A Happy Reunion

(To the tune of Amazing Grace.....)

Oh coffee mug
I love you so
At work, you comfort me
I lost you in the ICU
Today, reunited with glee!

Ah....so much to be thankful for!

A Brief Glimpse into the Weirdness that is my Brain

I was on long call at the VA last night.  Luckily it was a pretty slow night with only four admissions.  So there was no wailing and gnashing of teeth....the way I prefer it.  And for me, there is nothing quite like post-call sleep.  Crawling into bed, utterly exhausted, with a belly full of eggs and bacon is one of the best feelings ever.  And knowing that the crazy that lives at the hospital is now someone else's problem....well that's good stuff! 

So I crawled into bed at about 10:00am and, per usual, slept like a baby.  With a few interruptions from Charlie.  Per usual.  Luckily he usually responds to me yelling, "SHUT UP CHARLIE!  GAH!"  My post-call sleep was going well until the dreaming started.  In my dream Danny gave me a kiss on the neck....which turned into a huge hickey....because my INR was high.  Then my dad yelled at me because it looked "tacky" and "unprofessional." 

Awkward....

Veteran's Day at the VA

This morning I went to see an elderly patient with severe dementia.  He was in a pleasant mood during my exam and on my way out the door I wished him a happy Veteran's Day.  His face instantly changed and he began to weep quietly.  I could only make out a few of his words...
Laying there....

Dead...

Birds pecking at their eyes....

And then he broke down.  Inconsolable.  There are some memories that even Alzheimer's can't erase.


To those who have served our country so bravely.....

Thank you.

Sometimes it's hard to keep my pants up....

The Quadruple Grenade Sign....the poorest of prognostic indicators.

You say it's your birthday.....

Ah, October 18th.....a blessed day! 

It's really kind of sad when facebook has to remind you that it's your birthday.  Oh well, so be it. 

I woke up yesterday at 4:30am to the sound of my dear husband doing P90X.  He is a freak of nature.  I'm still trying to figure out what mutant gene he acquired that causes him to wake up at 3:50am to work out and that entices him to eat vegetables on a daily basis.  I have the opposite of that gene.  Or I'm just lazy and prefer buttered noodles, take your pick.   

Anywhoozles....I stumbled down the stairs and hurdled the baby gate, as I do every morning.  Yesterday I cleared it without incident....not always the case.  I glanced in the mirror and noticed a few pimples on my nose....probably from my increased Nestle Quik consumption.  I may be 31, but at least I have the complexion of a 13 year old!  Ah...thank you, T-Zone, for making me feel young.   ( I can hear all of you gasping....you thought I was 24, didn't you!?!?!)

Work was uneventful.  I would like to give a shout out to the patient, who prior to receiving a rectal exam from yours truly, stated, "Gosh, I wish you were some old, ugly lady....that would make this easier."  You made my day, sir.  You made my day.  Oh, and you were hemoccult negative....so that's good. 

My lovely attending, knowing that it was my birthday, decided that I should take off early in the afternoon, and so I did.  Thank you Dr. L for being so thoughtful.  And as for you, Dr. P.....YOU forgot my birthday....even though I'm sure facebook reminded you.  But I'm over it.  No, really.....it's cool.  I'm fine.  Clearly. 

I got home and called Danny.  He was at the store picking something up.  I imagined that he was buying me flowers for my birthday.....and the following is what I was planning on blogging after I received said flowers:

"My sweet husband....even though I've told him dozens of times not to buy me flowers.  He knew deep down that I really did want flowers."

He came home with a card and a bag full of Aspen Mulling Spice, a CD and Nutty Bars....no flowers.  And to that I say:

"My sweet husband....he knows that flowers only wither away, but this girl LOVES HER SOME NUTTY BARS!!!"

Later in the evening, Danny and I attended a free dinner at Ruth's Chris.  This doctor gig if finally paying off....'bout dang time!  Unfortunately, my steak came out well done.  In the ultimate show of selflessness and devotion, Danny gave me half of his steak, which was cooked medium to my preference.  I drank 1.5 glasses of wine, and per usual, declared myself drunk after the first glass.  Wine at Ruth's Chris is very potent.  I'm not sure what the speaker was talking about, but he was very energetic....and blurry. 

So that about sums up my birthday.  It was a good one. 

In crummy news, my Grandma B. fell and broke her hip last night.  She's currently at SMMC where they're getting her fixed up.  If you could send some prayers her way, well, that would be nice. 

An Ode to Rachel....on the Eve of her Wedding

All the wine at the rehearsal dinner tonight sent me into an emotional tailspin...several unfortunate people sitting in close proximity can vouch for this.  I will now type and cry, type and cry.  It's therapeutic.


