Introducing.....

PITTYPAT!!!!!!



In her bed...



On my computer...



Co-habiting with Kittywum....



Bumming around on Brad....

Why am I here?

My sister's post on the trials and tribulations of graduation from college and finding a conventional job and killing your soul or finding a non-conventional job (or not), nourishing your soul but risk being brokealonescared have promoted this post:

I am, despite my frequent negative commentary on this blog, extremely happy I am a doctor. It is an extraordinary privilege to enter into the secrets of my patients' lives, to be there at the beginning of life, at the end of life, and every phase in between. I see people at their worst, when they are sick, dying, suffering and have nowhere else to turn, and I would not trade it for anything.

So despite the humongous load of debt (300K, to be precise), the long crappy hours, there are moments when i pause and really realize that I love my job.

Cynical.

I will stand 2 FEET away from you as I interview you across the counter so you don't choke me. And why did they let you out of jail anyway?

Please do not tell me any more of your problems. And btw, the stitches across your severed (but sewn up) jugular disturb me. Please cover it up.

You are malingering. Don't you dare threaten to blow yourself up if I don't give you Xanax. No, actually, go blow yourself up. See if anyone on this planet gives a crap.

If you dislike your parents so much, stop living with them. After all, you ARE 36.

You are pathetic. You are 36 and living with your parents.

I know you need help but I'm going to leave now. I'm going to leave because I have been here for 10 hours taking on everyone else's shit, and I need to go home and have a beer.

The mental health system in California is broken. There is no fixing it.

(Disclaimer: I really do like my job, and I'm usually quite empathetic. It's just not an easy job and I now know why psychiatrists get therapy.)

Slut shoes.

...to go with my bright red, skin tight, slut dress.

to be worn at Brad's x-mas party.

pictures to follow.

The price of a good life...

One of my friends is contemplating quitting her OB residency and joining a family medicine one instead. It's not that she's lazy nor is it that she dislikes what she does. Rather, she is one of the hardest working people I know, someone who really goes above and beyond what's needed to be done, and she LIKES OB a lot. (something I can't comprehend)

The problem really lies in the fact that she is being worked to death; there was a time when she was on call Q2, and not stay at home, wake up once a night for a call, Q2 either. She wakes up tired and goes to bed tired. She simply wants her life back again, and so she's contemplating quitting.

This of course begs the question; what price to put on an enjoyable life? A life where your friends and family get to spend REAL time with you and don't just hover on the sidelines. And note, there are many people, myself included (hence the FP/PSYCH residency) who would say that there is no question that time with friends and the opportunity to pursue hobbies and interests is an essential part of a satisfactory life, that in this, there's not much room for compromise.

Of course, one could always say, it's only 4 years. OB RESIDENCY IS ONLY FOUR YEARS. But I'm sure that's what could be said about medical school as well. It's only 4 years. And residency, it's only 4 years. And fellowship, OMG, ONLY 3 YEARS. The onlys can go on forever and ever and ever....

I really don't have any answers for my friend, who, like most of us poor indoctrinated residents have always been taught to push the limit, to do her best and more, and who is finding, perhaps, that the limit is fast approaching.

Oh what comes through the ED!!!

8:00am conversation with pt:
Me: Hello Mr X. My name is Dr. Wu and I'm one of the psychiatrists on the service. I'd like to talk to you for a few minutes.

Mr X: it had to go. Because Jesus loves me. [gives me that schizoid flat affect stare]

Me: uuuuh

[fyi, uhhhhh is never really an appropriate response to a comment made by a actively psychotic schizophrenic]

Mr X: [looks down at his foley] why do I need this.

Me: because you cut off your penis.

Mr X: I didn't need it. Can you cut my balls off too.

Me: I don't think that would be a good idea.



10:00am conversation with pt:
Me: Hello Ms. I, My name is Dr. Wu and I'm one of the…

Ms I: [who has paranoid personality d/o] I KNOW WHO YOU IS. YOU IS ONE OF THEM HEAD DOCTORS. YOU GONNA STEAL MY THOUGHTS. GET THE FUCK OUT OF MY ROOM.


12:00pm conversation with the hospitalist on Purple Medicine
Dr. Sandy: [with slightly panicked tone] I need to consult psychiatry. I just got this pt who was admitted with a DVT and she's bipolar and she's not cooperating with the nurses I need you to talk to her

Me: um, well, have you tried calming her down?

