how tv can sometimes be good for your health

I asked my patient how she got her "good" cholesterol (HDL) to increase from a 50 to 70. She gave me a big grin and told me she had been eating cheerios every morning just like the commercial recommended. My HDL isn't even that good! An HDL >65 gives you one less risk factor for heart disease.

applicants

many of the applicants who came to this past weekend's 2nd look party were indian females. 100% of their husbands reported "computers" as their line of work and most could relocate and telecommute if their wives ended up going to our program. I really hope we don't get all indian females b/c that would truly mess up the diverisity of our program. We also need men!

Most of the attendees were also foreign medical grads who know that they have to work extra hard to get a residency spot simply b/c most programs would rather take american grads. These people are really super smart though--scoring many times in the 90% on board exams. Some have been doctors for many years in their native countries. But the thing is, if they can't speak English well, they're pretty much sheer out of luck in america. I had a really hard time understanding one chinese applicant's conversation with me. I kept on nodding my head and occasionally asking him to repeat himself. I felt bad, but if we can't understand them, neither will our patients and of course, neither will our spanish speaking only patients.

super bowl

somehow we ended up having a superbowl party. my husband bought tons of hot dogs, but our invitees who have none of it. "hotdogs,"they complained,"we want 'real' food." These Asians were showing their true unAmericanized colors (don't people just eat chips and hotdogs during superbowl parties?). Instead we ended up supplying meat and chicken and our guests did the cooking in our little kitchen.

life is grand

I'm in a great rotation with weekends free, reasonable hours, & occasional call!

behavioral science

although i love listening to my patients and am very empathetic to "most" of them, I almost can't stand talking about behavioral science stuff in our formal "psychosocial" conferences. I just get sick. I mean we all know how to say "i understand that you may be feeling this way," but must we harp on it repeatedly? I just about died during conference when we had to go over how to address losing weight with our morbidly obese patients. We spent an hour on something that in my opinion could have been covered in 10 minutes.

Do you know that you're considered morbidly obese and perhaps the vicodin that you keep on asking for your back pain is not going to help your knee pain-- and in fact, weight loss would probably do a better job. Most patients don't want to hear it, they want their pill and they want it now.

but the real truth of the matter is, how I can I tell my patients to diet when i'm here eating McDonalds' supersize fries?

selection

this weekend is our "second look " party where prospective candidates to our program continue to "play the game." they show up just so that we can tell if they "really want" acceptance into our program. it's one of the few loop holes in the whole system of matching into residency programs. programs are not allowed to promise a spot and are not allowed to tell the applicant they are ranking them. Somehow, however, word gets around, people show interest, and calls are made to ask people how they are doing. No call or thank you card usually means the candidate and/or the residency program are not interested. I cant' wait till this is over. all I want are hardworking, fun people who also know that they are "interns" and know what type of work and sheer humility go with that title.

love marriage

I attended an Indian wedding this weekend of a couple who were not "arranged." In other words, it was a "love marriage." My sister-in-law noted,"you can tell it's a love marriage because the couple is so happy, but everyone around them is disappointed." But that is not all that the controversy entailed. My husband alluded to this before we left when I asked," does it have to do with the fact that the groom is much darker than the bride?"

Apparently, the groom was from a lower caste than the bride. While the bride was distinctly lighter than the groom, it really has nothing to do with their caste level even though many of those in the lower caste are dark skinned. Since these Indians are Christians, the caste level was supposed to have been abandoned, but unfortunately older generations have so ingrained this thinking of superiority/inferiority that no has been able to free themselves of it. Sounds familiar a la Martin Luther King, eh?

So how in the world can people tell the caste level from which you were born? According to my sister-in-law, people inquire about your family etc. Detective work is done and by word of mouth, people find the information. Supposedly, marrying a person from a lower level is worse than marrying outside the race (like my husband did).

