The online journal of an Anesthesiology resident in New York City trying to get used to the idea of calling herself "Doctor" without using those finger air quotes.
perhaps not unlike the birth of reeses peanut butter cups
There was a patient today for which I was planning to do a saddle block, and in preparation, I took out a small ampule of hyperbaric bupivacaine (a kind of local anesthetic, like lidocaine) to use for the case. The ampule is a glass cylinder, just about an inch long and as thin as a toddler's pinkie finger, with a hollow glass stem that can be snapped off before the drug is drawn up and administered. They didn't stock hyperbaric bupivacaine in the OR where I was working today, so I actually walked all the way over to the cystoscopy suite, hunting through the drawers in three separate rooms until I found what I was looking for. This is called MAKING AND STICKING TO YOUR ANESTHETIC PLAN.
Well, turns out that despite my planning and despite my hunt for The Perfect Anesthetic, in the end that the case was cancelled--the procedure was listed as RECTAL EXAM UNDER ANESTHESIA and I guess he decided that was just as unappealing to him as it sounded, and never showed up. So I put the hard-won ampule of bupivacaine in the back pocket of my scrub pants, along with my iPod and a partially eaten Power Bar, figuring I would keep it handy, just in case the opportunity might present itself for use later on.
The rest of the day went as planned, and as I was walking down the hallway at the end of the day, it occurred to me that I could sure go for the rest of that Power Bar. It was all warm and melty from being pressed next to my butt all day (SO GRAPHIC) but I figured that would just make it easier to eat, because if you've ever tried to eat a cold Power Bar, you know that it turns to cement and you'll be working on that thing for hours. For those of you who are just disgusted at this point, please note that the Power Bar was simply next to my butt, but at no point during the day did it ever touch my butt. Got it? There was no Power Bar to butt contact. Therefore, still good! So I extricated the bar from my pocket, peeled back a little more of the foil, and without really looking, took a bite.
The first thing I thought when I felt the crunch was that this was just an unusually potent flavor crumble, the likes of which are seen in certain flavors of Power Bar--for example, Vanilla Crisp. However, the texture of the crunch was different from that of a Rice Krispie embedded in some sort of gluey carbohydrate matrix--much more crisp, much more bite, almost like a chip. The next thing I noticed (and this was probably just a fraction of a second later) was that this Power Bar tasted awful, kind of watery and bitter, like chemicals. What had just happened? Had I just shattered a tooth? How could I break my tooth on a Power Bar? And what was all this foul liquid leaking out? Some sort of mercury filling amalgam? Some sort of frightening nerve pulp liquified by years of subpar dental care on that crappy resident health insurance plan? What the hell was going on here?
I looked at the Power Bar in my hands. And what I saw was this: the vial of bupivacaine had, over the course of the day, worked its way into the bar itself, with heat and time pressing and molding itself directly into the goo. And when I bit into the Power Bar, I had actually bitten into the vial. I bit through glass. I WAS EATING GLASS.
Needless to say, I spent the next minute assiduously pooling my saliva and spitting into a sink, for fear (perhaps after one too many Tales of Intrigue) that I would swallow microscopic glass shard and cut myself internally and DIE. I do, however, think that the Power Bar saved me to some degree--it was so gluey and sticky that most of the glass shard just kind of got pressed into it, where they stayed in place, like bug in amber. (Aside: does anyone think that bugs in amber make creepy jewelery? I mean, I get it, amber is a pretty color, and nature is beautiful, whatever. BUT THEY ARE DEAD BUGS. I do not want to wear dead bugs as earrings, sorry.)
I thought that hazards of the workplace in anesthesia mostly consisted of environmental exposures, like standing next to the fluoro beam for hours at a time, or of biohazards like getting blood sprayed in your eye after someone dings the renal artery or some such thing. However, I now have to expand my scope of workplace hazards, those being the improbable hazards facilitated by my own ridiculousness. If anyone has a story worse than this, I would like to hear it.
(And for those thinking one step beyond: yes, my tongue and lower lip were quite numb for about half an hour afterwards.)
i like to pretend that it's some sort of eco-statement, not just procrastination
If you follow my Twitter stream, you already know that I just found out today that I passed muster and got approved for a Georgia State medical license! Licensed to THRILL, baby! And to treat hookworm!
and who is this steve irwin everyone keeps talking about?
I was working with an attending today who is Australian, recently returned to New York from a two year stint back in Australia as a matter of fact, and who I know has three very young kids at home. So of course when the chance arose, I asked him the most obvious question I could think of, one that I had in fact been mulling over since I realized we would be working together last Friday.
"So, you're from Australia, right? Do your kids watch 'The Wiggles'?"
He smiled politely. "Um, we don't, actually." And then, he added this next sentence which just made my mind explode. "Who are 'The Wiggles'?"
