Really Random.

... Because I woke up at 3-freaking-AM because I've been nocturnal for a week.


A week on night float for Ob-Gyn rotation.
Turns out it is even more mind-blowingly-terrible than days on ob-gyn.  Perhaps because the assholes who run this hell-hole-rotation somehow think it is appropriate to let students leave at 5pm during the day (making it approximately an 11hr day), yet on nights you are there from 6pm until morning rounds are over... and it goes like this... start at 7am and *could* end by 730-745am, but residents are a special breed of evil who don't give a flying-shit about students, thus, even if they are done with report they will continue sitting at the table (while students sit up against the wall because we can't sit at the big kid table) gossiping about patients or debating some ridiculous 'guideline' and going in circles about it.  During all of which students sit there awkwardly in silence, because obviously we can't interject into the 'conversation' nor can we get up and leave without properly being 'dismissed'.  Then, on top of that if there is a lecture that starts at 8am, night students are required to stay.  So that puts you to 9am.
Eugh. Whatever. I'm tired even just typing about it now.

I'm done night float for ob-gyn. That's all that matters.  I guess you could say I survived.  But that really depends on your definition of 'survival'. 



Ever wonder about what else happens when women push so hard to get a baby out of their vaginas?

They poop.

It really is true.  Sure - not every woman.  But yes. I've seen it.  And smelled it (is 'smelled' a real word? smelled? smelt? smelled? whatever. I really don't care).  It's not so much the smell of amniotic fluid and placenta that makes me have a minor gag, it's really the adult poop so close to my face. I guess poop is poop, but still, that part of it really did not make the highlight reel of this rotation.


Things that did become a highlight include:
- this itty bitty 24yo who initially was really struggling through the pain, yet did not want an epidural.  However after a couple hours of writhing pain she accepted the God given gift of anesthetic in the epidural space.  She was then able to relax and rest.  After giving her an hour nap, I go in with the resident to check on her.  She is all smiles.  "how are you feeling?'  "great!"  "do you feel any of the contractions?"  "Nope. Not really.  I'm just comfortable." "okay great.  well we will just check you and see if you have made some progress."  Resident checks her cervix and quickly looks up at me with wide eyes and is all "get the table and glove up. The baby's head is almost out".  We crazy-quick get everything set up, break down the bed, get this girl repositioned, and I look down and baby's head is literally a cm from crowning.  I look up at her and she is just straight up chillin', and texting.  We are like - okay put down the phone and how about you give a little push.  She gives a little "mmm" wimpy push... baby's head crowns.  Okay another push. "mm".  Head out. One more. "mm'.  Shoulders out.  Body out.  Welcome to the world kid.

- scrubbed into my first c-section, the attending puts the scalpel in my hand and is all "feel comfortable?"  me - eyes wide with excitement - "yes sir!" There's just something about making a sweetly smooth cut through flesh that really makes me come alive. you know?

- a patient with chronic hypertension with super-imposed severe preeclampsia and a severe intra-uterine growth restricted baby in the less-than-3rd percentile.  This woman was 28 weeks along, but because of the chronic growth restriction, the baby had not grown at all in the past 4 weeks - putting it at the development of a 24weeker.  Due the the severity of her preeclampsia, a code 30 (30mins from decision to incision) was initiated.  I was scubbed into this c-section and seeing something so tiny come out of something so large what truly astonishing.  I couldn't help but look over at the awaiting NICU team as they immediately intubated this little life that came out weighing 1pound 11ounces.  Their precision and skill is not something to underestimate.

- and of course suturing up abdominal fascia layers still makes the highlight reel at this point in my life.



I don't really have anything left to say at this moment.  I'm a little confused as the the day and time and what I'm doing with my life.

So,  in summation.


I'm counting down the days left in Ob-Gyn and I will get through it.  And never look back.  I will smile and be professional until 12pm friday afternoon, which is when I put the pencil down after the shelf exam, then I will walk away and sing Sara Bareilles' song "Sweet as Whole" at the top of my lungs over-and-over-and-over-and-over until I feel recovered from this living nightmare.

