What's the Worst Way...

...to wake up at 7am on your day off when you want to sleep in?

I'm going with spider on the face. Don't ask me how I know this...

Wow, Where Have I Been?

Basically, I've been spinning around in the wasteland of psychiatry. I know some people love the field, but it's totally not for me. The past three weeks have involved being locked in a unit with people who have comitted crimes while they were mentally ill. Let's just say some of the crimes freaked me out. Scary, scary, scary.

And what else was scary? How about the psychiatry SHELF exam. True horror. I didn't know probably 50% of the questions. Like, didn't know at all. Here's hoping for a miracle so I can pass and never have to deal with another psychiatry exam.

So now I will start six weeks of OB/GYN. It should be okay. I don't think it will be my passion and true calling in life, but I'll do okay and be at least somewhat interested.

Here's some good news: Financial Aid pulled through and I finally got my last bit of loan money for the year. Thank God, because I don't think my apartment complex would waive rent for the month of June if I explained that financial aid was making me crazy. Although it did take me about ten phone calls and actually driving to main campus to get the financial aid settled. But that's okay in the end. It's done.

And I think I get my next financial aid payment on June 27th. Whew! Going to pay off some credit cards and buy some books I need for boards. Can't wait!

Someone suggested to me that I might close down my blog while I'm interviewing for residency next year. I guess in the past some people have even pulled down their facebook accounts. But after thinking about it for awhile, I don't think it really matters if my blog is up and residency places find it. I'm just about the most boring person in the world, anyway. It's not like I'm talking on here about getting drunk every night or talking about how much I hate medical school. The truth is I behave more like a nun than a college student (for instance, I spent last night eating popcorn and doing a jigsaw puzzle), and I love medical school (although I hate things like financial aid).

The only pain in my ass right now is this lawyer that is settling my step-mom's estate. Seriously this lady pushed me to a majorly passive-agressive moment last week. She keeps sending me things to sign and then mail back to her. I'm not exactly the picture of organization, and sometimes it takes me awhile to mail things to people. Hello - I'm super busy and don't live right next door to a post office.

But the lawyer sent me something a few weeks ago to sign that lists what's in my step-mom's estate and I signed the thing and put it in an envelope and carried it out to my car. Then I realized my stamps were in my apartment, so I didn't send it out that day. Then I forgot about it.

Then I came home one day to see that I had a notice from the post office that I had something sent to me certified mail and I could go pick it up at the post office. Um... I'm not really free when the post office is open. It's not like I sit around my apartment every day watching Maury and waiting to sign for my certified mail. There was a post office right next to the place where I was doing my last rotation, but the certified mail wasn't at THAT post office, but one across town. So, basically, a big pain in the butt.

So I finally called the lawyer and asked her if she had sent me the certified mail. She said yes, and that she was on a big deadline and she needed proof that I had received that letter (the one I had been intending to send back but forgot about). I said I would mail it to her while I was in Zanesville (I was on my way back to town to get dental work done). But then I asked her if she knew when my step-mom's estate sale was and she said it had already happened and everything was gone. And she said, "You never contacted me." I was like, WTF??? I was in surgery when my step-mom died and had absolutely no time to deal with this stuff. I don't know if it was her job to let me know about the estate sale, but she could have told me out of the kindness of her heart. That side of my family has completely died off, so it's not like there were any relatives that would have let me know.

I was willing to take a day off from school and drive to Zanesville so that I could BUY things I remembered from my childhood with my dad and step-mom. I have a print of my dad's that hangs on my wall, but that's it. I talked to my brother the other day and he told me about a website where there were photos from the estate sale (which happened in April), and it seriously upset me so much. There were so many things I would have loved to have. Someone bought the lamp from my bedside table. Someone els bought the childrens books I still know by heart. It makes me a little sick.

But I'm over it now. And so I was so mad at the lawyer that I waited an entire 10 days to finally send that letter to her. Yeah, I realize that it was super immature but it wasn't completely intentional because I was distracted with other things. But I don't feel bad that it took me so long to send it to her. And I heard from my parents that the lawyer is pissed at me. Yeah, my hometown is small and everyone talks. Isn't there some sort of confidentiality thing in the lawyer world? I wouldn't walk around my town telling about patients I was mad at. What's the deal, lady? Be a little professional.

