door and have it be warm outside. We always say that you can tell who the Ohioans are because it'll be the middle of summer and we still brace ourselves before we open a door leading outdoors because we're so used to it being cold all the time.

I totally can't wait to be a snowbird :-)

User: jerseyjess Date: 2009-12-16 22:32 Subject: time on my hands Security: Public Mood: gloomy

I had a patient today in clinic who was a really heavy smoker. i mean, really. He admitted to smoking 3--4 packs a day. His fingers were all yellow and so were his teeth and even his hair was stained kinda yellowish. Plus he totally stank. I walked into the small, unventilated room and my eyes watered a little bit. Then after a while I had to excuse myself so I could leave the room and start coughing. It was seriously that bad.

Anyway, in addition to a little problem with nicotine dependence, he also had hepatitis B and C, as well as psoriasis and chronic pain from psoriatic arthritis in his feet. I asked what meds he was on and he said that he took 2 Vicodin every 4 hours. I asked him where he got those from (that's a crazy high dose) and he said that he was only supposed to have one every 6 hours but he was able to borrow some from friends so he could take more.

Here's where things start getting sticky: the only thing that worked for his psoriasis and his psoriatic arthritis was Enbrel. But Enbrel is the kind of drug that tones down your immune system a tad so you can't take it if you have hepatitis because then your immune system will stop fighting the hepatitis virus and you get crazy liver failure (and trust me, fulminant hepatic necrosis is not pretty. I've seen it. It's actually pretty horrible.) So we couldn't give him the Enbrel because of the hepatitis. But by not giving him the Enbrel, it meant he was stuck stealing Vicodin to deal with his psoriatic pain. But we couldn't really give him a different psoriasis medication either because pretty much all of them either knock down your immune system or get metabolized by the liver, and you can't use the latter kind in hepatitis patients either because you don't want to stress their livers too much.

Some days I really hate my "job." Today was one of those days. I had to go back into his room and tell him that we couldn't give him Enbrel because of the liver problems.
Him: Let me guess, they sent you back in here to tell me the bad news.
Me:P Yeah, pretty much. I'm sorry. We're not going to be able to give you the Enbrel. We want you to get a liver biopsy and then, depending on what the results show, maybe we can find a different drug that'll work for your psoriasis.
Him: It doesn't matter. When my psoriasis gets really bad, I just want to kill myself.
So that got my attention because really, I'm not good at dealing with those situations. That's a little more psychosocial than I like to get into in my every day wheelings and dealings. Plus I never know how to respond to that. I mean, what the hell am I supposed to do, sympathize and say "yeah, life is hard and I understand that sometimes it doesn't seem worth the effort?" That doesn't sound like a great sound byte, in my humble opinion. But you can't just blow that stuff off. I remembered from my psych rotation that you can't actually hospitalize everyone who's ever made a suicidal statement because then we'd all be in the hospital at some point in time or other. You're supposed to find out if the person has a plan. So I asked him, "are you planning on hurting yourself?" and he said "no" so that was kind of a relief because if he had said yes, i wasn't totally sure what the next step was.

So he left clinic, I started coughing, and that was pretty much the end of that. Although now I have to wonder--was I supposed to report any part of that? The guy admitted to taking much more vicodin than he was prescribed and stealing it to get more. And he admitted to suicidal thoughts. Should I have done more to follow up on those two thoughts than just mention them in the "assesment" section of my note? I was in sports clinic once and a patient made a statement about how he was in so much pain that sometimes he just wanted to kill himself and the attending called the patient's psychiatrist to tell him. Was I supposed to do something like that or is that an invasion of privacy? And was I supposed to call the PCP and let her know that the patient is abusing Vicodin? But if I do that and he can't get any, then the pain might cause him to do something drastic. So maybe it's best that I didn't do anything?

Did I mention that there are some days when I really hate my "job"? Because I really hate not knowing what the right thing to do in these situations is, almost as much as I hate not being able to help patients who are in pain. I sat through over 2 years of ethics class in med school and I still don't know what to do, ever.

User: jerseyjess Date: 2009-12-16 22:11 Subject: she's going to testify against him Security: Public Mood: blah

Patient: I'm pretty sure I have psoriasis because i'm having an allergic reaction to my knee replacement.
Nurse Practitioner: Oh, jess just did a presentation on that! Jess, why don't you do your presentation for Mr. Smith?