WHO ARE THE WIGGLES? Is he serious? Could there be another Australia that I'm not aware of, and could he be from this alternate Australia? Doesn't everyone in Australia know "The Wiggles" personally, just like how everyone in California lives next door to a movie star? TREAD LIGHTLY, FOR YOU TREAD ON MY DREAMS.
The theme from "Rocky" (not "Eye of the Tiger" proper with the trumpets, but the sad, ruminative piano riff on the same that they play during quiet moments, like when Rocky visits Adrian in the hospital when she's in a coma after she has a placental abruption secondary to working to hard at the pet store and it's sad and Rocky doesn't want to be a fighter anymore until Adrian wakes up due to the POWER OF HIS LOVE and tells him to WIN)
And then we all put our hair up in scrunchies, rolled up the sleeves of our jean jackets, and flattened out a cardboard box so we could breakdance on it.
Joe got me a box of Red Vines for Mother's Day. He then ate the whole package while I was on call last night.
I suspect this is only marginally better than getting me a bowling ball monogrammed "Homer."
Also: For those not yet inculcated, I am updating on Twitter even on days that I am not updating here. You can follow along if you're interested in reading extremely short messages several times a day about nothing in particular. (I know, I'm making it sound so AWESOME, aren't I? Clearly, I was born to do sales.)
because there may come a time when I might need that physics 101 textbook
I can think of several reasons why being a packrat could actually be adaptive--if you ever needed a shrink-wrapped Matisse calendar from 2004, for example, or an old Halloween costume last worn during your sophomore year in college. (The occasion could arise. Time travel, for instance.) However, there are two instances in which packrat-ism is disadvantageous. One is when you die, and they have to dig through the mounds of newspapers and clothes and old volumes of Encyclopedia Brittanicas from 1982 to find you. Two, when you actually have to move out of your house. The plus side is I'm sure that we'll find many things that we presumed were lost along the years. The downside is that we probably never missed most of these things in the first place.
Joe is the best at diuresing our posessions, and mercifully for everyone, he picked a time when I was actually sleeping to do something that was long overdue, which was to finally chuck all my notes from the second year of medical school. There was really no rational reason to keep them aside from sentimentality--given that they weren't indexed, anything that I really need to look up about nephrology or endocrinology or infectious disease I would first turn to one of my textbooks or Dr. Google anyway. But I just never had the heart to throw them out, if only for the reason that it was the only tangible proof I had left that I ever studied that hard. That, and the corpses of at least five different colors of highlighters that I'm sure I will get around to throwing out before the move as well. Memories, like the corners of my mind.
Anyway, we had a nice Mother's Day here. We met up with my family and went to the park, where we blew giant bubbles and flew some rocket balloons. In other words, it was more of a Children's Day than a Mother's Day, but that's what it's about anyway, isn't it?
So the graduation ceremony was nice, though as with all graduations, somewhat overlong. I didn't get to stay for the whole thing, since part of my task that afternoon was running home to get Cal so that we could make it back up to the graduation dinner. ("Why didn't you just bring him along to the graduation ceremony?" one might ask. Well, because I am an anesthesiologist by training, and my goal is to MINIMIZE pain. The idea of forcing a not-quite three year-old to sit through a three hour ceremony in which the defining characteristic, even for adults, is EXTREME BOREDOM...that would not have been a good idea.) There were some nice moments--I particularly liked the speaker they invited, who though he was the New York Health Commissioner (doctor, check; important, check) was only their second choice, invited hastily after they rescinded the invitation to their first choice speaker earlier this Spring. Who was the first choice? Eliot Spitzer. Nice.
My dad (who is a doctor too, as is my mom...I know most of you know that, but for those who don't it's sort of salient to the observation that follows), watching the processional of the soon-to-be-new-M.D.s filing in, noted that he had been to the White Coat Ceremony for this group of med students four years ago as well. The White Coat Ceremony, by the way, is this little induction-type event they have just prior to starting med school where all the new baby med students get crowded into an auditorium, lectured grandly about the glories of medicine, and are finally "cloaked" with their first white coats, which is, no matter how cynical and jaded you are, a very exciting event. "That was their happiest moment, I think," my dad observed. "They look a little more cautious now. They're not quite as idealistic. The reality has set in."
"Yeah," I chimed in not quite as eloquently, like some asshole frat big brother hazing the new pledges. "Now the PAIN begins!"
Fresh graduates, if I may be presumptuous, let me pass on some advice that my surgery preceptor gave me back in med school with respect to residency. "First there is pain. Then there is more pain. Then you learn to love the pain." Oh, Dr. Edwards, you were exactly right.
Congratulations, new doctors! You're going to be great. Now roll up your sleeves and get in here.
