Monday, September 15, 2003
Addendum....
I love hearing his voice at night, even if he can't be with me. I love the sound of it, the way his timbre is different when speaking to me than when speaking to anyone else. It leaves me feeling safe and heart-mended in the hours of sleep.
At least I have that.
Day by day.
A quiet day on the wards. Not much to tell. But I had my midpoint evaluation with JK today (Dr. M tomorrow) and he was most complimentary. He says I have initiative, curiosity, and a lot of energy, that I'm inspiring to be around and that it's unusually motivated of me to go in and see patients I'm not even responsible for. I didn't know he'd noticed. I love seeing patients. And I follow up on labs and I try to help out anywhere I'm needed. Isn't that part of being a good student? He wanted to know how I was getting along, if there were any problems. No, not a bit. I love the wards, I love the residents and the interns, and the nurses are nice. But it does seem kind of slow...and I've never done a normal newborn circuit. So tomorrow morning I'm going to pick up some newborns to help fill my days. And admit/discharge summaries. By all means.
And the dreaded question: What do you think you need to improve on? I was expecting it. I knew the answer. I need to work on organization and coherency. Very insightful. They'll come with time. You do much better if you take the time to write your notes out before rounds. And that's true. All of it.
The bottom line, O Best Beloved? JK finds me impressive as a student, and feels that I have a lot of qualities that will make me a good doctor. I'm ahead of where he'd expect me to be at the beginning of my third year, and I know what my weaknesses are. I'm doing well. Keep it up.
And then I gave my pager number to the intern, in case of admissions in the middle of the night, and I came home and slept for an hour and a half and didn't get working until well after 8. Nobody came in, apparently, as the pager is silent and I was off shift at 10. But I have a printout of the Limping Child outline for presenting tomorrow. And I know what I'm going to say, I think. And tomorrow I get to see Angel for dinner - and then finish writing my expanded H&P which is due Wednesday.
And after all that, it's nearly midnight again, and it's far past my bedtime. Goodnight, O Best Beloved.
Sunday, September 14, 2003
Sex and Candy.
I took the What Mythological Creature Are you? test by
Morpheus
?? Which Of The Greek Gods Are You ??
brought to you by Quizilla
Friday, September 12, 2003
RP Quotes from the new Mage game.
Cast of characters thus far for Mage ():
: Leynia, a Russian exchange student, majoring in biology-chemistry and minoring in English. A fifth-year senior. Verbena.
: Jax, a first-year from Chicago making up his own biohistory major. Verbena. Has an echoes that causes arousal in everyone around him.
: Liz, a second-year transfer sociology major from Loyola in New Orleans. Order of Hermes.
: Jen, a first-year computer science major, math minor from New York who's hooked on a mage-only form of XTC. Virtual Adept.
: Joseph, a junior transfer student from Wheaton College and devout Catholic who's been suited up with Jax. Major in political science, minors in computer science and music. Celestial Chorus.
: The Evil GM.
Joining us on Saturday nights when the schedule starts to rotate: .
- Phloxin (conversing with himself): Hi! You're a Shriner, too. --How'd you know? --It's the fez.
- Angel: Healing is a vulgar Effect. Me: Unless you use folk remedies. Angel: Ancient Russian magic...I mean, herbs! Me: Sorry, my English, she is no so good.
- Me: ...the New York equivalent of Boys' Town, because where else can you get bitch boots? Phloxin: Damn straight. Me: Well...
- Phloxin: Give me the fucking Internet!
- Me: Nothing like frostbite of the cock to turn one off.
- Me: She looks up at him. "I sincerely hope you're better at fucking than you are at dancing, because otherwise you're going to have a very lonely life." Phloxin: I want that!
- Angel (picking up the pager): Ha! You called too late!
- Me: I'm Jen. I have seen crack addicts with less energy than you.
- Me: Is that dancing, or epilepsy? Bri: Epilepsy.
- Jorath: You know that little switch? Turn the vibrator off.
- Bri: Bad vampire! Don't bite the faeries!
- James: We are known by many names through life. Whichever one is most appropriate at the time. Me: In that case, I'm probably 'bitch'.
