psychopathology

I visited a hospice center and went on a home call with the head physician, 2 psychiatrists, and one palliative care fellow. Driving back, the head physician started asking us how we felt, what we thought, etc. Coming off of behavioral science and family block, I have to say that at least I had my armory of psychoanalytic vocabulary to add to the conversation and understand where it headed.

The head physician pressed and pressed asking all kinds of, what seemed to me, rhetorical questions. He had this admirable, yet annoying way of being able to naturally conjure up in conversation, the more "intellectual" word choice.

Instead of "it was my mistake" he chose, "I was derelict in not doing this." There were SAT words in every sentence. I'm wondering, does he talk like this to his kids or what?

I like to say that I'm VERY REAL, down to earth. I'm pragmatic. I should have said "practical," but that word came up first. The thing is, I find it trying to talk psychoanalytically. I just didn't grow up that way.

I notice people are sad, depressed, mad, angry, and I empathize. But how all of it relates to the world and myself and politics, religion, the economy, I really don't care to think about. At least not today, after sleeping 4 hours, status post cleaning up after making cookies!

baked goods

For the past 2 weeks I've been trying to get sponsors so that I could raise money for this diabetes walk I'm doing on Saturday. There are five of us on my team and each of us is "encouraged" to raise at least $75. The walk is at Sea World, so if you make at least $75, you can stay in the park the entire day.

My husband and I have raised $192 between us, but the rest of the girls are having a hard time asking for money. We basically volunteered our friends and family to give money, but asking co-workers is a different sotry. So we decided to make cookies today so that at least in return for donations people could get a cookie.

We made about 6 dozen and finally perfected the last 2 batches. The first batch was salty and the next few were too doughy. By the end, we were fed up and sick of cookies. We were even a little bit ashamed of the first batch, so what did we do?

We prayed over the cookies hoping that some people would be generous enough to give good donations! I hope it works.

Here's our diabetes page

family block

This past wards call was not pretty. I was cross-cover, meaning I'm not on the regular wards team and am just covering for that call. Usually cross-covers are there for the night (12 hours), but in this exception I stayed from 6am to 12pm the next day. There were 27 patients and I did not know any of them. Lucky for me, the intern was on the wards team and was familiar with some of them, but she had been off th eprevious day.

We had consults, orders, discharges and guiacs (exams looking for blood in stool) on our to do lists. What made it worst was that two of our patients in the MICU (medical intensive care unit) got transferred back to the wards for me to assess and write a note and one patient all of a sudden went into acute renal failure. Fortunately, I blocked an admission from another hospital ER and only admitted one patient at 5:00am.

the following day, because of our "family block," where the interns have 2 week, call free conferences, we had no interns to see patients. That meant some upper levels on other rotations have to come in and round on patients. We are interns again--RELUCTANTLY.

The interns deserve vacation especially after their first 3 months of residency shock therapy. The intern with me did all the guiacs (5 of them). This entails using one of your fingers to get a stool sample and putting it on a card to check for blood. I give her props!

first time for everything

Today was the first time a patient farted while I was doing a pap smear. As I was taking the speculum out, she let one loose. The nurse looked at me, but I pretended I didn't hear it. I held my breath and just got out of there quickly.

"Black guy with a white chic"

Those were the code words given to the Child Protective Services social worker I shadowed one afternoon this week. We were looking for the "alleged perpetrator" (the white chic) and her baby who had reportedly been "physically neglecting" her 3 month old child and had been staying at a motel with a "known drug dealer."

The first place we visited was a seedy, 10 room PO-tel (a slang term used when a motel is owned by Indians who most often happen to have the name Patel, get it?). We first went to the motel office which resembed a 4 x 4 foot movie ticket booth.

"We're looking for a (Stanley)? we were told to mention 'a black guy with a white chic?' " The owner told us to check room 106.

We knocked on the motel door and a black guy answered only opening the door at a slight crack. The stench of dried sweat and cigarette smoke immediately hit my nostrils.

the man was fairly evasive with our questions and said he didn't know who "stanley" was. After a short while we were satisfied with his answers since there was no baby in sight that we could tell.

I couldn't believe I was on this "stake-out." Despite the fact that I was with a preppy, pearl adorned social worker, I felt like was on the TV show COPS.

So anyway, we ended up finding the couple at the man's mother's house. The house was nicely painted with good landscaping, but practically all the other houses looked run-down. As we drove down the road looking for this house, I noticed a lot of people hanging out in their front yards just shooting the breeze. We must have looked like fish out of water.

To make a long story short the mother and baby looked fine and actually had been staying at this man's house for a month. They had, however, stayed that the Po-tel for a few days a 5 weeks prior to our visit.

The man worked two jobs and denied being a drug dealer. All that we could establish, however, was that the baby looked physically healthy by my exam, but we had yet to deterimine if the mother was drug-free. She was to have drug test the next morning.

The life of a CPS worker, though rewarding, take guts and brawn. Besides having to visit some scary places, the work entails confronting a sometimes guilty perpetrator and having to handle the situation if the need arises to take away a child. I don't think I'm cut out for t personality-wise.

birthday

My birthday came and went. I didn't plan anything, didn't want anything. I spent the weekend by myself, went to outlet alone, slept late.

I did, however, have lunch after church with my friends (but we do that every sunday) and later, had dinner with my parents. What's funny, is that I paid for my own food, both times.

all my friends remembered to call me and as usual, my brother forgot.

BTW, I'm 29 now. eek.

fuming

today, I drove home with a scowl on my face thinking un-Christian thoughts about the people in the Medical Records Department. People in medical records hound residents about deliquent discharge summaries or charts that need to be signed at the worst possible moments--when you're asleep, post-call, on vacation,etc. Then, they slam you with a threat of suspension or suspension if you don't comply. I don't rate medical records personnel highly on my list of favorites right now.

optimists

today we bought a pregnancy test kit and a sippy cup.