So this is Christmas

One of the not-so-glamorous parts of my job is the hours (well that and giving people rectal exams, but the hours are bad too). It doesn’t leave you with a lot of options, especially for things that happen from 9-5 or on holidays. For example, I got 4 days off for Christmas, and while it's nice, it wasn’t enough time to go home. So what do you do in Chapel Hill (a college town) on Christmas? Well if you think dinner is on the agenda, you may be disappointed. Here’s how the night went down.

One of the other residents and I decide to hang out. He’s an Italian kid from Jersey. He’s Jersey enough to know people like those recently seen on “The Jersey Shore,” but normal enough to be embarrassed by them. Naturally, I call him “The Situation,” and mostly because it drives him crazy when I do. Around 5 o’clock TS and I try to hammer out some dinner plans. We start to call around for a reservation at the upscale restaurants in town (I mean it is Christmas right?). We find precisely 2 restaurants that are open, 1) has a dress code (not a big deal if you have time to change), and their last reservation is for a seating in about 10 minutes and 2) does not have any reservations the rest of the night. We’re beside ourselves, scouring the internet in search of new options, and cursing the fact that only 2/45 restaurants are open. We come up with a plan that goes like this, get ready and drive 25 minutes to Raleigh in search of an open restaurant. At this point we’re 1.5 hours into this thing, and we’re not going home without dinner. We drive around, but Raleigh looks like a scene from I Am Legend (i.e. we are alone on the streets). Finally, we find an Italian restaurant in a hotel in Raleigh. TS and I head in and get on the list. They tell us that the wait is about 40 minutes (again, we have too much invested at this point to give up now). So we head to the bar and grab drinks (I’m working on like my fifth Diet Coke of the night and at this point my I’m down-right jittery). 40 minutes later, we finally get a table.

As previously stated, TS has a strong Italian heritage and suggests that, “We should make this like a traditional Italian meal, with appetizer, pasta course, then an entrée.” To which I responded, “Why the hell not?! I mean it’s Christmas!” I get shrimp risotto, we split an order of spaghetti, and I finish with steak (an amateur’s version of rare). Dinner’s great and me and my buddy are chatting up the waiter about things to do in Raleigh. At which point, the waiter asks us where we’re from. I say, “Utah;” and TS replies “New Jersey.” To which the waiter responds, “Oh yeah? I love Jersey! I go up to Asbury Park all the time… I have a bunch of gay friends up there.” TS and I shoot each other a quick look, which we both immediately interpret as “Did he really just imply that WE might be gay?” The waiter wraps up his schmoozing, and TS and I start dying. I guess two guys can’t get dressed up, share a plate of pasta on a traditionally family oriented holiday without there being something sexual attached to it! I mean what’s the world coming to?!?

The Winter Storm of 2009...

So apparently winters in North Carolina are what most people would call mild. Usually 40's-50's with dips way down into the 20's and 30's. Infrequently, it "snows." Meaning a few inches of slushy, non-stick snow. When things get "bad," people panic. Bread, milk, and beer (the essentials I guess?) go flying off the shelves like New Moon posters in Santa's Secret Shoppe in Junior Highs around the country. This last weekend, we had several severe weather warnings for the weekend. The Meteorologists billed it as a disaster, even going so far as to call it "The Winter Storm of 2009." With this sort of reporting, it's no wonder that the storm was all anyone was talking about. People were saying things like, "We're getting snow this weekend", "I'm not going outside that," and "It's getting so bad that we may have to reinact The Lord of the Flies or the Donner Party and what-not." I mean I was worried...

I got off of work around 8PM on Friday, and headed out to a friend's house for a little Christmas socializing. There were about 1-2 inches of slushy snow on the ground, and half of the people cancelled their RSVPs for the party because of it. When I got to the hospital on Saturday morning, this "storm" had people terrified. Doctors, nurses, janitors and anyone else who worked in the hospital were making plans like, "I'm probably going to spend the entire weekend in the hospital," "I should have gone to the store last night to get bread and milk," or "I may have to sell everything I own to buy a gun to shoot myself... it's really my only option."

So when I got off of work on Sunday (after ~30 hours of work), I was terrified about what might await me on the outside. I figured even if all the predictions were overestimations, I was still going to be walking into Santa's front yard. And this is what terribleness awaited me as I walked out of the hospital...