- Me: If I believed in it (the rosary Jen wears as a necklace), would I be wearing it with Jesus's face in my tits?
- Phloxin: Poke, poke, prod, prod, prune, prune, trim, trim, soil, soil. (GM gives her an odd look) I'm working in the greenhouse. GM: OH!
- Me: Phloxy, can you repeat that poke, prod, prune bit?
- GM: You can conserve pot by smoking under the blankets. You breathe the same air over and over... Phloxy: You re-hash!
- James: Parker was a great guy, except his mice were all greasy. Quinby: That sounds faintly dirty. James: So was his keyboard. Quinby: Oh! Those mice.
- Me: No tit-nuzzling Jesuses today.
- GM: And now we're going to play a game to get to know each other. Me: Does this involve knives? GM: No. Me: Damn.
- Phloxin: What would it take for me to get a breeze going? James: Taco Bell run.
RP Quotes from the new Mage game.
Cast of characters thus far for Mage ():
: Leynia, a Russian exchange student, majoring in biology-chemistry and minoring in English. A fifth-year senior. Verbena.
: Jax, a first-year from Chicago making up his own biohistory major. Verbena. Has an echoes that causes arousal in everyone around him.
: Liz, a second-year transfer sociology major from Loyola in New Orleans. Order of Hermes.
: Jen, a first-year computer science major, math minor from New York who's hooked on a mage-only form of XTC. Virtual Adept.
: Joseph, a junior transfer student from Wheaton College and devout Catholic who's been suited up with Jax. Major in political science, minors in computer science and music. Celestial Chorus.
: The Evil GM.
Joining us on Saturday nights when the schedule starts to rotate: .
- Phloxin (conversing with himself): Hi! You're a Shriner, too. --How'd you know? --It's the fez.
- Angel: Healing is a vulgar Effect. Me: Unless you use folk remedies. Angel: Ancient Russian magic...I mean, herbs! Me: Sorry, my English, she is no so good.
- Me: ...the New York equivalent of Boys' Town, because where else can you get bitch boots? Phloxin: Damn straight. Me: Well...
- Phloxin: Give me the fucking Internet!
- Me: Nothing like frostbite of the cock to turn one off.
- Me: She looks up at him. "I sincerely hope you're better at fucking than you are at dancing, because otherwise you're going to have a very lonely life." Phloxin: I want that!
- Angel (picking up the pager): Ha! You called too late!
- Me: I'm Jen. I have seen crack addicts with less energy than you.
- Me: Is that dancing, or epilepsy? Bri: Epilepsy.
- Jorath: You know that little switch? Turn the vibrator off.
- Bri: Bad vampire! Don't bite the faeries!
- James: We are known by many names through life. Whichever one is most appropriate at the time. Me: In that case, I'm probably 'bitch'.
- Me: If I believed in it (the rosary Jen wears as a necklace), would I be wearing it with Jesus's face in my tits?
- Phloxin: Poke, poke, prod, prod, prune, prune, trim, trim, soil, soil. (GM gives her an odd look) I'm working in the greenhouse. GM: OH!
- Me: Phloxy, can you repeat that poke, prod, prune bit?
- GM: You can conserve pot by smoking under the blankets. You breathe the same air over and over... Phloxy: You re-hash!
- James: Parker was a great guy, except his mice were all greasy. Quinby: That sounds faintly dirty. James: So was his keyboard. Quinby: Oh! Those mice.
- Me: No tit-nuzzling Jesuses today.
- GM: And now we're going to play a game to get to know each other. Me: Does this involve knives? GM: No. Me: Damn.
- Phloxin: What would it take for me to get a breeze going? James: Taco Bell run.
I have a new rule for you...
...when the senior resident is on call, you get to go home early on Fridays.
I left the hospital at about 2:15 today, after drafting up my discharge summary for the sepsis baby. Have discussed matters of weekends with my resident. He says "How about you make up the time during the week?" I said "How about I take an extra evening call a week?" We agreed. I get to spend Saturday and Sunday at home. Yay.