Sometimes I can be perfectly sweet
Got this sugary me stuffed in my sleeve
And I talk of ponies and rainbows and things
And I'm just who you want me to be

But like most creatures down here on the ground
I'm composed of the elements moving around
And I grow and change and I shift and I switch
And it turns out I'm actually kind of a bitch

But that only happens when I get provoked
By some piece of shit asshole we all sadly know
And I sit and I write while reminding you all
That mean songs are still better than going postal


And that guy's an asshole
That girl's a bitch
Baby it's natural
No gettin' away from it
So sing it out with me
And then let it go
Fuck that guy he's just an asshole
Oh-asshole
Asshole
Asshole


I see I've surprised you with some of my words
And I know that surprises, while fun, still can hurt

And I hate to think that I ruined the day
Of the dick and the queen of the high horse parade

But I'm sick and tired of your poisonous ways
Your toxin wasting perfectly good space

And I say what I think
'Cause it's more economic than drugs or a drink


That guy's an asshole
That girl's a bitch
Baby it's natural
No gettin' away from it
So sing it out with me
And then let it go
Fuck that guy he's just an asshole


And I won't let him in
Under my skin

You're a sad sack of shit
That's pathetic
Just a festering sore
Who will never be more than that
If I don't let it


And that guy's an asshole
That girl's a bitch
Baby it's natural
No gettin' away from it
So sing it out with me
And then let it go
Fuck that guy he's just an asshole
 

So sing it out with me.  

If you were to ask me how 'things are going'

How I feel about finishing this rotation

How's Ob-Gyn!? you ask.


I miss psych


As if waking up at 3am is not cruel enough in-and-of-itself...

Ramada has thin walls.

Over the sound of the show I was watching in bed I can hear something... I'm all 'what's that!?!' So I turn down the volume on my computer.  Hear nothing.  Okay I'm just hearing things now, awesome.  Turn volume back up. Hear it again - like a gasping sound followed by a type of scream.  I'm all, 'oh my gosh is someone getting attacked outside!? Could I be hearing the sounds of a notorious crime in this town!?" 

Suddenly that gasp morphs into a moan. 

Followed by more shouts.

But I quickly realize the screams of "YES! YES! YES!" are not that of a crime of attack, but that of my neighbors having very loud sex. 

I turn up the volume on my computer to full.  I cover my ears.

More than a little over-the-top moans continue while my ears and soul bleed. 

"OH BABY! YES!"

I'm all ARE YOU FREAKING KIDDING ME!?!?! WHY IS THIS HAPPENING TO ME!?! WWWWWWHY!!!!

I guess a crime really was committed in the wee hours of the morning today. A crime against me.

A crime against my ears. A crime against my already wounded soul.



I shall be taking an extra, extra amount of melatonin tonight.

Re: I'm A Teary Toad

I came across this gem and I really feel like it embodies all I was trying to convey in my post about my new found crying episodes.

Breaking News Of The Day. I Don't Have Kids.

So I'm with one of my laboring patients today - a lovely, and very chatty,  23 year old girl about to have her 3rd kid.  She has her sister, mother, baby-daddy, and babby-daddy's great grandma all in the room. A loud bunch. But an entertaining bunch.  They are collectively trying to decide on a first-name for this baby-girl about to enter the world (coming up with some crap-stack-terrible-ideas for names), and then turn to me and say - I like YOUR name! I'm all, well thanks! I think it's a pretty good name!
Then sister asks me - you have any kids???
me - nope
patient - what!? really? how old are you!?
me - 25
patient/sister in unison - whaaaaat you 25 and you aint got kids?
me - nope
baby daddy (shocked) - whaaaat!? dat crazy! when you gonna have dem kids?
me - not for a looooong time (ie never)
baby daddy - you don't wanna be dat old 41year old picken' yo' kid up from kindergarten!
me - that's definitely not the dream. nope.


What a treat  - to evoke such a reaction of shock and wonderment out of a group of people of my being 25 years old and nulliparous. 

Turns Out I'm A Big Crybaby

What.... a turn of the lazy-susan. 

After years and years and years of being an lacrimal-duct-challenged robot, I have evidently turned into a bottomless pit of raging tears.  Okay, well not so much raging tears per say. Raging rage with the presence of tears is a more accurate description.  But whatever. Point being - I'm a teary faced little toad.

Do you want to know what really threw a lit-match onto this fuel-soaked-pile-of-suppressed-shit?
Being awake for 29hrs straight then getting home into bed and watching the saddest episode of Army Wives -- that's what.  (side note: yes. I am completely, 100% emotionally, committed to Army Wives. A show with a fan base consisting of menopausal house-wives and me. I'm not ashamed to admit this.)