Dr. Sandy: [who by the way is a very nice guy but with rather limited pt communication skills] welllll, I haven't talked to her today. But she's bipolar.

Me: yeah, but could you at least TRY talking to her before calling psych?

Dr. S: but she's bipolar

Me: LOOK, THE BIPOLAR PATIENTS ARE PEOPLE TOO.



3:00PM conversation with two patients (husband and wife)
Me: so could you tell me who tried to stab who first?

Wife: [raging borderline personality d/o, sobbing] I'M NOT LOVED.

Husband: [raging narcissistic personality d/o] my needs weren't met.

Wife: [screams] I'm not going to die alone, you Son of a fucking bitch.

Me: I want us all to calm down and take a deep breath.

Wife: I WISH I STABBED YOUR DICK.

Husband: I can't deal with this.

Me: [inner monologue…neither can I….]

You're CRAZY, I'm CRAZY, we're all CRAAAAAZY.

And really, that is the premier lesson in psychiatry. We are all pathologic in some way. Given the right stressors, we can all go over the edge. Hallucinate that there are little green men on the ceiling. Think our next door neighbor is out to get us. Or just plain stick a knife in ourselves.

So after extensive analysis of myself, I've decided that I'm narcissistic/dependent with possible OCPD traits. My boyfriend, Brad, is likewise dependent (although more dependent than me) with possible borderline overtones. My cat is histrionic.

The rest of my family? Well, there's my antisocial dad, my dependent mom (guess where I get my personality disorder from. Hahahaha) and my avoidant sister. I think that about sums it up for now.

Thank god I have family medicine to keep me sane.

Sorry about the hiatus.

It's not that I haven't had the time to write….it's just that I haven't had any drama happen to me. I really only blog when I'm angry/depressed/stressed, and let's face it, it's tough to be angry/depressed/stressed when I get off at 5 every day and I only have call every 6-7 days (and that's home call, mind you) Although once in a blue moon I do get called in for the psychotic suicidal ppl. In which case I just 5150 them. ( I LOVE 5150ing people)

Yes, I AM ON PSYCH FOR THE NEXT THREE MONTHS. More updates to come!!!!

Notes on Internal Medicine

My 82 y/o patient coded last night. He died of metastatic gallbladder cancer. He coded for an hour because I couldn't convince his wife to change his code status from Full to DNI/DNR. They were married for 53 years and she just wasn't ready to let him go.

My current attending yelled at me in front of the entire team for presenting a patient improperly on rounds, then later apologized when he realized that the patient was an old patient and not a new patient, and therefore, I did not actually present improperly. There was really no need to yell.

I tried to get a bus pass for a homeless pt of mine who didn't really need to be in the hospital but wasn't really safe to be left out, but the woman in charge of transportation wouldn't give me one. She told me that " the regulations state the hospital has no obligation to assist patients with transportation. If they can get here by themselves, they can leave by themselves" I told her she could go cram those rules up her ass. Ok, I didn't actually say that but I did tell her that her lack of compassion was disappointing in someone working in healthcare and that fortunately, I was the doctor and not her.

I don't think she liked hearing that.

The theory of practicing medicine and the reality of practicing medicine are very different. You could say that in the last couple of weeks I've really been in touch with reality. It's sometimes a little sobering.

You think your life is bad? Ha.

I don't have much to say about this current rotation. It's at the VA, so all I see are old, unshaven alcoholic vets who haven't taken care of themselves for the last 30 years and who are now, all of them, falling apart.

I don't dislike my patients, I don't dislike my rotation, I don't even dislike call all that much (so far I've gotten at least 2-3 hours of sleep a night)…I just feel MEH. MEH.

MEH is a feeling that's sort of between apathy and boredom. It really denotes an attitude of "gee I feel sorry for you, but my life is so crappy I can't bring myself to care".

I know I am not the only intern in this boat; residency has a way of turning compassionate, caring, empathetic people into sleep-deprived drones. Fortunately for those of us in family medicine, the drone like feeling seems to wear off once we hit second year….but for people in surgery and OB…I UNDERSTAND NOW. I understand why you are all nasty and rude and angry. Because all this abnormal living has sucked your humanity out through every available orifice…

Sigh

Vacation's over. Back to The Hospital tomorrow.