The most interesting thing that happened today - besides everyone thinking my pig is too cute - was the update on the kid I mentioned yesterday.
Seems around about 6:30, the father decided it was time for him and child to leave. The doctors felt at the time that the child was not stable enough to be discharged. It was explained to the father in plain terms that with his child's condition what it was, there was a very real possibility of him going into respiratory failure and dying if he were to be taken home. Please note: this child was a drop in his oxygen sats away from being intubated. We wouldn't have sent him home even if his parents promised to call 911 at the very first change. What the father did next sealed matters, though. His response to this explanation? "I don't care. We can't fucking afford to be here." Some discussion ensued, during which the father became belligerent. At one point he stated that even if all the the child needed to be discharged was followup meds at home - he wouldn't get them. Things got bad enough that Security was called in. Security escorted the father to the door. And sometime in there, he was overheard saying he was going to come back with a gun. Security was reluctantly convinced not to file a CHINS (Child In Need of Services) report on this kid.
Now it becomes a simple fact: We cannot legally or ethically return a child to a dangerous environment. And the father's words, followed by the child's mother's pleas, have raised the question in our minds of whether discharging him would do precisely that. So now instead of being willing to send him home as soon as he's stable - even if he's still sounding like he could use observation - we'll keep him here, because there is significant doubt in our minds as to whether his father would "afford" to call an ambulance in the possible event that this child occluded his airway and turned blue. That's how concerned he seems to be about money.
Mom, after Dad was escorted out by Security, began pleading with us to release the child. She's convinced that if we keep the kid, the father will divorce her, and her wifely green card will be null and void, and she'll be deported back to Russia. It sounds like a threat she's heard before. And she begged because "you don't know what he's capable of." This woman looks, acts, and sounds like someone who's completely under her husband's thumb. She acts and sounds like someone who's been abused. But we can't prove it, and we can't file a suspicion report on an adult.
The resident there overnight was worried, the nurses were unnerved, and everyone's trying to figure out what to do with this kid. Meanwhile, his X-rays from today show an airway the size of a paper straw and his mother is still trying to get us to send him home. When I left, he was going to have an ENT consultation and we were still wondering whether the parents' attitude would qualify us to file a 310 report with Child Protection Services. There's neglect and/or abuse implicit in withholding necessary medical services from this kid. Is it enough?
Will find out Monday after talking with S, the social worker. I told her I was going to want to know what transpired. Damn right I'm going to want to know.
But for now...I'm going to pack up and go home, where my Angel is waiting for to spend the weekend with me.
I have a new rule for you...
...when the senior resident is on call, you get to go home early on Fridays.
I left the hospital at about 2:15 today, after drafting up my discharge summary for the sepsis baby. Have discussed matters of weekends with my resident. He says "How about you make up the time during the week?" I said "How about I take an extra evening call a week?" We agreed. I get to spend Saturday and Sunday at home. Yay.
The most interesting thing that happened today - besides everyone thinking my pig is too cute - was the update on the kid I mentioned yesterday.
Seems around about 6:30, the father decided it was time for him and child to leave. The doctors felt at the time that the child was not stable enough to be discharged. It was explained to the father in plain terms that with his child's condition what it was, there was a very real possibility of him going into respiratory failure and dying if he were to be taken home. Please note: this child was a drop in his oxygen sats away from being intubated. We wouldn't have sent him home even if his parents promised to call 911 at the very first change. What the father did next sealed matters, though. His response to this explanation? "I don't care. We can't fucking afford to be here." Some discussion ensued, during which the father became belligerent. At one point he stated that even if all the the child needed to be discharged was followup meds at home - he wouldn't get them. Things got bad enough that Security was called in. Security escorted the father to the door. And sometime in there, he was overheard saying he was going to come back with a gun. Security was reluctantly convinced not to file a CHINS (Child In Need of Services) report on this kid.
Now it becomes a simple fact: We cannot legally or ethically return a child to a dangerous environment. And the father's words, followed by the child's mother's pleas, have raised the question in our minds of whether discharging him would do precisely that. So now instead of being willing to send him home as soon as he's stable - even if he's still sounding like he could use observation - we'll keep him here, because there is significant doubt in our minds as to whether his father would "afford" to call an ambulance in the possible event that this child occluded his airway and turned blue. That's how concerned he seems to be about money.