Clearly it was a memorable presentation.

The only fly in the ointment is, the presentation had absolutely NOTHING to do with titanium allergies OR psoriasis. It was about how to choose a prophylactic antibiotic to protect your knee joint from skin bacteria. And even if my presentation was relevent (which it wasn't), I'm pretty sure the patient did not want to hear it. Even Dr. Dermafem didn't want to hear it yesterday when I did it and it's her job to sit there and listen to stuff about skin. And now I'm inclined to believe that the NP wasn't paying attention at all because really, there's no way to confuse the topic of my talk that badly.

So instead of redoing it, I just told the patient that it was impossible that the psoriasis on his shins was caused by the titanium in his knee. (trust me, it is impossible. it's possible that the stress of the surgery caused him to develop psoriasis, but even that's pushing it) He didn't like that answer and tried to tell me that parts of the artificial knee had migrated down to his shin and causes psoriasis to start growing over it. I gave up fighting pretty quickly.

User: gitster Date: 2009-12-16 11:37 Subject: Blogsphere identity Security: Public

I sometimes visit others' blog pages on git that are popular in bookmarking sites (e.g. はてな, De.li.ci.us), primarily in order to learn what interesting things they are doing with git, but also to spot and correct misinformation to save new people who read them from getting burned. Many pages allow or require me to leave some clue to identify me, but the strictness of input validation varies a lot. The loosest ones let me say anything in the name field and leave the URL of my blog, without any authentication. Some uses captcha but they do so only to make sure I am not a robot, so with respect to making sure who I am, they are just as loose. I am wondering how people prevent naive readers of these pages from mistakenly think that I said something outrageous in others' blogs if a third-party that is in no way related to me writes crap and left my URL. One way would be to stop visiting others' blogs and when such a problem surfaces claim that I never leave notes on others' blogs hence the problematic note cannot be mine, but there is no way to prove or disprove such a claim. Also that strategy will allow me to actually say something outrageous and later claim that it is not mine. Perhaps people don't worry about these things?

User: gitster Date: 2009-12-16 02:17 Subject: Fun with Kogai-san Security: Public Tags: git

A few months ago while I was visiting Japan, I was interviewed by Dan Kogai (of Perl "Encode" fame) for Web+DB Press magazine. The article will be in the 54th issue, and it is part of the "Dan Kogai meets Alpha-Geek" series of interviews. I found it a bit confusing that at least in my case, it was more like "Alpha-Geek Dan Kogai meets a guest". I am certainly not.

I was also a bit disappointed that he seemed to have thought that I was older than I actually was X-<

But nevertheless, I had fun.

User: jerseyjess Date: 2009-12-15 22:36 Subject: and you learn to accept it Security: Public Mood: whiny

While I'm complaining about stuff, can I just say that it really annoys me when a patient tells me something and says "shouldn't you be writing this down?" I'm not totally sure why this bugs me so much but it's one of my pet peeves. I think part of me is just insulted that the patient doesn't trust me enough to remember stuff long enough to tell it to Dr. Dermafem.

Me: Have you had any unexplained changes in weight recently?
Patient: How recently?
Me; in the past year
Patient: No, I guess not
Me: OK, so--
Patient: Well, the reason I asked how recently was because about 5 years ago I was diagnosed with diabetes. So after that my wife and I went to a dietician and he put us on a special diet. So I managed to lose 20 pounds on this diet and I was around 260. I stayed around 260 for a while but then I gained all but 5 pounds of it back. So that's why I asked you how recently but since you said a year, that doesn't really count.
Me: OK, so--
Patient: Shouldn't you be writing this down?

I'm not saying there aren't times when I forget to write something down and then I don't know the answer later on. It happens a lot. Particularly when I get really tired. But I don't need to sit there taking notes on every little thing the patient says. Especially the stuff that the patient himself acknowledges doesn't answer the question posed (for 2 reasons!) And I only get 4 lines to write a history of present illness on these derm forms. So if I start writing everything down on the form that the patient tells me, I'm going to run out of room at some point when they're talking about the grandchildren and before I get to the part about the crushing chest pain that radiates down the left arm. Plus I have a decent memory most of the time and I can remember stuff and write it down later. I guess patients are worried that their story is going to get twisted or forgotten in the retelling, which is a pretty valid fear. But I kinda wish they'd put a little more faith in me. And if they think I got something wrong, they can always tell it to Dr. Dermafem or the nurse practitioner when they come in the room with me. (i do tell all my patients that either dr. dermafem or the NP will be coming back with me after i'm done in there)

Man, I'm really whiny tonight. I should probably go to bed instead of complaining.