It's all worth it though. Of course, sometimes I feel like it'd be better if I just got a job folding jeans at the Gap.

Fun Stuff

Here's me and Brad camping in Mendocino. Well, actually, it's us taking a walk along the cliffs.





But Mendocino is very pretty isn't it? A bit cold…at around 55 degrees, but that's what campfires are for.





And then we stopped by Santa Rosa to say "hi" to Ele and Emiko and Namiko. I admit, it's an absolutely atrocious picture, thanks to Brad's inferior picture taking skills, but Namiko was also pretty heavy.





It turns out that Ele and David are homesick too, for Philly. Of course, if you consider what we moved too…Santa Rosa and Davis, it's no wonder we miss Philly. I mean, cow tipping isn't really my thing, really.


Although drinking expensive wine at expensive looking wineries IS my thing. Which is the other thing I did this weekend.

It can't get worse so It has to get better.

As I sit here trying to enjoy my 2 weeks off of any clinical responsibility (vacation, yea!) I suddenly realize that I've checked my electronic in box on our EMR every day since vacation started, that I'm completed 3 old pt charts in the last couple of days, and that I called 2 pts last night to give them their lab results.

And I have a feeling that this is how it's going to be for the rest of my life were I a full time family doctor. Work is going to be impossible to leave behind because every pt has 3000 different demands that all need to be addressed NOW.

Unless I decide to practice only psychiatry.

A little explanation needed.

For the last couple of weeks I've spent some time with the fertility clinic at The Hospital. I don't have my own patients, but that's ok, because frankly, fertility is too complicated anyway for me to learn how to manage in 2 sessions. But the doctor I was working with was pretty good, a little short on the counseling and empathy part of it…but really good otherwise and let's face it how much REI (reproductive endocrinology and infertility) doctors go into REI for reasons other than lifestyle and money anyways? The real empathic ppl go into primary care. (ahem, ahem)

So I did get a lot of learning out of the experience, and I did, I really did learn a lot about infertility, but the thing is, what I don't get is the why. Why is fertility so important to women? Not that having kids is unimportant, but in 2 afternoons, I had 4 women out of 8 break down and start crying, and 2 others that ALMOST cried while on the table getting artificially inseminated. And usually the spouses that came in with them (all men so far) look uncomfortable and awkward and none of them quite know what do. This one poor guy yesterday kept saying "it's ok, it's ok" to his wife, because clearly he didn't know what to say, and then his wife was screamed "IT'S NOT OK. I'M NOT NORMAL" and started bawling. And all I could think was maybe some couples counseling should be a prerequisite to starting fertility treatments. Like, why is a psych evaluation a prereq for gastric bypass, but something as emotionally wrought as infertility not have any requirements?

And all the scheduling of sex that goes on with the treatments. And the calendars. And the hormones. And the $$$$$$$. And is it worth, is ALL of this worth living your life like you're nothing but a vagina, uterus and 2 ovaries.

IVF is only 40% effective in a woman in her 20's. By the time she gets to her late 30's it's less than 25% effective per round. And it's easily 10K per round. So someone, please, explain to me why it's worth it.

They feel...odd.

I had a pt today who was worried about a breast mass. She was only 29, so I wasn't particularly worried. She got undressed, I started the typical breast exam…and then…..

Me: "implants?"

Her: yeah, I went up three sizes.

Breast implants are the ODDEST feeling things. They didn't move with her body….and they just sorta stuck out there. I had her do the hands on hips thing and twisting torso thing to see if there was any skin dimpling, and her boobs didn't twist with her. Oh, and I couldn't feel a damn thing through those implants. She could have had a rock hard mass and I would have missed it.

Not that I'm against boob implants and all that, but I really think women should think twice before getting them. There's always the Brava system….

I have....

more elastin in my skin than all you "other ppl" 'Cause I'm Asian. So I'm going to look young for years 'n years 'n years. heh. heh.

(I've been hanging out with med student pathologist-to-be on the service)

Oops

Oh, so I guess I'm not supposed to puncture the cervix with that? sigh.




at least the bleeding stopped quickly.

How incompetent is YOUR Emergency Department?

Before I get into another surgery bashing, negative bitch blog, I'd first like to interject that me and Brad had a lovely weekend in SF. We shopped, had brunch, shopped some more, had dinner, hung out with friends…etc.