Mom, after Dad was escorted out by Security, began pleading with us to release the child. She's convinced that if we keep the kid, the father will divorce her, and her wifely green card will be null and void, and she'll be deported back to Russia. It sounds like a threat she's heard before. And she begged because "you don't know what he's capable of." This woman looks, acts, and sounds like someone who's completely under her husband's thumb. She acts and sounds like someone who's been abused. But we can't prove it, and we can't file a suspicion report on an adult.
The resident there overnight was worried, the nurses were unnerved, and everyone's trying to figure out what to do with this kid. Meanwhile, his X-rays from today show an airway the size of a paper straw and his mother is still trying to get us to send him home. When I left, he was going to have an ENT consultation and we were still wondering whether the parents' attitude would qualify us to file a 310 report with Child Protection Services. There's neglect and/or abuse implicit in withholding necessary medical services from this kid. Is it enough?
Will find out Monday after talking with S, the social worker. I told her I was going to want to know what transpired. Damn right I'm going to want to know.
But for now...I'm going to pack up and go home, where my Angel is waiting for to spend the weekend with me.
Thursday, September 11, 2003
How did it get to be midnight again?
Have been goofing off all afternoon. Bought a few presents for Angel. Didn't get started on studying until 9. Didn't get all that far. Now it's time to go to bed, and I haven't gotten you an update on today, O Best Beloved. And today...was interesting. I'll recap the highlight of my day, which was choosing the other new patient who came in overnight to cover, and leaving the kid with croup for the residents.
En bref: If your child comes in with croup, and the doctors are concerned enough about it (croup can be very mild, or occasionally a kid will come in with what sounds like impending respiratory failure) to recommend he stay for observation...listen to them. If you happen to be at the Hoosier Healthwise hospital, which gets all kinds of funding to help pay for hospital stays when patients cannot...listen to the financial counsellor. If you happen to be currently going through a bankruptcy, and are completely broke, and have no insurance (except your wife's, which kicks in on the 15th of September - whereas today is the 11th), please consider that the doctors are not saying "we would like to watch your kid just to be on the safe side." Please consider that the doctors are saying "your child's breathing is so close to total collapse that we don't feel like we can responsibly allow him to leave this hospital." Please consider that we are afraid, given the degree and intractibility of your child's stridor, that he might suddenly go into respiratory failure and die.
Isn't that just a teeny tiny bit more important to you than your fucking bankruptcy and the fucking hospital bill?
Don't you think, O Best Beloved, that any rational parent, when told by a doctor - several doctors - that their child is not stable enough to leave the hospital, would then say "okay, we'll do what it takes and worry about the bills later."? The father of A apparently disagrees, as he was threatening to leave at 10 AM when we did morning rounds, before the hospital could "suck one more fucking dollar from me." When it was explained to him that his room billing went from midnight to midnight, he informed us that he was leaving, no matter what condition his child was in, at 11:30. That was as long as he was going to let us keep his kid. Because they couldn't afford this, and the hospital wasn't doing anything to help his kid (observing, pulse ox, and two overnight neb treatments with epinephrine back to back apparently don't count, because we didn't do more treatments or something) and we were just keeping the kid here to make more money.
I am speechless. We've explained to him multiple times that his kid isn't in a stable or safe condition. We want him here, where we can have him intubated and breathing 100% oxygen inside of the two or three minutes it would take to get him in the car. Where, should his airway close off as it is obviously threatening to do, he can get the help he needs. We want him in the hospital because it's the best place for him to be. We're fucking doctors. We want to do the best fucking thing for our patients.
JL called S, the social worker, and they discussed our options. It's going to be up to R, the first year post-MD - the intern on call tonight - to deal with the situation. To decide whether he thinks that this kid is going to have to stay regardless of his parents' wishes. Because since A is 18 months old, witholding necessary medical treatment from him can be qualified as abuse. And we can call security and have Dad escorted out, and file a report with CPS against the family, and we can make goddamned certain that A stays here, if we think that his situation hasn't improved enough for him to be safe going home. But we have to be certain that that's medically necessary. What a nightmare.