User: jerseyjess Date: 2009-12-15 22:19 Subject: intergalactic Security: Public Mood: blank

I was running the other day and I was trying to think of what this year's resolution should be. 2 years ago was to quit cursing (I'm doing a lot better with that) and last year was to quit hitting snooze so much, which didn't go too well. So I was thinking maybe I could resolve to stop interrupting people so much because I feel bad that I don't let people finish their sentences a lot of times and it's pretty rude.

The problem with this is, sometimes you really have to interrupt patients. I know they teach you that everything patients say is important, but a lot of times it isn't and you have a finite amount of time to get to the important stuff. And what patients think is important is not always what's actually important. I was talking to a guy today who's going into radiology and he said one of the perks is that all the important information is already there for you and you just have to interpret it, you don't have to be the one to dig it out. So if I just let my patients talk forever, I wouldn't get too much more useful information than I would if I interrupted and redirected. And a lot of times you kinda have to redirect patients after they get on a tangent and that can involve interrupting because if you wait for them to finish, you'll be there forever. Generally if they start talking about how smart their grandchildren are, I interrupt and attempt to steer them back to the problem at hand because really, I'm a busy woman.

The only time I won't interrupt a patient is when he/she is talking about someone else's death. I feel like it's really rude to interrupt someone when he/she is talking about something that personal, so even though it generally has nothing to do with their chief complaint, I let them go on a little bit longer.

So I'm not sure how I can turn this into a new years resolution--what am I supposed to do, not count patients as people? Or should I actually stop interrupting my patients so much? The latter is probably the preferred option because I'm sure I interrupt people too much and miss important stuff that way but at the same time, when you have less than 10 minutes to do a history of present illness and a physical exam, you can't mess around too much. Maybe I should just resolve to have better bedside manner. I was talking to my baby brother today and he said that he thought my bedside manner was terrible and I was mean to my patients, but I really don't think that's true. I know I complain about them all the time, but I really do try to be polite when i'm with patients and I try not to show it when I'm losing my mind. I'm pretty sure I've never rolled my eyes in front of a patient before, although i promise the temptation is there on a daily basis. But I really do try to have good bedside manner and i'm sorry it doesn't shine through in my blog.

User: jerseyjess Date: 2009-12-15 21:58 Subject: keep it copacetic Security: Public Mood: pissed off

Dr. Dermafem: You realize that if you match here, it's only because Dr. Orthohead enjoys staring at your boobs and wants to have sex with you eventually.

It is really hard for me to articulate how much that pissed me off. Because I really don't think that's a fair statement at all and I don't think I deserve that. I tried laughing it off and saying "I'm more than just a great rack," but she said "i'm sure you are, but all he cares about is your boobs."

Screw you, bitch.

It's probably a good thing tomorrow's my last day on this rotation because I'm not sure how much longer I can go before I snap at Dr. Dermafem and say something I really regret.

User: jerseyjess Date: 2009-12-14 22:54 Subject: again and i can't turn away Security: Public Mood: enraged

I started getting really excited that toilet bowl cleaner was on sale for $0.99 so I decided to mourn my youth and buy some animal crackers.

Anyway, I was sitting at home, eating my animal crackers like a normal human being, when all of a sudden I noticed that some of the crackers were in the shape of a HOUSE! Seriously! Which means that I was eating crackers that weren't animal crackers! The package clearly said "animal crackers." They did not warn me that they were going to sneak in non-animals and hope that I didn't notice. So I was stuck with all these stupid houses that didn't taste as good as the giraffe and horse and cow and pig. I mean, there was no way these things were anything other than houses, so I can't even try and convince myself that they're some sort of animal. And even if the cracker people decided to toss in some houses so that the animals had a place to live, then they should have warned me so that I knew what was coming before I munched through a bunch of them. Plus they put in way too many houses. There was at least a 1:1 ratio of houses:animals. I mean, was I supposed to give each animal its own house? Because that's stupid, they'd get lonely. The only animals I can think of that didn't live together were the three little pigs and we all saw how well that worked out--they all wound up in the brick piggie's place in the end. So I'm not about to try and separate out all these animals.