Notice the bacon!!!!


Ok. Now I get to bitch.


Our urgi center at the VA, (one can not properly call it an ER) is staffed with non-ER trained (the argument can be made that they are barely trained at all) doctors. Now, granted, the training one gets in residency is important, but it's impossible to learn EVERYTHING in residency. What's more important is that you learn the skills needed to be a self-learner.

These urgi/ER docs are unfortunately, incapable of learning anything new. They are unable to:

1. Work up abdominal pain. NOT ALL ABDOMINAL PAIN SHOULD INVOLVE A SURGICAL CONSULT. Gastroenteritis, as an example.
2. Drain an abscess. Look, if I, as a 1st year PSYCH/FP resident can drain a goddamn abscess, they can too. And if they can't, it's time to pick up an ER textbook and LEARN.
3. Adequately tell the difference between mild SOB and life threatening hypoxia.
4. Suture. They can't suture. WHY CAN'T THEY SUTURE???

And furthermore, they're all insecure. They're all incompetent and insecure, but instead of striving to overcome that incompetence by, oh, reading, they yell at me when I go down there and try to tell them that no, neither pancreatitis nor gastritis require immediate surgical intervention.

The downward spiral.

I wore this out. With danskos.




I'm so ashamed of myself.

What makes me happy.

Almond Cookies from Milette Patisserie. (Nina: maybe almonds should be next on your to try list? )




Stuffies.





Spending time in Napa with my honey.




Vacation with my sister.




Aaaaaand knowing that I ONLY HAVE ONE AND 1/2 WEEKS OF SURGERY LEFT. (ok, it's more like 2 weeks, but i'm rounding down)

Surgical Rounds.

It' s probably going to come as no surprise that lately, I've been a little STRESSED. I'm stressed because I'm overworked, under paid, sleep deprived, on a crappy surgery rotation, but more than that, I'm stressed because my co-intern on this rotation (who is actually a surgical intern) is a ball of nerves. He has been so beaten down by his prior surgical rotation where he worked 100+ hours a week and came in at 3:00am every morning that he EMANATES anxiety and stress. The boy needs some Ativan.

Unfortunately though, his stress is making mine worse. For example, this morning, I updated the patient list, and I put two patients, who are in rooms 043 and 042 at the bottom of the list. Well, unbeknownst to me, the surgeons here have a particular order in which they like to round. They start at one end of the hallway and wrap around to the next one, and so the patients have to be in exactly the same order. But I figured, what's the big deal….I'll just correct it next time.

Not so.

Me: yeah, well, when we start rounds I'll just mention that we need to see 043 and 042 first. *shrugs*
Him: NO. WE CAN'T DO THAT. THEY'LL BE UPSET. WE HAVE TO CHANGE IT. I HAVE TO CHANGE IT. NOW.

(I stare at him blankly)

Him: DR Q HAS THE POWER TO FIRE ME. YOU. THEY LIKE THINGS TO BE PERFECT. IT HAS TO BE PERFECT.

(Dr. Q is this important surgical guy who does NOT have the power to fire me….but in any case, my stress level has already risen about 10 fold in the course of this short conversation)

Me: okok. I'll change the list.

Him: OMG. ROUNDS IS STARTING IN 10 MINUTES. WE HAVE TO HURRY.

So unfortunately, this conversation wasn't as much funny as it was pathetic. Ugh. I just feel so bad for this guy who is being crushed slowly by the wheels of residency. That's how the surgeons remake themselves, by pounding down the new interns and then building them back in their own image. Ugh.

The truth about Q2 call.

They can only get away with it if they say it's "home call".

And if it's "home call" (ie, you can stay home and field calls and consults) they don't have to give you post call day off.

But "home call" is just as bad, if not worse, than in house call when you get called into the hospital for 3 admissions and the nurse calls you repeatedly about a bradycardic (yet asymptomatic) man who has been admitted for a pacemaker placement.

Yes, i know he's bradycardic. no i don't want to do anything about it BECAUSE HE'S GETTING A PACER TOMORROW.

But it's ok... because i just informed the family med dept that i will be going over my 80 hour a week mark. And they will soon be pulling me off this ridiculous Q2 call.

HORRORHORROR.

I have Q2 call for Surgery next month.

I have nothing more to say.

So what if you couldn't eat?