Is your child's life not worth more than money? Do you not understand? What gives?
I'll leave the rest for another time, as Angel forgot to bug me for bed at 11 and it is now after midnight, and I have to be up at 5:30. Good night.
Open season on interpretations: "remort"
Death came
in a car
filled with hellfire,
brushed by
on butterfly wings,
paused,
and looked me in the eyes.
And seeing
(for Death would know)
that we are well acquainted,
he and I,
Death passed me by.
"remort" 11-Sep-03
Wednesday, September 10, 2003
El garatillo
Learned, thoroughly, about asthma tonight. Also took a nap. However, I should go to bed soon.
I have made myself another journal (5 codes a month and all, I can squander them) for writing about the things I learn about. If you want all sorts of spam - the sort of things medical students learn, and all - then you can watch and be enlightened. However, entries are quite long and not LJ-cut. I'm writing it for me, O Best Beloved, and giving you a chance to peek through my window. I was going to make an RSS feed of it, but I can't do it directly (can't add feeds from livejournal.com), so I'll have to play around a bit and see if I can fudge it. Otherwise, either watch the journal or deal with the spam, if you're interested.
I did not do my expanded H&P. I have delayed it this evening, until the weekend. This means that if I do it tomorrow, I will be Ahead of Schedule. I am, however, Behind Schedule regarding the application to St. Francis, and I should do and mail that this weekend. I did, however, spend quite a lot of time learning about asthma. I should find my guide to topics, and cover those in as much detail.
Is tomorrow Thursday already? How time flies. I need to learn more.
I wish I'd brought Dr. M's trivia questions home. I know that "el garatillo" is a 17th century nickname for diphtheria, even if I can't find it in association with Goya - or indeed find the painting he showed us and attributed to Goya in any of the image archives online. I can't remember the other trivia, dang it, or I'd have it done.
This will work quite nicely, I think, with the connection in my room. I have a couch, which is comfortable enough, and in fact would fold out to form a bed should the need for something more than my twin arise. I should ask if it would be okay if Angel came down, for me to fold out the bed.
wants me to run B-movie for her Hallowe'en party. I need to post quotes, oh yes. Lot of things to do this weekend, including getting my pass from Curves (I need to keep working out), eating lots of fresh steamed veggies (I'm living on chicken and cheese sandwiches, soup, Slim-Fast, and cafeteria food, Angel. I need veggies. I'm craving broccoli and cauliflower), and going to the license bureau to get my driver's licence address changed.
But right now...I need sleep. Bedtime for Medical Students, O Best Beloved.
YAY!
Today at the hospital was relatively uneventful, except for the baby we'd seen last night. The snuffly one did eventually feed, and without desatting. The well baby...well...he came in with no stool, dropoff in feeding, bilious vomiting, a distended abdomen, and huge loops of bowel on X-ray. And went straight to Riley for a lower GI evaluation, after we determined he did indeed have a patent anus and suctioned a bunch of bilious mucousy stuff out of him.
Otherwise, other than me nearly falling asleep once, I did some scheduling of subclavian line removal, looked at patients and monitored them, and generally did scut work all day. Could be worse.
Dr. M, my attending, when I said I'd work Sunday morning and make Saturday my day off, said that they might treat me as a special case - since my husband's in Ft. Wayne - and that we'd see how busy we were on Friday. That gives me hope. Lots of hope.