So what is the couple to do? Well, they can't worship at the groom's church b/c she is not pentecostal and they can't worship at her church b/c he's from a lower caste and he's pentecostal. Therefore, they'll have to go to an English church where interracial marriages are accepted and live a much happier life in my opinion.

reliving 3rd year

I had to consult cardiothoracic surgery today on a patient. The first surgeon who called me was fairly nice and then I got a page back.
In a very irritated male voice "This is DR . .. you talked to my intern about a guy with 2 vessel disease. WHY DID YOU CONSULT US?!"
I started going into the story whereby he interrupted and asked "WHY DID YOU CONSULT US?"
I fumbled, "Evalution for CABG (coronary artery bypass graft.)
HIM: FOR 2 Vessel disease??!! (he said it like he meant "you idiot!")
ME: well, we consulted cardiology b/c . . . .and they thought he should benefit from a CABG before undergoing lower extremity intervention.
HIM: WHO did you talk to? (I answered) He's just an intern. What DOCTOR did you talk to!
ME: (anwering ever so kindly) I don't remember, but I can look it up for you (which I did and gave him the name. I then explained about the patient's cardiac w/u and how I'd leave all the information at the patient's bedside)
HIM: Well just leave all that SH** at the patient's bedside.

Cardiothoracic surgeons are sooooooooooooooooooo mean! I had the same experience as a third year medical student. They like to belittle you and make you feel like you are nothing. I would really love to report that guy. How rude that he would curse in a professional situation just because he's a surgeon.

just like butter

I had such a great call last night especially since I was with such a great upper level. This guy is so calm when it comes to admissions or when patients start "breaking" on us. I hope I am just as good of an upper level as this person next year. Anyhow, oe of our patients started having oxygen desaturation to 70s, but was totally asymptomatic. Basically you want to be "satting" in the 90s to ensure oxygenation to your blood. If I were on call with my previous third year, he would have gotten anxious and would have been yelling at the top of his lungs. This guy, however, had his wits about him. Chest X ray, ABG (arterial blood gas), 100% Non-rebreather. He ordered them calmly. usually people need to be intubated with sats in the 70s but since she was asymptomatic and we weren't sure if they were too accurate (she moved around a lot and the monitor was on her finger), we watched her and she moved to the high 80s in seconds.

saying good-bye
some patients end up being the hospital for weeks and so I get attached to them since I see them everyday. I finally got to discharge one of my patients who had actually been in the MICU before she was transferred to us. She hadn't walked for 3 1/2 weeks since she was confined to her bed and so didn't even think she could. The nurse and I assisted her as she walked down the hall and she couldn't believe she could go that far. You get deconditioned after you've been the hospital for so long and you almost have to reteach yourself how to walk, feed yourself, and take a shower. When we were done and she had walked w/o becoming short of breath, I told her she was ready to go. I loved seeing the look of pure elation on her face when I told her. That's when life is rewarding.

gluttony

I had the past 5 days off and loved every minute of it. Relatives came into town so we all took turns having dinner at eachother's houses. Talk about gluttony.

I really love how large and crazy my family is when they all get together. We played Guesstures and Taboo and just laughed at how competitive and silly everyone could be. I needed that.

So i'm back in the ole doldrums of you know what. must I whine again?

baby fever

I found such great deals on children's clothes at baby gap and Old navy after christmas. So many of my relatives and friends have or are just having kids. I had so much fun shopping for the little ones that I almost convinced myself that I wanted one NOW. My boss at the clinic told me she waited till after her residency b/c it was so much easier, but then again, 2 of the 3rd year residents pumped their breast in between seeing patients last year.

PROS about having a child now: I'm younger, my child can grow up with the rest of my friends children, the experience and joy of seeing my child when I wake up everyday

CONS: time, money, fatigue, time, time time

Time
How much of my free time is spent watching TV/being on the internet/being lazy? Time is always going to be a factor. I'm sure I'll find some time to spend with my child God willing.