Position awkward

I remember looking at interns and residents with awe, and thinking I will not be able to do that. Presenting 10 patients, putting in orders, reassuring families, coming up with a plan as the attending pimps you in front of the crowd while everyone stares at you like you're some bearded lady in a freak show. 

Then I became an intern, and honestly as bad as it is, it's not THAT bad (usually). The most annoying thing is being annoyed with good intentions of other people. For example, you're trying to get your trillion tasks accomplished and a nurse who is 3 times your age comes and serenades you with some psychosocial issue. You try not to appear annoyed, as she probably will take that as you being a disrespectful petulant child, but the frustration is overpowering sometimes and unavoidable. It's never personal obviously. It's only that you as an intern have 15 other issues vying for your attention that you need to get accomplished in an X amount of time, yet appearing annoyed or frustrated will potentially make your life harder in the long run if said employee takes it personally. After all she could be your grandmother. So you smile and nod politely which only encourages more in depth conversation which you really have no time for. 

The Rubick's cube of human interaction = resident. You're sandwiched between parents who expect you to know things, the attendings who think you know nothing, the nurses who know the hospital infrastructure inside and out and the medical students who keep asking you questions that you once knew and now can't remember. 

KD

Tooling around

The most obnoxious thing about being an intern is carrying a ridiculous amount of office supplies with you. On a daily basis this is what I must schlepp with me from room to room when pre-rounding and rounding all day.

1.) A stethoscope (obviously.)
2.) Black pens. These MUST be black if you deal with paper charts.
3.) Multi colored pens (to eliminate the confusion of the ADD-ness of this profession when you're pulled in fifteen different directions as you're trying to place orders, draw blood, talk to a family, and write a discharge simultaneously.)
4.) Maxwell's (pocket sized handbook of random equations and lab values)
5.) A Maxwell's knockoff of the hospital's preferred regulations on how to calculate things like TPN (total parenteral nutrition... for the nonmedicals I won't get too much into it, but basically how to calculate a form of nutrition that is provided through an IV)
5.) prescription pads
6.) a potpourri of passwords stored on a color coded piece of paper and always inconveniently inaccessible when one needs it most
7.) A reflex hammer, a pen light (I fail in this on a regular basis)
8.) Forms. For everything: meds, blood bank, labwork, nontraditional labwork, nontraditional meds only supplied by a random underground facility in the North Pole... you get the picture.
9.) a Phone
10.) a pager
11.) and last but certainly not least, meal cards.

I am convinced that one of the rites of passage of becoming a good intern is to be cool about carrying all this without fumbling and dropping half of the items in the process. However, to help you get there... these things are amazing:

They're called storage clipboards and this particular one is a Saunders Deskmate. Changed my life (and enhanced my nerd status dramatically, but at least it reduced the awkward fumbling).

Laters,

KidDoctor

what day is it?

No time to breathe.

I need an infusion of a concoction of Adderall + caffeine + redbull 24/7. Will be back when I have >24hrs off work. Til then I'll be catching up on sleep for 14 of those and binging on large amounts of calories for the other 10.

Maxed out on credit cards. Student loan payments accumulating. Paycheck in 3 days. I need a sugardaddy to save me.

Orienting ....

It's been a while.

So I started residency orientation and it's absolutely ridiculously busy. It basically consists of 8 hour days of team building exercises, PALS (pediatric advance life support) courses, computer training, and lectures on professionalism. And then there are the numerous social events. Sometimes I wonder if I fit into this extrovertedness that comes along with the career of a physician. You are with the same group of people all day every day and moments alone are rare. I am already starting to miss "me" time.

On top of that I am scraping by on litte to no money because I don't get paid for a while and student loans have been completely extinguished a long time ago.

I will be responsible for the lives of little children in Tminus 5 days which is more horrifying than invigorating at this point.

I am committed to learning as much as I can, saving more than a few lives, and trying to educate parents and kids. Will keep you posted, just wanted to update tonight. and verify that I am still kicking.

Kick, flail, kick

KidDoctor

Jumprompers and Peanut Allergies

The other day my roommate came in wearing the cutest ensemble - a romper and wedge heels. I never knew what a romper was before. I also never really understood the concept of one, but this is what it looks like (no this is not my roommate):

Now after some googling action, I discovered that rompers = jumpsuits which I always thought were meant for anyone under five.... but I now can see the appeal (although the full-length ones still don't quite make sense to me.....:

Mmmmm ..... think I'll pass on the full body suit.

On the pediatric front......

............ for those of you battling peanut allergies with your kids, an interesting fact picked up in clinic today = the aroma of peanut butter or the proximity to peanut butter will not induce an allergic reaction. Many parents believe that the odor from peanut butter can result in a severe allergic reaction, but allergic reactions result from direct exposure to food proteins (as the food proteins are the actual allergens that prompt the body to react). The aroma of peanut butter is due to the natural oils in peanut butter, and not directly to the protein that causes these types of reactions.

