Sunday, July 26, 2009

i have tomorrow off!

life is good...i stepped out of the VA yesterday at noon and i won't have to go back until TUESDAY! how exciting!

today i got a new book called "how to cook everything vegetarian" by mark bittman. i'm really excited about the prospects. the only reason i got it was because H got me a gift card to a local bookstore and today i actually went in to use times. not that i want to become a vegetarian, but i'm always looking for ways to expand my vegetable repertoire...

i'm currently debating ordering a bunch of various kaplan flashcards for step 2 studies. yes, step 2. not that i'm wanting to really study hardcore NOW, but i do need help shoring up my diagnostic skills, and i think these cards would help me out.

i went to the gym today...powerwalked for 30 minutes on an incline. it's amazing how fast your body gets out of shape when you don't have the time to properly work out. once medicine is over, maybe i'll have more time.

the green beans i have planted in my fake garden are starting to flower...i hope this means i'll have real beans in the next few weeks! the dill has died, but my parsley is growing baby parsley leaves. the mint is trying to take over my porch...maybe i'll try to trick one of the runners into growing in a different pot.

tomorrow i'm making this fruit "tatin" that i saw the barefoot contessa make on the tv. she used plums, and i'm going to use plums, blueberries, and strawberries. it's like a caramelly cake pie sort of thing, and i'm kind of excited to make it. also, i'll be making some banana muffins for my team. we're on call tuesday, and it's nice to have good snacks laying around.

i learned last week what melena smells like. just imagine the nastiest poo smell ever. we opened the door to one of my patients' rooms and the smell just hit us like a freight train. just awful.

also, i don't understand the logic behind a patient's family deciding that the patient should now be full code (previously DNR/hospice) because the "patient would want to be full code now". well, currently, the patient has severe dementia, is nonverbal, been coded several times, has a trach and requires ventilation, severe upper extremity contractures, and just lays in bed all day drifting in and out of consciousness. this poor person's eyes are just sunk into their head, no teeth whatsoever. when i went to see this patient before pre-rounds, i knew he was nonverbal, but i still make it a point to talk to the patient and explain what i'm doing. it's just good practice, and maybe he can hear me. i could hardly hear his heart over the loudness of his lungs. and then he scared me, because he coughed, i wasn't expecting him to make any noise towards me. and i let out a yelp, and then started laughing, and explained to the patient that he startled me and how silly i was. i tried to listen to his abdomen, but couldn't really get very far due to his contracted arms. quick check of his legs for swelling and then i told him goodbye. it was a little bit creepy, that whole encounter, not because the patient was scary or anything like that (ok, maybe just a tiny bit because of eeriness of it all), just the situation he was in. i don't know what the family is thinking, or their reasons for doing anything, and i shouldn't judge...everyone has their reasons. but i can't help but make a mental note that if were in that patient's position, i would want my family to just let me rest.

on another note, i've realized that whenever i talk to a patient, my redneck accent comes out in full force. maybe it's because i talk a little bit louder than normal to the older people so i can make sure they hear me. i thought it had gotten cleaned up, but for some reason, it's coming back with a vengeance. not that i's amusing to see the look on people's faces when they see an asian girl talking all southern at them.

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