Today involves sleeping and washing dishes. Maybe a little studying. I'll try to be better about posting, I promise!

Julia, the Medical Wonder

While I was on surgery in February, one of the attending surgeons told me that I should get this little bump on my right arm removed. I'd had the bump for over ten years and it just didn't seem too important to me. I'd had something similar taken off my leg when I was a kid and didn't remember it being a big deal, so I figured the bump on my arm was just a simple calcium deposit or something. The surgeon said it's just good to take things like that off.

The surgeon was super nice and told me to just show up at his clinic on a Monday or Wednesday and he would remove it. I didn't even need to make an appointment!

So last Monday I had some free time and I ran over to the surgeon's clinic to get my freaky bump sliced and diced. Imagine my horror when I walked into the hallway of the clinic and saw asshole resident himself standing there. Yeah, asshole resident was on service with the nice surgeon who was taking care of my arm. Asshole resident was the last person I wanted to see, but at the time I hadn't received my grade yet so I didn't know just how much of a jerk he is.

Knowing that it is a teaching hospital, and appreciating how much I have learned from patients who are generous enough to allow me to watch their procedures, I had decided ahead of time that I would allow any residents/students to watch my bump removal. If it had been located someplace a little more delicate I might have thought differently, but it was on my arm for crying out loud.

I have to admit, though, when the surgeon came into the procedure room alone and shut the door I was pretty relieved. I really don't think I could have handled asshole resident being in there.

So I was really nervous because I'm a huge wimp about pain. But the surgeon was super nice and he used a tiny needle and took a long time numbing up the area. I was impressed. It seemed to take forever for him to get the bump out. I could feel him grabbing 4x4s and putting pressure on the wound. Then he asked his nurse casually, "Could I please have a bovie?"

And I asked, "So is it bleeding a lot?"

He replied, "Oh... It's just oozing a bit."

Yeah, sure.

So he put several deep stitches in and then did some subcuticular stitches (for those of you who may not be in the medical field - subcuticular stitches are all under the skin and all you are left with is a simple linear scar from the wound). He used teeny tiny vicryl. I have to admit, a week and a half later it looks completely fantasic. I couldn't be happier with this surgeon's stitching skills.

Anyway, I'm sure you are tired of reading about my stupid bump removal. And this is the part of the story that gets more interesting.

I looked up my pathology report the other day and it identifies my bump as something a little more than a simple calcium deposit. It's actually an osteoma cutis. Basically, my bump consisted of bone cells and cartilage cells. How freaky is that?

I tried to do some research on osteoma cutis, but there wasn't much out there. So I decided it wasn't too important and went along with my week.

Fast forward to this past Friday where I was talking with one of the pathology fellows at a forced medical student fun day. I asked her if she had seen anything come through the lab with my name on it. She said no, so I told her it was an osteoma cutis. Her eyes lit up and she said, "That was YOU? Oh my God! That was the case presented this week in pathology case conference!" So there you have it - my bump is weird and freaky enough that it was actually presented to the residents/students. I'm famous!

So sthe path fellow is going to hook me up with the pathologist and I'm going to go down to the lab and look at my freak of nature this week.

And unfortunately it doesn't end there. I actually have four more of these darned things. Yeah, I'm a freak. Only one is big enough to cosmetically bother me, so I don't know whether I will get them all removed or not. I will go talk with the surgeon this week as well and see what he thinks I should do.

I already knew I was weird. This is just more proof.

No Honors in Surgery

So I busted my butt for surgery. I did phenomenally well (for me) on almost every single component of the surgery grading system, but still didn't get honors. I seriously feel so discouraged right now I can't even put it into words.

And I know this sounds silly, but I am really upset that I got my worst eval from the attending I liked the most. His eval is singlehandedly bad enough to give me a high pass instead of an honors in surgery. Yeah, it was that bad. They grade us on a scale of 1-5 and and he didn't give me a SINGLE 5 on anything. Come on. I know I'm not the best student ever, but I tried really hard and I think I deserved at least ONE 5.

And of course the resident that made me cry several times (not in front of him) and who I had to deal with for two months instead of just one gave me horrible evals. Great.