Rachel is the one I met in the 1st grade.  She had just moved from the "dot" and I was her mother's worst Johnson County nightmare.

Rachel was my three-legged-race partner during field day.  We won second place.  I have not seen her move faster than a walk since that day.

Rachel is the one who cried with me before I told my mom about the stupid thing I did in 8th grade. 

Rachel is the one who used to love wearing "country apple" body lotion from Bath and Body Works.  That is, until her mother told us we were too old to go around smelling like fruit.

Rachel is the one I spent countless hours with at 3&2, watching baseball games on warm summer nights. 

Rachel is the one who spent hours with me at Abercrombie & Fitch, even though the plaid carpet made her dizzy. 

Rachel was my very first roommate.  She is the one who tolerated one year of me eating powdered coffee creamer out of the can, leaving my cheese wrappers lying around our room, and setting my alarm clock for ungodly hours.

Rachel is my Endless Love duet partner....even though she always makes me sing the boy part.

Rachel is the one who looked me in the eyes and said, "I've always thought you should be a doctor."  And when she said it, I had the confidence to do it. 

Rachel is the one who thinks that God sent a hail storm just for her, so she could collect the insurance money and buy herself a Louis Vuitton bag.

Rachel is the one I think of when I hear Aerosmith or Tom Petty on the radio.

Rachel is the one who fell in love with a boy named Travis.  And when I saw the way he looked at her tonight as they were practicing their vows, my heart was happy....because I know he is the one. 

Congratulations, my dear friend!

I'll see you in the morning, after I buy myself some waterproof mascara.

First Impressions

I'm fairly certain that when people meet me for the first time, they think, "Now there's a girl who is clearly more concerned with skin cancer than she is with vitamin D deficiency."

This has been on my mind for a while....just needed to share. 

Numbers

Yesterday....

4:50 - the time I rolled out of bed.  Moaning and cursing.

9 - the number of consecutive days I'd worked.

14 - the number of hours I worked in one day.

1 -The number of cinnamon rolls I ate.

4 - The number of cups of coffee I drank.  The minimum required dose to maintain consciousness.

3 - The number of pagers I carried.

0 - The opportunities I had to go to the restroom.

5 - The number of times I've heard Dr. S's sepsis lecture. 

2 - The number of admissions I did after 1600.

7 - The number of times my stupid ID badge fell off my coat.

52 - The number of seconds it took me to pull out a pericardial drain.  My fellow told me if I went too fast I might tear the heart. 

8:15 - The time I left work.

1 - The number of drinks consumed before I declared myself officially intoxicated.

2 - The seconds it took me to fall asleep after crawling into bed.

Happy day off to me!!!  It's about freaking time!

Assumptions....

Several years ago, I promised my BFF Rachel that I would buy her a fancy pair of designer shoes for her wedding.  At that time, she was single and I made this promise based on two assumptions.  Either 1. Rachel would never get married, or 2. I would be extremely wealthy by the time she finally did meet that special someone. 

Well, turns out that Rachel met, fell in love with, and is now engaged to a wonderful guy.  I've learned to look past the fact that he went to MU, and focus on the things that we have in common; a mutual admiration of station wagons (be it Volvo or Subaru), and old plaid-lined Lands End jackets.  We have a strong foundation.  And of course, we both love and adore Rachel.

So....Yay!  Happy!  Fun!  Rachel and Travis are getting married!

And I am left scratching my head as to how assumption number 2 hasn't quite panned out.  Yeah, yeah...I'm a doctor....but I'm so far in debt from my medical school loans that the only thing I can afford to be is a doctor.  And the last time I calculated my hourly wage, it was approximately $4.00.   

None the less, a promise is a promise.

So Rachel and I did lots of internet searching for fancy bridal shoes.  We looked online at Bergdorf, Nordstrom, Neiman Marcus and Saks 5th Avenue.  We both fell in love with a pair of Manolos, only to be crushed when we found out that the $158.00 price was the price for the knock-offs and the real Manolos were closer to $600.00.  Gah....I still weep.

Then Rachel finally narrowed down her favorites to a group of about 4 and let me make the final decision,  which was a bit nerve-racking.  The choice of wedding shoes is not to be taken lightly! 

So I picked out a pretty little pair of Vera Wang slippers and my promise from years ago was kept. 

And if I start looking thinner over the next few months, its likely that I can't afford food. 

Cheers to Rachel and Travis....and Vera!

Oh....and if you happen to be attending the blessed event, please take a moment to admire the shoes.  I would appreciate it.  Thank you. 

