move your body

this is overdue, but props to michelle obama's campaign against childhood obesity:

http://www.letsmove.gov/

and because it's my NEW FAVORITE THING EVER: beyonce/michelle obama's movement to end childhood obesity with sick dance moves: check out the video here.

I may or may not know all the moves now :)

the people we used to be

some sage advice from a quote cited by a friend today in a discussion on how we're all still becoming who we are, every day, and the importance of remembering all the many people we - and all our friends - were before.

we got to reflecting about just how much our ideas of what makes us happy and what we want in the future have changed, especially since starting medical school, from the visions we held of ourselves before.

Yet those visions of ourselves are never fully evaporated, just incorporated and interpreted in new ways.

~~~~~~~~

“We are well advised to keep on nodding terms with the people we used to be, whether we find them attractive company or not.

Otherwise they turn up unannounced and surprise us, come hammering on the mind's door at 4am of a bad night and demand to know who deserted them, who betrayed them, who is going to make amends.

We forget all too soon the things we thought we could never forget.”

-Joan Didion

~~~~~~~~

(you might need to click on the photo to make it bigger, but that's second grade me up in the upper left corner with the rest of my class and the VP and principal. Right before they took the photo, I said "WAIT!" and proceeded to take my awesome pink headband off and put it on - backwards. Yup, I guess I've always had some issues with photos)

2 times 2

so last night was my last night call on pediatrics and it was AWESOME. instead of being in the ER admitting really sick kids all night (which we also did, and which I also really like, actually), we got to be the peds team for a C-section of newborn twins!!!

and then we got to do it again for a C-section for ANOTHER SET OF TWINS!

it was a little crazy for a while with the second set because they were really small and came out a little bit blue and not breathing, but with some quick resuscitation and waiting for their little lungs to kick into gear breathing outside the uterus, they did just fine.

They always say the true test of if you should be a pediatrician or an OB is where your attention is in the delivery room - are you focused on the woman or on the baby?

what if I am a really good multi-tasker and am interested in both?

gahhhh

and here's my fellow med-student and me in the ED after the deliveries, around 3am.

(which explains why we look kinda silly - I have to stop sticking my big chin out in photos)

(**these are obviously not actual pictures of our patients, but newborn babies sorta all look the same anyways, right?

plus more or less vernix (the white stuff) and blood on them)

~~~~~~~~~~~~~~~~~

"med students are JUST like people -

there are some good ones and some bad ones out there"

-my senior resident

Code Red

I had my first night call on peds yesterday. "What is night call?" you might be wondering (I'm looking at you, mom and dad) Well, for me - it means that for this week instead of arriving at the hospital at 6am and leaving at 6pm, I arrive at 6pm and leave at 6am (or whenever the senior resident sends me home).

Yesterday, my fellow med student and I rolled into the hospital at 5:30pm in scrubs, armed with coffee, pagers, stethoscopes, and study materials (sometimes if it's a slow night, there's a lot of time to study, or so we hear).

Soon, the daytime resident starts "sign out" which is when they tell the night team (hey, that's us!) what happened during the day with each patient and what they need to make sure to check or evaluate overnight. About two patients into this sign out, all 14 pages at our table go off (each resident has at least 3) with a message something like this "CODE RED. APPROX 3YM IN MVA DRIVER DEAD AT SCENE. LOC AND FEMUR FX. AIR ARRIVAL 1840."

we calmly finish one more patient then race down to the emergency department where we spend the next 8 hours - first, with this trauma, next with a 13 year old who was in a different type of motor vehicle accident (MVA), and then with a months old baby with suspected sepsis. Before we knew it, it was 1:30 and we were just getting dinner. I actually really loved it. except for this morning when I felt a little bit like death.

the top 5 things I like about night call so far:

* fewer people running around the hospital

* there's a smaller staff that has to communicate more; it has a "we're all in this together - we are holding back the world" type feel

* drinking coffee at 3 pm and not worrying if it's going to ruin my night's sleep

*having time to do all the things I'm normally too busy working to do

*getting to sit and rock a baby that can't sleep because that's my JOB.

and the best part so far?

the parents of the little baby with possible sepsis decided to go home to be with their other very young children, but were so worried about leaving their baby at the hospital overnight without them, that the mom looked at me and said "You'll hold him if he cries? You'll be checking on him?" and I could say

"yes, ma'am I will - I'll be here all night"

:)

wax on, wax off

the manfriend and I went on a run the other day and talked about the goals of third year

as in, WHAT ARE WE SUPPOSED TO BE DOING RIGHT NOW?

it's such a strange middle state between the past few years of everything being about how much we learned, and years before that (and years to come) of us being actual working people who are performing a job and a service that is important. I've been feeling really badly about performing exams on patients who have already had exams performed on them just so I can learn.

But I was recently reminded that except for the patients, the medical students are the only other people actually PAYING to be at the hospital.

which brings me back to my original question: what are we supposed to be doing right now?

and what we came up with is that this time period is sort of a mix between

(1) an apprenticeship,

(2) a consumer of an educational experience (sometimes to the annoyance of many other people) and (3) kinda, maybe, sorta in a very small way actually helping people

because of this, we have moments where we find ourselves assigned to do things that do not seem helpful to either our patients or to our learning, which I'm now calling the WAX ON/WAX OFF PART OF THIRD YEAR. This includes getting to the hospital to be on call at 7am on a Sunday even though we don't have any patients, standing by an inebriated patient as he recovers slowly to make sure he doesn't leave the hospital, holding a baby for 5 hours of overnight call because it just had surgery and screams every time it's put down in a crib.

I'm not saying these aren't also learning experiences, but it's more the way the karate kid had to learn the discipline of karate by washing Mr. Miyagi's car. We learn the discipline of medicine from these things - what you learn when you just listen, what a hospital is like at night, the frustration of not getting to do everything else you want to do in your life because you have responsibilities.

But there's also the consumer of education part where I have to remind myself that I need to examine this patient not because no one else is examining him (many people are), or because I'm likely to see something everyone else has missed (that seems unlikely) but because someday I'm going to have patients like him and I'm going to need to know how to do the exam and what to be looking for. And (and here's part of the maybe, sorta, just a little bit helping people piece) he's receiving better care because he's at a hospital where people are constantly thinking about how to do the exam correctly and what they should be looking for, and they are doing this a lot because they have people like me around asking them about it.

~~~~~~

Daniel: Wouldn't a fly swatter be easier?

Miyagi: Man who catch fly with chopstick accomplish anything.
Daniel: Ever catch one?
Miyagi: Not yet.

and

Miyagi: First learn stand, then learn fly. Nature rule, Daniel-san, not mine.