One of my patients is this 62 year old guy who had epiglottal cancer and is now terminal. He's extremely malnourished, G-tube dependent and unable to take anything orally except a little jello. He tried living on his own and failed miserably, and consequently landed in the hospital on our service. So here's this ornery guy who's making the nurse's lives a living hell, who's refusing to take his G-tube feeds because they're "not right", and who went down to the cafeteria to get a cup of parfait and threatened to shove it down his throat.

I went up to talk to him, and I realized that he's difficult because he's scared, and defying doctor's orders is his way of trying to take back control of his life. And he wants to eat because eating is the only thing he has left that gives him pleasure.

So as I was sitting there trying to convince him not to gobble down the parfait, I was thinking in the back of my head, " who CARES? He's going to die a horribly painful death of metastatic cancer, let the guy EAT. I mean, which way is a worse way to go? Aspiration pneumonia or cancer mets to the bone? And he's clearly still mentally competent….he could go eat a steak in front of me and I couldn't do anything about it.

Luckily, the speech and swallow therapist agreed with me, and said he could go enjoy himself, because hey, he's about to kick the bucket anyways. But to be living a life where a basic human instinct, eating, is thwarted is just SAD. When all your nutrition comes from little cans that you pump into your stomach is just sad, sad, sad. Who the hell wants to die like that?

DieDieDie

The (long) white coat. A symbol of responsibility and professionalism.





Hahahaha. I want to BURN IT.

Cipro or Keflex?!?!?!

Mr. R was given 60meq of KCL. I didn't see the order, so I gave him another 40meq.

The pharamcist called me and asked me did I REALLY want to give Mr. X Bactrim, seeing as how Mr. X was allergic to Bactrim.

It took me 15 minutes to relocate Ms. D in the ED, because the nurse gave me the wrong code for the adjunct ED door.

I completely blanked out while presenting Mrs. A to the attending at morning rounds. Of course, Mrs. A did have 18 meds and 12 problems.

And finally, I'm so goddamn busy I don't have time to be hungry anymore.

Slogging through orientation.

The panic has set in. I was doing well (ok, not as well as I'd like, but still relatively calm) until last night at this barbecue I was told that usually interns need about 1/2 hour per patient in the morning to preround. So I calculated. 5-6 patients. Rounding at 7:30. I HAVE TO GET THERE AT 5:00. WHICH MEANS I MUST WAKE UP AT 4. FOR FAMILY MEDICINE WARDS.

Cue panic.

What's in a name?

Question. What do you say when other people ask what you do? Do you say, I'm a Dr, or I'm a Family Doctor (or appropriate specality) or I’m in the Medical Profession or what I've been saying, "I'm doing a medical residency".

So here's the thing. I feel stupid saying I'm a doctor and lame saying I do "medical stuff". But not everyone knows what "medical residency" is, and so then I have to explain it, which is just awkward.

Or maybe I am the only one who is having this problem??? Regardless, this would all be so much easier if I was an attending already. I would REALLY like to be an attending already.

I don't do dishes.

Article from the NY Times:
When Mom and Dad Share it All.

Women do about twice as much around the house as men…which hasn't changed much since the 50's, even in families where husband and wife have full paying jobs.

Childcare looks even worse; it's divided on a 5 to 1 ratio. Why am I not surprised?

Two actual couples, mentioned in the study, one in which he is a college professor and she is a physician and one in which she is a college professor and he is a physician were asked about their schedules. In either case, Deutsch [social scientist] says “both the husband and wife claimed the man’s job was less flexible.”

Perception is everything. 58 percent of women say the division of labor in modern families is not fair to them. (Eleven percent of men, in turn, feel that the division of labor in their own marriage is unfair to them.)

To everyone who asks me (over and over again) when I'm having kids/adopting, etc. etc. WHENEVER BRAD CAN SHOW ME HE CAN DO 50% OF THE HOUSEWORK AND KITTYWUM CARE.

Especially the kittywum care.

Grow, my child, GROW.

Lately, I have been blessed with a urge to garden, to make green things grow. As I have no gardening experience whatsoever, I decided to start with something failsafe…hard to kill and easy to grow. I decided on herbs, because I thought they were rather useful, and I could recoup my supply costs by not buying overpriced basil and thyme at the supermarket. And plus, according to HGTV,

"Herbs are some of the easiest plants to grow. They're tolerant of less
-than-ideal soil conditions; they're bothered by very few insect-and-disease
problems; and they reward you with all kinds of yummy surprises"

Well, here's my thyme pot. After one week.