What is this world coming to if you can't even trust your animal crackers not to betray you?

User: jerseyjess Date: 2009-12-14 21:56 Subject: Pour some Ancef on me... Security: Public Mood: quixotic

I pulled together a powerpoint on "Protecting Hardware from Skin Flora: Prophylactic Antibiotic Choices in Total Hip and Total Knee Arthroplasties" in 20 minutes today so go me. I have to give a presentation tomorrow in derm and I was supposed to pick a topic that had something to do with ortho and something to do with derm so this was the best I could think of off the top of my head. And the only reason I came up with it was because JBJS had a really awesome review article on the subject in October. I'm hoping no one notices that I only mention skin flora on two slides. The rest of it is more ortho-related. Whatever, I don't really care, if they want to give me a "pass" instead of an "honors" for this rotation then they are more than welcome to.

Today we were with the nurse practitioner all day. I think I've mentioned before that I don't like the NP. Today further cemented that. Holy crap, she really really really really annoys me. I don't think she's a bad person and I'm sure she means well, but she spends most of the day talking to hear herself talk. So I just want to tell her "shut up already! the patient left 20 minutes ago! You don't need to keep on talking about his unusual shaped mole!" Also, she spends forever with each patient. But not in the Dr. Selleck tell-me-your-life-story way. More in the way where she talks to the patient while flipping through his/her chart, which means she doesn't pay attention to either of the two. So then she needs to ask the questions again. Then she needs to flip through the chart again. Also, for whatever reason, she'll never put the chart down on the desk. She hands it to me. Then when she needs it again, she'll stick out her hand and I'm expected to put the chart in her hand so she can flip through it before handing it back to me. I don't get it but I'm not about to fight it.

And the NP told me today that I should go to the antique mall because I would love it. When I was working in rehab that summer, for whatever reason, physical therapy decided to take a bunch of stroke patients to the antique mall for a field trip. I'm not sure why they thought taking a pile of middle-aged men to go antiquing was a great idea but hey, their prerogative. Anyway, there was one patient who couldn't speak at all who wound up going. When he got back I saw him and I asked him how the antique mall was. I figured he was going to roll his eyes at me because that was generally how he communicated, but I guess he must have been really moved by the antique mall because he screamed at me "BORING!" I guess it was so boring, that the damaged part of his brain was inspired to work again so he could communicate just how boring it really was. I'm pretty sure they never took the stroke patients back there although there was that fiasco later on where they tried to get the spinal cord injury patients to play volleyball. It went about as well as you'd think it would go. Generally people who can't move their arms aren't good at volleyball. Anyway, I have about as much interest in the antique mall as the stroke patients. Possibly less. As anyone who knows me will attest to.

But...I only have 2 days left of this rotation (I'm taking off Thursday and Friday to go down to Florida for my interview) so that's pretty nice because it's been a crappy 4 weeks. I don't find the subject material interesting at all and the attending is a piece of work, which is not a great combination. I was hoping to come out of this with a great female role model and an appreciation of the differences between a papule and a macule. I figured out the latter but I'm still sorely lacking in the former so it's back to the drawing board.

User: jerseyjess Date: 2009-12-13 17:03 Subject: middle Security: Public Mood: content

The hotel I was in last night had a remote-controlled mattress(!!!!!) I figured out after a while (OK, technically someone told me) that if you pressed the "up" button, it made it firmer and if you pressed the "down" button, it made it softer. So that kept me occupied for a while. As in, I spent the better part of Law and Order playing with the bed.

Then they had french toast sticks at the breakfast buffet. Since the program was nice enough to give me a $10.99 breakfast buffet for free, I had to eat at least $10.99 in french toast sticks. Man, those things are awesome. i truly believe that french toast tastes better when it's in stick form.

Plus the program gave me a coffee mug and specialty popcorn in addition to the hotel room and the breakfast. That was good too :-)

User: jerseyjess Date: 2009-12-11 20:55 Subject: Eau de Rotting Feet Security: Public Mood: nauseated

I tend to be a tad scent-sitive, in that I buy lotions without fragrances, I never wear perfume, and being around people who wear too much perfume makes me cough and my eyes get itchy. There's a woman who used to work out at the same time as me and after she was done, in the locker room, she would spray perfume all over herself and I would start coughing from across the locker room because she put on so. damn. much. I'm not allergic to fragrance or anything, but i prefer to smell like soap. Unflavored soap. And a little bit of deoderant.