Bacon

Dear Cardiology Patient,

Although I have no evidence that you have coronary artery disease and your work up for chest pain has been completely negative, I cannot, in good faith, let you have a regular diet while you are on the cardiology service. While you are in the hospital, you will comply with the low sodium, low fat, low cholesterol diet.  My apologies.

Now excuse me, I have to get down to the cafeteria before all of the bacon is gone.

Your friendly cardiology resident,

CBart, MD

oops....

Today I accidentally texted my pulmonary fellow, thinking I was texting Danny.  I asked her to call the exterminator.  Then I told her I loved her.

Disturbing

Yesterday one of my co-interns was wearing a fabulous pair of Frye boots.  I lusted over them.  I resolved to buy myself a pair someday.  Then I resolved never to spend more than $300.00 on a pair of shoes.  Now I am in a state of perpetual turmoil. 

Then I went home and dreamt that I had my own pair of Frye boots.  It began as a very happy dream.  All of my friends and co-workers were very excited for me and my new boots.  Then I looked down and discovered that my legs were covered in hair....thick, curly man-leg hair!  It was awful!  How could I not have noticed this when I decided to wear a mini-skirt with my Frye boots? 

The dream went on and ultimately I had to shave the legs of one of my (male) staff doctors before I could shave my own legs and remedy the situation. 

I have no idea what this all means....

Still distraught,
CBart

Anatomy of Night Float

I am on my third night float rotation this year and I am starting to notice some patterns....

The phases of night float...by Christi Bartlett

1.  The Mauling Phase
 - This phase begins as I walk through the door of the Med 3 room.  The respective members of the Med 3, Hematology and Oncology teams wait, perched, ready to pounce on me, much like fresh meat.  Then the mauling begins as upwards of 50 patients are handed off to me at a dizzying rate.  I am left bruised and beaten.  I also get to hear about the stuid thing I did the night before and how the staff couldn't believe that I gave a patient 60mEq of K instead of 40......ahem.

2. The Nursing Shift Change Phase
 - This typically happens during or shortly after the Mauling Phase.  Night nurses start their shift and notice loose ends from earlier in the day that I HAVE TO ATTEND TO RIGHT NOW!  There is usually a patient with a blood sugar of 425 during this time, as well as a patient with a blood pressure of 200/98.  Inevitably, there is also a patient who has no admission orders.

3. The "I'm Starving" Phase
 - This phase is usually starts around 2300, and involves a trip to the all night cafe downstairs.  I typically look at the same 3 meal options (frozen pizza, fettuccine and macaroni and cheese) and contemplate their nutrition facts before ultimately opting, again, for the fettuccine.  Then I have to talk myself out of chocolate milk...never easy. 

4. The "I Need More Coffee" Phase
 - This is more of a chronic issue, rather than an acute phase, but not until the "I'm Starving" Phase is over, do I typically act on the "I Need More Coffee" Phase.  During this phase I take the steps up to the 6th floor....to burn off my fettuccine....and I sneak into the nutrition room and snatch some coffee, 2 creamers and 3 sugar packets.  Heaven knows how long that coffee has been sitting there. 

5. The "Code Blue and/or Rapid Response" Phase
 - Just as it seems things have settled down, we hear the infamous beep of the code pager.  Expletives are muttered under the breath of the night team.  We grab our coats, stethoscopes and walk swiftly to the coding patient.  Usually anesthesia and the ICU team have already arrived, so we (the interns) stand against the wall and try to look like we are contributing...the whole time thanking the good lord that someone else got their first to run the darn thing. 

6.  The "Let's Try to Learn Something" Phase
 - This phase involves choosing a previously recorded lecture from a list of podcasts and trying to stay awake long enough to try to sort out ILD, UIP, NSIP, ARDS, AIP, DAH and COP.  This lecture was discontinued early as we decided that our brains were too sleepy/overwhelmed/mushy to retain any of the information. 
*These lectures are often chosen based on the attractiveness of the attending....*

7. The Sleep Phase
 - Hahahahahahahahahahahahahaha...........

 - And when I do get to lay down, I typically have some obnoxious VeggieTales song stuck in my head.
 - And if I don't have a VeggieTales song stuck in my head and I do manage to nod off, my pager goes off 5 seconds later.  Then I lay back down, manage to fall asleep....pager goes off....repeat cycle x 50 bazillion. 

8.  The Check Out Phase
 - No doubt the best part of the shift.  This is where you inform the primary teams of the events of the night and hand off every bit of responsibility to them.  Then you hand off the code pager...such a fantastic feeling. 

9. The Breakfast Phase
 - Usually accompanied by my fantastic co-intern....the other CB.  Bacon is always consumed during this phase.  This is where I drink more coffee....usually to cover up my horrible morning breath.