Brad told me to cut my losses and get another one at Home Depot.

On the Road Part 2 (well, more like Davis, Part 1)

Hi All, This isn't going to be a very exciting post, except for the fact that you get to see my new car!!!!!




It's a Honda Fit!!!!! I had to bargain pretty hard for this one. The Chinese in me really came out. (for those of you unaware of the sterotype, Chinese people are CHEAP. We love to bargain and we hate paying more than we have to). Of course, I guess it's not a sterotype if it's true. Heh. One of my Jewish friends (not Nina) told me once that Jewish people like a good deal too. Is that true, Nina?

But other than that, not much else is going on. Um, me and Brad got our new apartment, and the movers came with our stuff. The Apartment is cool, with lots of space and Davis is a cute little college town with lots of "crunchy people" . I joined this crunchy co-op that has lots of those same crunchy people working there.

Oh, and panic is starting to set in with regards to residency. I don't expect that to dissipate until the end of July.

I also found this misc. picture that I thought I'd post. Still have to find the equivalent of Tiffin in Sacramento.

On the Road Part 1.

We started our drive from Philadelphia to Davis on Saturday. After a heroic struggle to put everything in the car (which failed btw, and resulted in me having to ship my stuffed animals through UPS) Brad, Kittywums and I were off.

The car is sorta filled to capacity.




So now, after driving for about a total of 20 hours and traveling through 5 states, I've come to the same realization that I had when driving from California to Philadelphia. There is SHIT in the middle of this country. Note below:



But I exaggerate of course. How can there be nothing but shit in the entire country? There's also a lot of white people. And not a whole lot of other colors of people.

But there's lots of cows, and sheep, and horses, and lots of even more tons of empty space.

Whew.

Now if only that MD was linked with actual knowledge.




What exactly is Kena doing?




Do we look pensive? We were trying to look pensive.




Highlights from the day:

1. My cap threatened to fall off as I was walking across the stage.
2. Dr. Z hooded me. How cool is that!!!!
3. Why does my dad have to wear the same jacket to every function in his life...the same jacket being this tattered windbreaker number he got at Mervyns.
4. Green (as in green hood) is not my color. I prefer red.
5. Our speaker, DR (I get real annoyed at the dr part) Milkien gave a perfectly self-absorbed, indulgent, pompous speech all about himself for 20 minutes.
6. It's over. Thank god.

The Med School Prom

I LOVE getting dressed up and looking pretty.




The boys look pretty too.




...but the girls look even better. Aren't Licette's boobs nice? I wish I had her boobs. (Brad wishes I had her boobs too)




It's Jess. And Andy. Looking Serious.




And last but not least, Dan. heh.

One more Kittywum post.

So you all know how my cat is overweight? Well, a couple of weeks ago, I decided to take an active role in reducing her poundage. I bought a harness and a leash and I started taking her for walks.

It's been interesting.



I've since discovered that cats don't like to be walked. Nor is Kittywum all that keen about being out of doors. But it's the other pet walkers that really crack me up. Apparently, a cat on a leash is a rare thing indeed because people gawk at me like I have leprosy or something. Sheeeeesh. It's just a kitty out for a stroll. Mind your own business.

Holy Crap I'm going to kill someone!!

For the last couple of months, ever since I matched, I've had this increasing feeling of fear and terror related to starting residency. I am TERRIFIED of either maiming, crippling, or killing some poor soul who didn't realize that the "doctor" he was assigned to just fucking graduated from medical school.

Of course, I realize that a lot of this fear is unfounded; after all, generations of new MDs have safely traversed residency and come out the other end as competent, caring physicians. it's not like I think I'm any more stupid than the average med student and I have the added advantage of actually caring about my patients.. BUT…BUT….still…..

My biggest fear is that someone is going to code on me during my first day on service, and I will be staring down at the hospital bed not knowing what the hell to do; all my ACLS training will have evaporated into thin air, and I will be useless.

And then there is the additional and equally valid fear that I will mistake a microgram for a gram, or I will accidently give an extra blood pressure medication to someone with heart failure, or I destroy someone's knee cartilage while doing a steroid injection, or…. OR….