Got an e-mail from Dlink this morning:
Date of Reply: 9/9/2003 10:46:54 PM Products: DWL-800AP+ Operating System: Windows XP Home Please try upgrading the firmware on the router to the latest, 2.2 or 3.2. Hard reset the router and reconfigure. Depending on the dates of the 2.18 firmware, there were some problems with repeating being able to work. This may be the case here........... When you entered in the lan mac address of the router into the remote ap field, did you get this off of the status page in the router configuration???Felt stupid, as I knew there was a firmware upgrade and I hadn't installed it. Did so. Tried again, with little hope. Bing - instant throughput. I am now in my room, with my privacy and my stuff, considering if it might not be advantageous to move the repeater over to the wall directly opposite my room. It would mean I was no longer going repeater to wireless NIC through quite as many walls, but would add some between the router and repeater. Why fuck with it? It's working great. Have been nearly falling asleep all day. Think it would be wise to nap for a bit while Angel is away (I got him a present for his upcoming birthday, yay!) and then do my work. To nap, now.
YAY!
Today at the hospital was relatively uneventful, except for the baby we'd seen last night. The snuffly one did eventually feed, and without desatting. The well baby...well...he came in with no stool, dropoff in feeding, bilious vomiting, a distended abdomen, and huge loops of bowel on X-ray. And went straight to Riley for a lower GI evaluation, after we determined he did indeed have a patent anus and suctioned a bunch of bilious mucousy stuff out of him.
Otherwise, other than me nearly falling asleep once, I did some scheduling of subclavian line removal, looked at patients and monitored them, and generally did scut work all day. Could be worse.
Dr. M, my attending, when I said I'd work Sunday morning and make Saturday my day off, said that they might treat me as a special case - since my husband's in Ft. Wayne - and that we'd see how busy we were on Friday. That gives me hope. Lots of hope.
Got an e-mail from Dlink this morning:
Date of Reply: 9/9/2003 10:46:54 PM Products: DWL-800AP+ Operating System: Windows XP Home Please try upgrading the firmware on the router to the latest, 2.2 or 3.2. Hard reset the router and reconfigure. Depending on the dates of the 2.18 firmware, there were some problems with repeating being able to work. This may be the case here........... When you entered in the lan mac address of the router into the remote ap field, did you get this off of the status page in the router configuration???Felt stupid, as I knew there was a firmware upgrade and I hadn't installed it. Did so. Tried again, with little hope. Bing - instant throughput. I am now in my room, with my privacy and my stuff, considering if it might not be advantageous to move the repeater over to the wall directly opposite my room. It would mean I was no longer going repeater to wireless NIC through quite as many walls, but would add some between the router and repeater. Why fuck with it? It's working great. Have been nearly falling asleep all day. Think it would be wise to nap for a bit while Angel is away (I got him a present for his upcoming birthday, yay!) and then do my work. To nap, now.
Tuesday, September 09, 2003
No, when we're doing newborn exams, we never wear clothes....
..we wear scrubs.
That's the quote I overheard during a lapse in rounds today. It was...well, disturbing at best. Arrived at 0700 for once, instead of 0710 or 0715, despite taking a shower and snoozing my alarm too long. Pre-rounded on one baby boy, sepsis, doing well. Woke him up to look in his mouth (I can look at ears without waking a baby, but mouths...well, no such luck) and he sneezed on me. It was sort of cute in an "I'm now showered in droplets of respiratory secretions" kind of way. Called JK to get my otoscope handle back before attempting to pre-round on one little boy, stridor secondary to probable croup, and was for once not given another new patient. But he did tell me to copy my chart note so he could write on it.
I went to newborn rounds and took my chart note writing to do during them (I don't have any newborns). JK scribbled over my chart note copy, and gave it back to me with a mention that overall it was satisfactory. Change the order of my past history: PMHx, Hosp, PSHx, Meds, Allergies, FMHx, SHx, instead of the essentially random way I was doing it. Get all the information in the HPI. Next to my Review of Systems, he put **good** with little asterisks and everything. That made me proud. JL, in casual conversation as I was discussing my congenital disorganisation and need to compulsively organise everything, told me not to worry so much, that I was ahead of where she'd expect. The interns can't seem to remember whether I'm in my third year or my fourth. I survived the morning pimping session by Dr. M.
Rounded with peds around 10:30 or 11. JK prepped me by making me run through my presentation on B with stridor before rounds. He works hard, but he's super laid-back. Reminds me - right down to the initials - of Josh, the pastor's son. We talked over the plan, and I was reassured that I didn't need to know treatments necessarily, just know the differential. It went, overall, quite well, although one of the interns asked a lot of questions. JL says it's rude for interns to pimp the medical students in front of the attending. I didn't know that.