10.  The Erroneous Post-Check Out Page
 - This is when a nurse calls you about an issue after you've already checked out to the primary team.  It begins with a bit of annoyance because, "why are they calling night float at 7:30????" but ends with pleasure as you return the page and ask the nurse, very nicely, to CALL THE PRIMARY TEAM!  FOR THE LOVE OF PETE!

11. The Car Ride Home
 - This is the part of the day that I don't really remember, but somehow I make it to my house every morning....with just enough energy to climb the stairs and curl up in bed.

Then Charlie starts whining. 

Then I yell "SHUT UP CHARLIE!  FOR THE LOVE OF PETE!"

Ode to Color Pink (Crayon)

Weezy's favorite color
You were Charlie's favorite too
Now you're in the backyark
In a lump of poo

Lent - not to be confused with the stuff in my bellybutton

Ah, the Lenten season is upon us.  I typically don't give anything up during lent because 1) I'm a horrible person and Jesus will likely scold me someday.  Then he'll give me a hug and tell me, "It's cool."  And 2) I really don't have many vices....that I am consciously aware of anyway....that would be good candidates to be given up.  Danny has decided that he is going to give up coffee for lent.  This worries me.  The boy drinks two pots every day.  Minus whatever I manage to steal from him when he isn't looking.  I am anticipating a painful period of withdrawal....headaches....rigors....seizures.  Well, probably not seizures, but it's not going to be pretty.  To make things worse, he is the sole producer of the coffee that I drink and he has informed me that he will no longer be making my coffee either.  I'm not sure why I have to suffer during his time of sacrifice.  It's cruel....and it isn't very Christian if you ask me!  So I will be visiting QT on a more regular basis for the next several weeks. 

As for me....I couldn't sleep last night, so I got up and watched TV.  The only thing that was on was Two and a Half Men.  I felt a little dirty after watching it, so I opened up the Bible and read for a bit, cleansing myself of Charlie Sheen.  I sat reading for about thirty minutes, chewing fervently on my fingernails when it hit me.  Nail biting....it's what I need to give up. 

Hi, my name is Christi, and I bite my nails.  And the skin around them.  I have been a life long nail-biter, much to the dismay of my mother and grandmother who have staged many an intervention on my behalf, and have made countless attempts at bribery.  There was a time that I managed to stop biting my nails, shortly after Louisa was born.  I wasn't even trying to stop.  Babies are just that time consuming.  I didn't even have time to nibble.  I managed to maintain this life-style for several months.  During that time, I was able to enjoy activities I had never tried before....painting my nails, opening soda cans, picking my nose with more efficiency and tenacity than I've ever known before!  That all ended in July, 2010.  My first month of internship.  The combination of a certain Hematology attending and the overwhelming, un-subsiding anxiety that comes with being responsible for human lives was just too much for my little nails to survive.  It started with one nail here, half a nail there....then it became an all out massacre. 

There was blood. 

Since that time, my fingernails have been nothing but nubbins.  And my nose-picking has suffered for it.

So there....I just spent thirty minutes of my life re-hashing the tumultuous tale of my fingernail woes...which will end on Wednesday.  Say a little prayer for me.

I'm not exactly sure what to do on Fat Tuesday.....

A Lament

I've been a little bit gripey the past few days.  I will blame this on my wonkey sleep schedule and call it "lamenting" rather than "griping."  Capiche?

My first lament involves Panera.  It has nothing to do with the taste of the food or the quality of the service, but rather the fact that they have plastered the nutritional information of their food all over the menu.  Gone are the days where I could assume that because I was eating a turkey sandwich and small bowl of mac n cheese, that I was making a wise dietary decision.  I can no longer claim ignorance.  Now I know that a bowl of mac n cheese (oh Wisconsin cheddar....you will be the death of me) and a turkey sandwich have 1460 calories and 82 grams of fat.  Gah, I say!  The only thing that could possibly be worse than knowing the nutrition information of my food is seeing a picture of the cow Ruth Chris butchered to make my filet mignon.  Devastating.

Lament #2.  So, I just got a cute new pair of glasses.  They make me look smarter and more sophisticated.  I started at a 0 on the smart and sophisticated scale, so this is quite a little victory.  I have been wearing them for the past several days, and during that time, when I would look in the mirror, I looked a bit thinner.  Not that I had any reason to be losing weight (see above lament), but I was excited none the less.  Fantastic!  So today I decided to wear my contacts.  I took a bath, looked in the mirror....and did not look thinner!  Blast!  My glasses were deceiving me.  My soul weeps.