You see, the possibilities of screwing up are endless. So for anyone who thinks that doctors are overpaid professionals, the only thing I have to say is, "let's see you take on this level of responsibility, you sanctimonious pompous ass."

Open letter to the Moving Company.

Dear moving company,

This upcoming move has been very stressful and expensive for me. Searching for a moving company has been an integral part of this stressful experience. In fact, you were the 14th company that I talked to. I had high hopes that you would be the one, but instead, all you wanted was my money. FUCK YOU.

It was pretty obvious right from the beginning that there was something fishy going on. First, there was the out of town address in Florida. And then, there was the discovery of MULTIPLE addresses spread out over 4 states, along with your 9 expired licenses stretching back to 1996.

And plus, moving company, you gave me a quote of$ 2000 to move 4500 lbs of my shit from Pennsylvania to California, a grand total of 2,797 miles. Now I love a good deal, but that number is ridiculously low.

But I was still willing to give you the benefit of the doubt, because I'm basically a nice person and I really don't want to think that you want to rip me a new one. Unfortunately, then, I found this little website called movingscam.com. And lo and behold, you were on their blacklist

And to think I was going to ship my stuffed animals with you. I would never have seen them again.

Love, S.

The vet said Kittywum was "chunky".

The vet was really trying to be nice, because by any estimation, 30% over your ideal body weight is OBESE.

My cat is obese.






She is now restricted to 3 oz of low fat dry food a day. And no snacks.

What I am doing off rotation (ie. I’m bored)

7:00am - wake up. Because Brad is making lots of noise in the bathroom and I can't get back to sleep even with earplugs

7:15am - shuffle into living room, turn on computer and make coffee. Consider getting dressed. Eventually.

8:00am - funny haha. Still in PJs, blogsurfing and drinking coffee.

9:00am - well gee darn. Haven't moved an inch. Now thinking of putting on running clothes and going to the gym.

10:30am - whoopee. Finally at the gym after 1 and 1/2 hours of procrastination.

11:30-12:00 - lunch.

12:00-4 or 5:00 - play on computer. Chat with Licette on AIM. Call my sister on Skype.

5:00 - realize that my entire day is gone, I haven't done the laundry, thought about making dinner, cleaned the cat litter or read my latest JAMA issue like a good medical student.

5:30 - Brad calls and asks what's for dinner. Me: "chinese takeout"

If anyone has a more productive day than me, please comment. Because I am in such a deep shithole of laziness I can't climb out.

Apartment angst

I'm having some difficulties looking for apartments in Davis. You'd think, wouldn't you, that a little college-town in the middle of central CA, a town that sorta smells like COW when the wind blows a certain way, would offer plenty of cheap housing.

NOT SO.

There are no 2 bedroom apartments under 1200, at least none that I would set foot into. Hell, I wouldn't even put Kittywums in there.

The last loft I looked at, the last gorgeous loft with granite counters, hardwood floors, fireplace (which I wouldn't need but would look oh-so-trendy), and in apartment full-sized W/D, was $2200.

And speaking of washers and dryers, why, oh god why is it so hard to find an apartment with a washer and dryer? I mean, I just too fucking old to be trucking my laundry down the stairs across the courtyard to the laundry room every single week. BLEH. JUST BLEH.

In addition, dishwashers. I feel like if an apartment doesn't offer W/D, the least they could do is offer a goddamn dishwasher.

Ok, I think I'm finished ranting. Be on the lookout for additional moving to California bitch posts.

I want to go back. :(

I just spent the last week or so running around Europe, visiting my sister who's studying in Leuven, this quaint little college town not too far from Brussels. I had an awesome time. Plus I got to drink with Stephanie (who previously was too young to drink in the States, plus she looks like she's like 16 years old) AT AN ACTUAL BAR.

So we start off in London which was snowy and cold and damp. I loved it!!!! Unfortunately though, it was rather expensive thanks to the worthless dollar.

Here's me in front of Tower of London. I look a little frozen, don't I.




I ran headfirst into the Tibetan vs. Chinese protest as the Olympic flame was passing through London. I slunk away and tried to look American.




Me 'n Stephanie (aka Stepums) in Leuven


I think they drink a lot here. The Cafe is a euphemism for Bar.....which also serves espresso. Because beer and coffee are two very important joys in life.