Ran out from our rounds to make it to Riley for noon lectures. Today it was on anaemia. Quite interesting, even if I was falling asleep on the spot. Grabbed McDonalds due to driving need for salty french fries and caffeinated pop to keep me going. I'm so bad. Used the old trick of filling my cup with ice completely to cut down on how much actual pop I had. It worked, for a while. Long enough to get me going through the afternoon.
I was with the interns on the newborn side. I learned how to do a newborn exam, both from JL and from the interns. I learned how to do a mom talk - funny how everyone does them so very differently - and even got to do some. Checked in on newborn babies, got to pass a nasal catheter to check for patency on a snuffly baby, wrote cards and ran errands - I don't mind the scut work, it gives me time to think - and then it was time for them to go home.
I was on evening call tonight, 4-10 PM, usually gets out earlier. And JL was going to let me out earlier. We were capped on our floor because nurses were understaffed, so there were no admits. And there were hardly any babies. And then we decided to go see a C-section. And when we got there, the nurse said Are you Peds? And JL nodded. And she said I hadn't even called you yet. They wanted us there. Failure to progress, possible chorio, generally ickyness.
So I stood by and I helped dry off the baby, and I held her up for her father and mother to see, and I stayed out of the way while they suctioned and gave breaths and finally took her over to Special Care, which is the magic word for NICU. She should be fine, precious thing with her head all stretched out and funny-looking from being in the birth canal so long, just needs her lungs cleared out. I took my gown home, all sentimental-like. And some extra scrubs.
Then I wandered the nursery and looked at Baby D, who has two very black parents but looks quite white. And the snuffly baby came back, still snuffly. He's got a little chin. Pierre-Robin syndrome (or Robin sequence) can't be ruled out; I haven't looked in his mouth. But his ears and eyes look more normal after seeing his mom's. JL thinks he probably has laryngomalacia. I need to learn about that. He won't eat, sounds awful noisy when he breathes, and is generally a worrying baby. We put a pulse ox on him while he slept, and he seems to be getting enough oxygen.
And then Mom came in, and somehow it had gone from getting a taco salad in the cafeteria around 6 or 7, to walking over to Special Care carrying the new baby girl's anti-kidnapping tag and a box of medications around 9, to wondering what Baby A's problem with breathing was. And JL turned to me and said "You want to go home?" I did. I was exhausted and feeling a little useless. "Go home."
Called my baby sister on the way to the car, talked for a bit. She's started school at IPFW for the nursing program (good for her!) and is now 4 1/2 months pregnant. Reminded her to take her prenatal vits, congratulated her on it all, and just thought about how things change. In my mind she'll always be my little Ernie, who climbed out onto the roof of the back porch and got stuck, the time I locked her in her room when I was babysitting. Just a little girl.
But she's nineteen, and she's going to be a mother soon, and she's going to school, and she's working at getting her own place, and she's not my little Ernie any more. It's strange how things change. It was good to talk to her. We didn't so much grow apart when I went to school as we were never really truly close, not like Michelly and she were. I feel strange trying to make lunch dates with my sisters, feel old.
Daddy found a 1980 Mustang for Paul with like 37,000 miles on it. The owner's a mechanic, it's been in proper storage. He's thrilled.
It's late now, too late for me to still be up writing, O Best Beloved. I had poetry in my mind when I drove this morning with the radio off. I thought of it again when I stopped to go to the bathroom and just sat in the stall, in the cool and clean and tiled empty space where briefly I was the only person, the only sound. I even pulled my feet up and sat like a little ball, and I loved it. I walked out eating a hamburger (I washed my hands first), and revelled in the startled looks I got. I have some of it written down, but some of it, I think is lost. It will return. I can't even express to you how good it feels to have, even briefly, that flow of tangled words that form poetry, the symbols that collect and gather, that connect me. It reminds me that I am still who I am.