The average of my other residents evals: 95.8%

The average of dickhead resident evals: 75.1%

Does anyone else see a difference here? And dickhead resident's evaluations counted for 27% of my evaluations in surgery. That's how much time I spent with that guy. How can they allow one resident to have that much sway over a student's grade? Even though the difference isn't quite enough to get me an honors in surgery even if they throw out one of his evals, I think I will go speak to an administrator about the fact that this can even happen. A resident should not be able to evaluate the same student twice on the same rotation.

Ugh. I just lost ever bit of motivation to study. What's the point anyway?

Psychiatry Is Making Me Crazy

I moved to the city of my psychiatry rotation yesterday. It's only an hour away from my regular apartment (you know - the one I'm paying for while I don't live there), so I just drove here in the morning before work.

I am working with one other student on this rotation. We met with the coordinator in the hospital at 8am and she showed us around and tried to get us oriented to our surroundings. She also told us that we are supposed to meet with a psychiatrist Wednesday morning at 8am ata location away from the hospital. Then she showed us the psych ward and left us to meet our preceptor.

We waited around a little bit until our preceptor got there and she is super cool. She told us we should get to work "around 9" each morning. And she brings us breakfast and coffee in the mornings. And she told us she writes good evals. Sweet. She also gave us some paperwork to do yesterday evening.

So I totally procrastinated last night (watched Toddlers and Tiaras on TLC - completely appropriate for my psych rotation) and didn't get my work done. I figured I would do it in the morning. So I went to bed and tried to sleep. Unfortunately, the apartment is a little creepy and I got a little scared. Even the Sesame Street sheets on my bed didn't help. If anything the sheets made it creepier. At one point soon after laying down, I heard my bedroom door open ever so slowly. I said, in a shaky voice, "Laura?" No response. I said again, "Uh, Laura - is that you?" Still no response. So I willed myself out of bed and looked into the hallway. Nobody was there. "Laura?" Apparently Laura was either asleep or thought I had completely lost my marbles because she didn't answer.

So I went back to bed and tried to reassure myself that there was a logical explanation why my door suddenly unlatched itself and opened. I was then amazingly able to fall asleep only to have the most vivid nightmare I think I've ever had. There were guns and violence and a psychopath killed my family in front of me and then I somehow escaped and was running to the police. And the police didn't believe me and thought I was actually the one who killed my family. So then I woke up in a complete panic with my heart racing and had to really talk myself down from the urge to have a complete meltdown. I somehow managed to go back to sleep, though, so everything ended up okay.

So I got up early at 7am and ate breakfast with Laura while working on my paperwork I hadn't done the night before. Suddenly, around 7:35 I remembered my 8am meeting with the psychiatrist. I had totally forgotten! So I ran around and threw on a horrible outfit (black pants and black sweater) and ran out the door to find his office.

I arrived at the office before the psychiatrist even got there, so things were going okay. The other student on my rotation was nowhere to be found, though, so when the psychiatrist showed up I had to go in alone.

The dude was really nice, but the first thing he asked me was, "So what kind of feelings did you experience yesterday when you first entered the locked psych ward?"

Oh shit. Was this supposed to be a therapy session? Wtf? I thought he was supposed to welcome us to the psychiatry rotation or something.

So I said, "Actually, I was working at a hospital on my family medicine rotation and we saw patients on a locked psych ward there. And one day a patient got a little violent and I had a vasovagal episode, so I was a little worried yesterday that I might have that happen again." About halfway through that little explanation a part of my brain started saying, "Shut up dumbass! He'll figure out you're nuts!" But I just kept talking.

And he continues to ask me questions about the anxiety I experience when dealing with violent or angry people. At one point I reminded myself to not fidget so I would look a little less anxious and then I reminded myself, "You f-ing told him you almost passed out from seeing a little bit of violence - the anxiety ship has sailed. Fidget away, oh anxious one!"

By the time I finally got to leave, I felt like I had been completely drained. The guy was really nice, and to be fair he told me a lot of great stuff for succeeding on my psychiatry rotation. I wonder, though, if after you've been a psychiatrist for so long it's hard to talk to people in a normal manner (you know, without asking about feelings and stuff). At least he didn't ask about my childhood or if I've ever been abused. And I managed to NOT tell him about my psycho nightmare last night.