Amsterdam was fun too. lots of fun. But I can't really say anything because I might have been googled by ppl from my residency program. Enough said. Draw your own conclusions.

Brad in front of a canal. I think this is after he partook of the items for sale at a "coffeehouse". He's very happy.





Me and huge penis. And small penises. All courtesy of one of Amsterdam's sex museums...which was a little more, um, stimulating than looking at Van Gogh all day.





And just some other comments....

Kids are allowed in bars. Very cool.
People in Europe are skinny. Which makes the average American tourist stick out like a sore thumb.
Not that there aren't other things to make the American tourist stick out. Like tennis shoes. And baseball caps. And the dreaded MONEY BELT.

But it was loads of fun and now I'm back in Philadelphia. Boo.

Me vs. The Insurance Company

It's a regularly dull day at the dental clinic when I'm asked to translate for this Chinese patient with a kid who needs some serious dental work. No problem. Eventually, it becomes clear that he needs a referral to an Orthodontist, and he has no idea how to navigate the world of insurance. Still no problem. I offer to call Americhoice for him because, hell, not like I'm doing anything else useful that day.

(btw, AmeriCHOICE is a quite a deceptive name...)

[phone rings. recorded message comes on. FOR 3 MINUTES. "blahblahblahblah..press one if you are a healthcare provider, 2 if you are a policy holder....if none of these choices are correct for you please press 0]

So I press 1. another recorded message comes on.

[Healthcare providers do not have access to information through this number Please dial xxx-xxxx)

What the fuck? Why the hell did the message tell me to press 1.

Fine. So I call again, go through the entire message AGAIN, and this time I'm smart enough to press 0. Straight to a LIVE PERSON.

Boredinsurancelady: welcome to americchoice. what is your policy number

Me: Actually I'm calling on behalf of a patient of mine; I'm looking for a list of orthodon....

Boredinsurancelady: I need your tax ID number.

Me: ...my what?

Boredinsuranceloady: in LOUDER VOICE (because clearly I'm an idiot for not knowing what a tax ID number is ) YES, THE TAX ID NUMBER.

Me: [running over to the office manager] I'm on the phone with Americhoice and they want a tax ID number

Me: [to the insurance lady] look, I'm just looking for a list of Orthodontists that take insurance, I don't need special provider information.

Bored (and bitchy) insurance lady: doesn't matter. I still need the tax ID. Do you want to call back?

Me: [thinking about how long it took me to get someone on the phone] NO!!!! hold on. I'm looking.

[office manager finally finds tax ID]

Me: wooo hooo. Here it is. 376926o

Insurance lady: ok. i'm sorry, we don't have a list of orthodontists. please call this number instead.

Me: What!@#@!#. Then why the hell was I looking for the tax ID number.

Insurance lady: [click]

Time elasped: 45 minutes.

Change

The self I left behind in CA is not the self that I am now.

The bittersweet nostalgic feeling that swept over me as I was meandering down Kelly Drive took me totally by surprise “I’M GOING TO MISS THIS CITY”

Oh Philadelphia, you’ve snuck under my skin.

Part of me, a large part, wishes I had no moorings. No ties. That I didn’t get teary eyed when thinking about things (and people) I will leave behind.

Part of me, a much smaller part, wants to go back home.

All of me realizes that I will be ok.

But that life is bittersweet.

The only thing that stays the same is change….

Drumroll please....

I'm going to be a family doctor AND A PSYCHIATRIST. At UC Davis.

Holy shit.

The One and Only MATCH

Tomorrow I will be participating in the completely archaic and humiliating process called "Match". At Match, I will learn where I will be living for the next few years, during which I will be brutally worked to death for very little pay or compensation. But that's ok, because at the end of it all, I will be a full-fledged doctor, subject to the whims and whimsy of insurance companies and litigation happy lawyers.

But that all happens tomorrow. Tonight, I'm going to get drunk.

Well this is new....

Hi people. So I am going to ditch my MySpace blog in favor of this big new space on blogspot. Which I think will enable me to ramble on even more endlessly than before.

Oh yes, and for those of you all new readers, I'm not a doctor yet. But I will be...in approximately 2 months. Don't, I repeat, don't go to the hospital I will be practicing in. Because I don't know SHIT, and I'm about to get an MD.

Cheers.