Anyway, today in clinic I had a patient with the absolute most smelliest lesions on her feet. I walked into the room and the smell hit me and oh G-d, I couldn't breathe. For those of you who have never smelled rotting flesh that's just been released from a sweaty ace bandage, trust me, you're lucky. She was missing a lot of skin on her feet. She was missing so much skin on the top of her right foot that you could see her tendons, those thick white cords across the top of the feet. Except on her, they weren't white. They were covered in thick yellow grease. She was also missing skin on the backs of her heels and you could see straight to the bone in one part. The surrounding skin was bleeding and oozing pus, so it was a thick liquid that was red blobs swimming in yellow-tinged mucus puddles. The remaining skin on her feet was discolored a violaceous hue and covered in scales. When I went to touch her feet (wearing gloves!) chunks of skin started flaking off. I couldn't figure out whether it was best to breathe through my nose and get the full effect of the smell, or breathe through my mouth and risk inhaling a skin flake. In the end, I decided to go with the smell, even though it was horrible. Seriously, I can't even think of anything to compare it to, it was so bad. I would rather hang out with my cadaver from anatomy lab then her feet. I'm pretty sure I would rather kiss my anatomy lab cadaver (RIP Bernie) than smell this patient's feet.

Then I had to go get Dr. Dermafem and she came in the room with me so I had to smell them again. Then we left the room but i had to get a consent for medical records form signed so I had to go in there again. Then I had to bring her a prescription so I had to go in there again. Which meant that by the time I was done with all that, I was starting to get the feeling that I smelled like her feet. I mean, enough of those smelly particles could have landed on me and covered me with their foul stench in that amount of time. At the very least, I'm pretty sure I got smell-particles caught in my nose-hairs because I kept on smelling that horrible rotting smell.

I think I'll wash my white coat when I get back to my apartment. And I'll say a prayer that I never ever ever ever ever get Bullous Pemphigoid.

User: jerseyjess Date: 2009-12-11 20:42 Subject: when the wheels touch ground Security: Public Mood: calm

Dr. Dermafem and I had some girly-bonding-time today after my partner and the resident left. (I was finishing up a note) After she made the requisite comment about my boobs (she informed me that women with big boobs, like me and her, couldn't play golf because "the girls get smooshed." Good to know) she mentioned something about doing kids' melanoma screens.

Dr. Dermafem: They're at the age where they find penises funny
Me: Well...penises are kinda funny, I guess.
(it should be noted, I meant the word "penis")
Dr. Dermafem: You're right, they are. Did you know, the best kiss of my life was with a woman?

And really, what the hell was I supposed to say in response to that? The conversation died soon after although Dr. Dermafem did wish me luck on my interview tomorrow. And I did giggle a little when I saw her husband after I left clinic and was walking up to the gym.

That being said, Dr. Dermafem is not the only attending to tell me about her private life. One of my attendings once told me all about his vasectomy. First he told me about how his wife told him to get one, then I heard about the procedure, then I heard about his recovery from the surgery. Seriously, I don't need to start imagining my attending's penis, which is what I'm going to do if he starts telling me about his vasectomy. I had a different attending who told me about his colonoscopy, which meant I had to picture him lying on a table with a camera up his butt. Wow, thanks for that image. Then one of my attendings really crossed the line and told me about how often he and his wife had sex. I suppose it could be worse, one of my friends was with him and he showed her a naked photo of his wife, but still, hearing about them doing it was pretty icky. Plus he told me that if his wife died, he would be devastated, but if the kids died, he would be OK with it. I really didn't have a response to that one.

So sometimes I wonder, do people realize that they're leaking personal details? Or is it just that you get so used to being around someone (I worked one-on-one with a whole pile of attendings for 4--6 weeks) that they forget to turn on the filter? Which leads me to wonder how much personal information I've divulged to my attendings. My OB-GYN attending asked me about my menarche and I told him, but I feel like once I realized that he didn't actually have the right to ask me that, I became more guarded about the information I volunteered. I didn't want him to say that he assumed I was comfortable talking about sexarche/thelarche/masturbation with him because I had already told him personal details about myself without being prompted. But I'm sure I let my guard down at some point in time. Not that I really have all that much info to divulge, but there's stuff that my attendings don't need to know about me. Like whether or not the best kiss of my life was with a woman.