I could go on, but I'm going to chose to be a positive person now.  Cup is half full.....of cold coffee....

Over and out. 

Nights at the VA, Part Deux

"Ahh!  Salam and good evening to you worthy friend.  Please, please come closer...."

Quick!  Name that movie!

I am once again blogging from my sad little night call room at the VA.  With my sad little bowl of Chef Boyardee.  I had a week of vacation 2 weeks ago which was glorious, now I'm back at it....saving lives and taking names.  Well, I'm not really saving lives.  As of yet anyhow.  Mostly just following up potassium levels and writing for sliding scale insulin.  It's a glamorous life.  And I'm not taking names either....they're actually just given to me.  On a piece of paper.  Next to one of the names on that piece of paper are the words, "Pt's BP dropping, may crash tonight."  Ah, lovely. 

My biggest struggle so far tonight has been my ravenous appetite.  This is a bit of a problem because, well, I'm at the VA and, low and behold, they don't have a Waffle House on the premises.  What they do have is a little room with a refrigerator and random snack food.  I've visited this room twice already.  The first time I took some cereal and the second time I opted for the aforementioned Chef Boyardee.  You can imagine the vast array of culinary temptations if the best I could do was Boyardee.  I won't bore you with the details.  I will tell you that the light in the little room with the refrigerator in it has been burned out since Friday.  And it's dark.  And scary.  I have to prop a basket up in the doorway so the door won't close all the way.  If I could remember anything about physics, I could do a better propping job to keep the door open a little wider....but that was too many years ago and my brain has grown old and weary. 

So anyhow.  Now I'm eating my twicely aforementioned Boyardee waiting for some labs to come back so I can try to go to sleep. The good thing about working nights at the VA is that I typically get a few hours of sleep.  The bad thing about working nights at the VA is that I have to leave my sweet husband and cute little P. Nutty girl at home. 

In closing.....
 - Vacation = glorious
 - I'm hungry
 - Following up on and replacing potassium = glamorous
 - I miss my peanut
 - Goodnight

While driving home

As I was driving home today....in my super-rad station wagon....I became keenly aware of that pesky roll of fat that has persistently protruded over the top of my pants for the past 17 months.  And I thought back to the days, many moons ago, when I worked at Jerry's Bait Shop and would tie my Budweiser t-shirts up in a knot to show off my belly.  (What?  Stop looking at me that way.)  I never ONCE had to suck in my belly.  Even when I was sitting down.  No fat rolls.  No blubber.  I took those days for granted. 

As I drove, I sat up as straight as I could, arched my back a little bit and sucked, and sucked and sucked some more. But the roll would not go away.  It actually shifted to my back a little bit. 

Then I went to my mom's house and ate a cookie.

The End

tap tap...this thing on?

So....I used to have this thing called a blog.  And I would update it on a semi-regular basis.  Then I started this thing called residency.  And my blogging took a backseat.  As did my housework.   And my personal hygiene.  And my knowledge of celebrity gossip.  Can someone please tell me what Lindsay Lohan is up to these days?  Rehab?  Jail?  My world is spinning out of control. 

I'm finishing up a pretty rough three month stretch.  I started out on night float at the VA.  Not a bad gig.  My job there is essentially to make sure that nobody dies over night and admit any new patients who show up in the ED.  And I actually got a little bit of sleep each night.  Pretty sweet when you can sleep at work. 

After night float, I went to the ICU.  I believe I blogged about this previously, so I won't bore you with too many details.  Lots of ventilators, vasopressors....that sort of stuff. 

Then I went to cardiology.  This is one of the more dreaded rotations.  We cover both floor status patients and really sick cardiac ICU patients....who have come in with a major MI....and coded several times....and are clinging to life by a thread.  You know....that sort of stuff.  I managed to survive that rotation relatively unscathed.  As did most of my patients. 

Now I'm on a general medicine rotation in the hospital.  My team (an attending, one senior resident, two interns and a menagerie of medical students, pharmacists and pharmacy students) round on about 16 inpatients daily.  We have a constant influx of admissions and discharges (Can you have an influx of discharges?  Does that make sense?  Is that an oxymoron?  Am I a moron?  Don't answer that.).  It's super busy, but I enjoy it. 

On a sad note....one of my very favorite patients passed away this week.  He fought a long hard fight against a nasty disease.  I will miss you, my friend. 

On a happy note....in exactly two weeks, I will be on vacation!  Yippee!  Perhaps I will catch up on my personal hygiene. 

Happy weekend everyone!

CBart, MD

PS - let it be known that I spelled "menagerie" correctly on the first try.  Spell check did not have to correct me.  It's the little things.