Running through my head all day - the theme from M*A*S*H * (Suicide is painless) and Every Rose has its Thorn. What does that say?
And I am going to sleep, to be up again in less than six hours. Please don't make me work the weekend...
Monday, September 08, 2003
ARGH!
I hate electronics.
Got home. Angel was mowing the lawn, so I went and holed up in my room (still no working repeater) and did my admit H&P from this afternoon while listening to Chicago. Fixed Meeta's PDA. Felt accomplished (it was only 8!) so I tried a few more things with the repeater.
Dlink had better fucking well get back in touch with me soon. E-mail support should at least give the courtesy of a "we got your e-mail" e-mail, right? Tomorrow, if I have still heard nothing, I will re-send. And make a fucking pest of myself. There's a good place in my room to work - but I have to choose between talking to Angel and doing work...and Angel wins every fucking time.
I feel like crying. I'm so frustrated. And after a day that (despite the disappointment of learning that yes, indeed, I am supposed to work one day of two per weekend) was pretty damn decent.
I walked 5.3 miles today, according to the Avandia pedometer. Go me. Maybe I will make headway on my bra size, currently a catalogue-only 40H by the most recent measurements.
I am going to get my Nelson's, and read about stridor and asthma. Right now. Because I have to know for tomorrow.
...after I talk to Angel, and quit flipping out.
Noon conference...
Got up today, O Best Beloved, and lingered a bit too long on the snooze. Was ten minutes or so late. But nobody saw me sneak in and I rounded on my patient before asking about new arrivals. " Pick up a few patients, if you want." Well, it was more like a suggestion that I take on helping out with two of three asthmatics. I should have gone over asthma. But I muddled through, somehow. Presented one of the kids, let the intern present the other. JL made me do hers, silly resident. It was a most interesting case, though. The thing we're wondering about this 14 year old asthmatic girl is if her psych history might make her a patient with vocal cord paralysis and not true asthma after all. A most interesting question.
It was almost as interesting as the question we were presented in morning report. The baby with a ringworm-style rash, oral ulcers, and dry cough who's been like this since a few days after birth. Peds derm says neonatal lupus has a very rare incidence of oral ulcers, but there she was.
Noon lecture is on nutrition. Important Fact: Progestemil Formula tastes extremely bad, according to Dr. G. Bad enough to gag a maggot. Try to avoid it.
Sunday, September 07, 2003
Dear D-Link TechSupport:
Oooh, what a neat feature!
Checked my friends list this morning, compulsively. Semagic popped up a message, to remind me:
Happy Birthday, !
I miss M.
Saturday, September 06, 2003
String, or nothing!
Preying mantis on the door. Saw Dad tonight, he got to meet Quinnie finally.
Need to get Jen out and let her stretch her wings. Or write more backstory, so as to have a reference point for consistency's sake when making references to her angst. I found a shop in the mall, called Nirvana, that's practically Jen's wet dream place to shop. Mind has now fleshed out her outfits and her look more.
Scale says 215; I've lost another pound without really trying. I love being shipped all over the hospital, usually in too much of a hurry to wait for the lift.
Mage tonight was much funness. Am made jealous by Angel's command of the six bajillion White Wolf books, but am reassured that he is jealous of my command of things that can go wrong with the human body. Psyche, formerly an ice bitch par none, is now smiling at people, and spending her study time teaching Typheous while cuddled up with his arm around her. This is a breakthrough for her, although she's going to pick up a shovelful of angst as it dawns on her that she's taking time out for herself, rather than working on the very large problem of why her protegee has taken to disembowelling boys with sewing scissors and pulling knives on Psyche's friends. As well as other small matters, like saving the world from a bunch of strangely disturbing vampires. Psyche, as they say, has issues. The psychological ramifications are endlessly fascinating. But she's a teenager, so it's mostly just hormones.
No, really, all my characters in RP are loaded with angst. Gabi was the only one who wasn't, and she was a vampire.
Option 2 seems to be working, in combination with acidophilus (not taken at the same time as the antibiotics) and a good night's sleep last night. Feeling much better. TMI survey later. Bed now. Angel is waiting.
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