A recent study actually tested this theory: kids with peanut allergies (and apparently very cool parents) were exposed to the aroma of peanut butter at various distances and no reactions were observed. However, when allergic kids had direct contact with the peanut butter, hives were noted in the area where the peanut butter was placed on the skin. Anaphylaxis, a serious allergic reaction that can lead to death if not addressed quickly (aka immediately) can present with a widespread rash, nausea, diarrhea, vomiting, throat swelling and low blood pressure, but is usually only present when peanuts are ingested or touch mucous membranes, such as the inside of the mouth or eyes. With that said signs of anaphylaxis can happen 30 minutes - 2 HOURS after the ingestion of an allergen, but usually require a couple of symptoms (not just diarrhea, vomiting which may also be a sign of food poisoning if 2-3 hours out).

Anyway... interesting take, thought I would share.

Jelly to your Peanut Butter,

Sticky KidDoctor

In the light of recent events....

The past few days have been pretty heavy on the American public. With the Boston Marathon bombings and the Waco, TX explosion many lives have been affected, and it is sad to think that random everyday moments can be so rudely interrupted by tragedy, especially if such tragedy is voluntarily caused by fellow human beings as with the former. As a pediatrician in training, I'm always curious about how a human being as young as 19, as in the case of one of the brothers responsible for these Boston bombings, can develop into this type of extremist and have in mind the idea that he is somehow doing himself and others a favor.

According to one militancy expert who specializes in counterterrorism, criminal behavior, and forensic psychology, "a sense of normalcy can pervade groups of extremists when individuals surround themselves with like-minded compatriots." http://news.yahoo.com/psychology-boston-marathon-terrorist-10-questions-retired-marine-165947383--politics.html If kids grow up with this idea that these actions are respected and somehow earn one a place of honor in society, they, just like kids in the U.S. who aspire to be the next great pop star, will seek to emulate these figures.  Whereas idolizing LiLo (self-destructive tendencies, rehab stints, and all) is somehow okay for tweens in the Western world and condemned in other nations, the seeds of idolizing religious extremists are planted early in these kind of groups. Of course, these two mentalities are completely different and looking up to a pop star or celebrity does in no way, shape or form equate with carrying out this kind of a terrorist act, but the main idea behind why people, and kids, choose a certain way to think may be similar. You do what you know.

If you grow up with an ideal that is part of your environment, as false as it may be, eradicating that ideal becomes difficult, bordering on impossible. This is not meant as an excuse, it's just faulty programming that when reinforced becomes difficult to extinguish. It's the same thing with any society, culture, etc. If one grows up in poverty, it's difficult to break the cycle because it's comfortable to identify with the surrounding environment, and if one does not do so, one is somehow betraying everything one ever knew about that environment including the identity that has defined that person and letting go of such an identity is a scary thing. The thought patterns become deep rooted and lead to actions. Anger does not help; identifying the best way to not propagate the mentality or the anger is key to preventing these kind of things from continuing to happen.

So, I've refrained from telling people about this blog, as I would like to keep it anonymous...... but that also means no one is reading it unless people know it exists, so I'm going to attempt some creative ways to let people know about it. (Free ice cream?)

If you have ideas, and happen to come across this blog before I spread the word somehow, comment or hit me up.

Raindrops on roses and whiskers on kittens,

- Kid Doctor :)

The Perks of Being a Medical Student.

I'm cooling off at a Panera Bread. Why?

Because it is early April, it is over 90 degrees outside, and we just learned that the air conditioning at the house which I share with multiple roommates is broken. That's right. I'm in my late 20's and I still cannot afford my own living space, but have been shelling out over 50 grand for tuition over the past 4 years. Logical this is not. Socially acceptable, yes. It appears to be appropriate to spend more in tuition each year than the average American starting salary and not be able to afford a personal 1 bedroom apartment. Is it just me or is there something wrong with this picture?

So back to the lack of assistance from electrical advances of the past few decades. Mother Nature didn't exactly turn the thermostat up gradually, but decided to shock us into subservience by going from 40 something degrees to 80, then 90 something in the course of one day (which is what often happens in the region where I attend medical school). This pretty much left us panting like dehydrated dogs after we realized that the AC was blowing hot air into each of our rooms, and of course these things take time to get fixed if you're living in a privately owned house with an owner who does it all himself. Not that he's not great about these things; he is, but instant gratification has taught us to pay for and rely on a system that caters to our whims, and our whims get whiney within a few hours if not catered to instantly. 

Our internet also decided to rebel. We called the cable company twice and it kept on just timing out. And of course, the person at the cable company had no idea what else to do besides reset the modem and the router over and over.... and over again, solving nothing. Sigh. The joys of the 21st century. 

On a brighter note I ended up selling all my old furniture, which means all I really need to bring with me when I move for residency is anything that will fit in my car and leave a small patch in the rearview mirror to be able to maneuver semi-safely between lanes of traffic. Score. Cash and less things to move.

It's the little things. 
- Kid Doctor