So I'm not crazy, right? Right?

Ironically, Psychiatry May Be the Rotation that Leads to my Psychotic Break

So today was the orientation for my psychiatry rotation. Six weeks of crazy fun! And by crazy fun I mean a crazy amount of fun! Okay, still sounds bad - perhaps I should refrain from using the word "crazy" for the next six weeks?

Anyway... Does anyone remember what happened to me last time I was locked in a psych ward (while on my family practice rotation)? Yeah, vasovagal episode where I almost bit it in front of my entire team. Wow. So the thought of psych wards freaks me out a little. Clearly I am not meant to be a psychiatrist.

But I have to say the orientation was hil-freaking-arious today. We had to practice our escape moves in case someone grabs ahold of us. And I swear to God we learned how to "break the wrist and walk away". Jocelyn and I practiced this on each other and kept throwing in little Napoleon Dynamite lines. It was great. And I couldn't help but think that this move will help me next time I'm trying to get out of my grandma's nursing home and some little old man in his wheelchair grabs ahold of me (this happens to me on a regular basis, seriously). Yeah, I'm sick.

We also learned how to get away if someone grabs your hair. I have sisters. I already know how to get away from someone who has me by the hair. The guy who taught us the defense moves was some super karate guy or something and he scared me just a little. I think he could have killed me with his bare hands. I really loved the point where he used me as an example for how to get away from a choke hold. I was actually just a little scared for a second. Imagine how I will react if a patient gets me. I see a vasovagal episode taking over before the patient can choke me to death.

And the best news ever is that although I have to live in student housing for the next three weeks at an away rotation, my roommate is Laura! My favorite person in the world! Woo hoo! Three week slumber party here I come!

I Hate My Teeth

I went to the dentist on Monday and my dentist told me I had put my root canal off waaaay too long (the tooth has been slowly dying for 18 months now) and I should just let him do a root canal this week while I am on spring break.

I actually have a really sweet financial deal with my dentist. You see, I have to drive 3 1/2 hours to Zanesville to see him, but he is a great family friend and just sends the bill to my parents. So I never have to pay for anything as long as I'm seeing him. Now, if I go to another dentist my mom would probably still be willing to pay for it, but I would have to write the check and then ask her for reimbursement later, which is a pain and I usually don't follow through.

So I made an appointment to get the first part of the root canal done today. I hardly slept last night because I was really worried. I like that my dentist is essentially free to me, but he can sometimes be a little less than sensitive with my wimpiness. Like one time I told him that he was hurting me and he said, "I'm not hurting you, your cavity is hurting you." Yeah, whatever. Like the cavity picked up a pokey metal thing and stabbed my tooth with it.

On Monday at my appointment he reached in my mouth first thing and tweaked my dying tooth. I let out a quiet gurgled scream and closed my mouth as soon as he removed his hands. Then he wanted me to open up again so that he could check my other teeth for cavities. Are you kidding? You lost your chance, buddy. Fool me once shame on you. Fool me twice? Shame ON ME. Yeah, I'm clearly a baby at the dentist office. But I did finally open my mouth again after he promised to stay away from evil tooth #4. It's not like he had to pinch my nose closed or anything.

But this morning I got to the office and sat in the waiting room reading about cardiomyopathy (the most painfully boring subject in medicine) and he came out to get me for my root canal. That's Zanesville for you - the dentist himself gets you for your appointment.

So he gave me the nitrous mask and one shot of novocaine. I asked him (while admittedly high as a kite) if one shot was going to be enough? Really? Maybe just one more for good measure? But he assured me that one was enough. I realized at this point that my legs were each hanging off one side of the dentist chair but I didn't really care. Hell, the dentist could have doodled with a sharpie on my forehead at this point and I wouldn't have cared. That nitrous mask is an amazing thing.

And the good news? No pain during the root canal. None at all. Granted, there could have been pain and I didn't notice because I was very relaxed and happy.

But now the injection is wearing off and I'm starting to feel some pain in little tooth #4. I took 800mg of Motrin and we'll see what happens. I hope my dentist did a good job with my root canal and I don't need to have it redone or anything.

Let's just hope I get a little more than what I paid for.