Me, post call. Probably the ugliest side of me.  I get all curled up in bed, resume watching an episode, and one of my favorite characters dies!!! *Normal* me would be all, 'aw that's to bad'.  *Post-call* me was freaking hysterical.  Face half covered with blankets as I sob! You know what I mean? The 'ugly-cry'.  Through broken heaves and sobs I'm crying out in a deep manly voice - NOOOOOHOHOHO!! WWWWWWHY!?!? NOoooohohoNoo! Wwwwhy!!  Not. *choke on tears* Jer-e-my *choke on tears*  My eyes quickly became swollen from the fast escape of tears, which is when I finally had some voice of reason say "what is happening to you right now!? stop this! sleep!"
So I listened.  I passed out instantly.  Woke up 6hrs later - it was 3pm.  I got up to eat, and resumed watching more of the episode.  Started bawling again.  Turned it off at 5pm.  Then woke up next to my alarm at 5am to go back to work.  That's right. Do the math - I slept 18hrs. 

One would think this amount of sleep would cure any illogical, unreasonably excessive emotion.

One would think.

However, add a dash of effed-up hormones to the mix and a dollop or heap of misery while in Ob-Gyn rotation...


You get me.

An unpredictable basket-case.

...Doing more than just dipping my toes into the sea-of-mental-break-down.

My Mother Is Cray Cray Awesome

After hearing their daughter vent about how some bitchy OR nurse ruined their already crap-filled day... *some* mothers may say things such as, 'oh sweetie - that doesn't sound pleasant, but maybe you have to think about your own attitude toward things like these as well." or "oh honey -you can't let those little things bother you".
Instead my mother sends me the following to keep me laughing and lift my spirits all day long. What. a great lady.


 






The woman knows me well.


And this pretty much sums up my life right now.
http://whatshouldwecallmedschool.tumblr.com/post/48282906110/every-day-since-the-start-of-medschool

I May Need An Intervention Soon.

Okay. I know. I totally went overboard on the last post...

The general feedback from the last post was more along the line of pure disgust, to which, at first I was all “what are you talking about – it wasn’t that bad”.  Then I realized the line of ‘disgusting’ has been crossed so far that the line is now a dot to me, and sometimes my social graces forget that not everyone tolerates such mental imagery like some of us sick-folk.

I actually don't have anything to say right now... I just want to write to tell you that I am well aware of the fact that I have totally fallen off the deep end. And I mean deep deep deep end.  I have so many stories that come to mind when I'm driving, or falling asleep, then I get busy or forget or get complete mental block and can't summon the energy to write it out.

Then I feel like I get too far behind and start forgetting particular highlight-worthy moments!  This is where you can come in... did I have a great conversation with you over text during a particular ridiculous med school/life moment that you can remember!? Send ME a message and relay it back to me!! I need to be reminded!

I was just looking at some of the earlier times I wrote on here and was shocked!  Firstly, by the fact that I started this in 2011 and we are already well into 2013.  Shit.
Secondly, at how many times I posted in a friggin month back then!! What the hell happened you guys!? Now it's like 4 months in between stupid stories.  My first thought was, 'wow girl! you were so diligent and really on top of your shit with balancing school and blog crap!'.  This was quickly followed by, 'wow girl. you really had no friends. you really didn't get out much. you really had no outlet source whatsoever.  I'm surprised you didn't write more! sad sad little girl'.
Actually I know what happened... I got back to North America and got a phone where you are now at my fingertips! And facetime. and skype.  Thanks a lot imessage. you totally screwed my goal of medschool documentation.

Reality: I still don't have many friends in school.  I still don't get out much. I should be writing more. but alas. I suck right now.

Eugh.  Seriously I'm so pathetic right now.  I finished pediatrics, and I can confidently say - I will not be a pediatrician.  Now I'm in ob/gyn.  Finished week 2/6.  Aaaaaaand already I can strongly say - I will not be an obstetrician or gynecologist.  Eugh. Not. For. Me.  No. Nono. No no no no. No.

On a different note. I totes wanted to bitch slap an OR nurse today. I also had the pleasure of dealing with a twat-faced bitch of an attending.  She's the kind that hates students (I'm sorry I wasn't aware there was a school you could go to where you went straight into being an effing attending!); doesn't want you to scrub in on cases so you are stuck standing in a corner with the trash and can't see for shit; doesn't acknowledge your existence as a human-friggin-being (I shit you not. Today she did the hand gesture to say "I need a pen stat", so as I was right beside her and had my pen handy, I pull it out of my pocket and hold it out for her... the bitch doesn't take my pen.  Just stands there, looking through me as I stand with my pathetic pen-in-hand floating in the air, and waits for the resident to go across the room to get his pen.)
 Some of my favorite ecards came to mind - particularly today - as I was hidden behind my surgical gown and mask...

To the OR nurse today.


To majority of my classmates



and a very important prayer to me



Okay seriously you guys (you know who you are!!), send me a message telling me YOUR favourite story I have shared with you so far!! Help a pathetic girl out!

Surgery In A Nut-Sack-Shell

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The world of surgery was a whirlwind of awesome and shit.  Sometimes it was pure awesome. Sometimes it was pure shit.  Sometimes it was awesome shit. 

I would leave my apartment at 4:00am, walk 5 blocks to the subway, arrive at 5:15am, and walk 8mins to the hospital.  We had lecture at 5:30am given by the Godfather of surgery – sure, he was partially deaf, had an 87-year-old-man limp in his gait, and yelled at the group for being dumbasses from time-to-time, but damn…he was sharp.  Beyond brilliant. 

630am morning rounds would begin with all the students (I think there were around 20 of us), interns, and residents.  For an hour-and-a-half, the huge effing flock of us would go floor to floor, room-to-room, discussing the management of every patient surgery had.  Students had the additional job of being in charge of wound changes on patients, and it is this wound-change duty where I had my first taste of the surgery rotation.  Day 1. 6:31am.  First patient room in the CCU.  Fornier Gangrene – which is a fancy way of saying: flesh-eating disease of the perineum (the area between ones’ legs). Are you reading this and crossing your legs in protection of your perineum?  You should be. 

There is no way to describe the smell of this kind of wound.  It overwhelms you as you walk into the room.  Keep in mind I literally have no clue what I’m doing and really have not seen any “true wounds” in my life.  So I follow into the room and take notice of what the interns and residents are doing and just blindly do as they do.  Gown up. Gloves on. Grab onto patient’s hips and start rolling him.  ‘oh my gosh. We are rolling him over. What the hell is going on here!?! Holy sweet baby Jesus what is that smell!!?! Oh Lord. Oh no. WHAT THE FRACK STACK! This man has no flesh on his ass left! Welp. His inner thighs are gone too.  Oh wow.  That’s an edematous scrotum there.’

My approximate inner thought process as I am half draped over this man’s hips, holding them up as the rest of the team pulls out all the packing material and bandages from this man’s ass/perineum.  An added treat to this flesh eating disease’s ravenous appetite is the fact that essentially all the tissue surrounding the rectum has been debrided away – so it’s like a dangling rectum now – and there’s no bowel control in the slightest.  In simple terms, every morning we had to partake in this huge process there was always a pile of diarrhea.  Whaaaaat. A great way to start the day.

Not only will I never forget this man for the sheer fact of the extent of/location of his gangrene, but he also was the first case I scrubbed in for in surgery.  He came in a few days before I started with a few odd looking spots on his scrotum… this RAPIDLY turned into a surgical emergency of necrotizing fasciitis. He was taken into the OR for debridement, after which he was at risk for renal failure due to so much muscle tissue necrosis.  He was on his way for dialysis when he coded for 45mins.  Now he is ‘alive’ but with ‘minimal brain activity’.  His family refused to look at his wound, and refused to let go.  At the end of my first week in surgery, I went into the OR for this man’s: suprapubic catheter (pee out the belly into a bag), colostomy (poop out the belly into a bag), and more debridement.

 The debridement part:

·      Legs in stirrups.  In lithotomy position.

·      Bed raised as high as it can possibly go

·      Legs raised as high as they will go

·      It’s just me and the chief resident up close and personal.  Chief resident pulls out the rectal tube previously inserted and we both jump back as liquid shit sprays – super soaker style. 

·      As chief resident cuts away more and more and more necrotic tissue I have to stand beside him, cupping this patients freely exposed testicles.  That’s right. There was literally no scrotum left.  It was a tragic case of not-so-eazy-breezy-city.

And that about sums up the first surgical case I ever scrubbed in on.

I have a few more stories left to tell.
If I happened to tell one to you in the moment back when it happened and you found it particularly entertaining or fascinating.  Or just ridiculous.  Email me and remind me of it!

Miss you all! More than you know!

xoxo