You can imagine how cold I felt...

My Front Porch Looking In....

I have had a lot of ideas in my lifetime. Some good, some bad, and some terrible. One of my more recent terrible ideas was to sell all of my furniture prior to moving to NC from WI. It all made sense at the time. I would sell my stuff for about what I paid for it in Utah, take that money and spend it on new stuff in NC. Thus recouping some of the money I had spent in the first place and saving the moving expenses that I would need to get the aforementioned possessions to NC.

This sounds great on paper, but that’s where the greatness ended for me. Things went south, well, right at the beginning. So early, in fact, that I am not sure I ever actually headed north. The problem started with my underestimation of the WI-used-furniture market. To say that I underestimated the robust nature of the furniture market in WI, is like saying the Grand Canyon is big, War and Peace is long, or my dad is argumentative. None of these analogies comes close to adequately describing the epic failure that was my underestimation, the massive nature of the Grand Canyon, the effort required to read War and Peace, or the frequency and intensity with which my dad likes to give me the business.

What does any of this have to do with anything? Well since that epic failure, I have been replacing my old furniture bit by bit while at the same time paying down my credit cards. The precarious position in which I find myself, reminds me a lot of our hunter-gatherer ancestors. You know, finding a little something here and a little something there (I know it’s a stretch but bare with me… it’s the closest I’ll probably ever get to feeling like my mountain man older brother). So, bit by bit, I have been adding my collection. I started with a couch; and, through the suggestion of my sister, added the rug. The ottoman was my own, most recent, decision. To make a long story short, it’s started to make my living room feel like home. I realize that I still have a long way to go, but even the little additions have helped me feel much more at home. Which as far away as I am from my family at this time of year… means a lot.

Happy Thanksgiving!!!

A lot to be grateful for this year! Including the fantastic vacation I just got back from here’s the highlights in “I’m-rushing-to-a-friends-house-to-gorge-myself” mode. I just got back from a vacation to Utah which included: visiting family friends in St. George, The Pizza Factory with my Currently-Cougar Siblings (and their families), fantastic seats at a Jazz game with high school friends, mini-Thanksgiving with the family, tour of my brother’s Castle, quick hunting trip into the same brother’s backyard (whose only interesting event was keeping an eye on my brothers and making sure they didn’t shoot me or each other), the BYU-Air Force game (reminded me of both the pros and cons of my BYU experience… fantastic overall, but easily downgraded at least one notch by a few tools who act as the proverbial turds in the punch bowl of Cougardom), and of course the cherry on top…. Seeing New Moon with my mom and sister! Seeing this movie with my mom and sister was like eating manicotti, super cheesy and soft in the middle but a great overall experience!

Charleston

So the first weekend of October, I went to Charleston, SC with some friends from work. The weekend went like this... This is a picture I took of Charleston from the top floor of a hotel we stopped at one night.

I was on-call on Thursday. Meaning I work up at 4:30 AM, and work from 5:30AM to 11:30 AM on Friday (30 work hours total). Get home, pack, finish some work from home. Leave for Charleston at 4PM (~36hours awake)... I sleep for the first 2 hours. Arrive at Charleston at 8:00PM on Friday, go out with friends until 3:00AM on Saturday. Get up at 9:00AM Saturday and go to the Beach until 4:00PM. Head downtown for dinner, go on a walking tour of the city. Go out with friends again until 1:00AM, then drive four hours back to NC so that I could go to church and my buddy could be on call. I drove while my friend slept so that he was as rested as possible for call (you have to make sacrifices to have fun.... My youngest brother can tell you all about it... he’d sacrifice ANYTHING for fun).

Story.... We decide to take a walking tour of the city of Charleston, that supposedly details haunted buildings in Charleston. What better way to kick off a night than heading out at 9:00PM and hearing scary stories. Here’s how I envisioned it... a guy looking like Vincent Price would take us around scary buildings in Charleston, as we jumped every time we heard an ominous board creak. However, in reality... our tour-guide (Stew) was more like Matt Damon from the Informant
dressed in khakis shorts, a khaki shirt, and (you guessed it) a khaki hat. The outfit was topped off with copious amounts of sweat, and the tour consisted of walking past (not into) “haunted” buildings, as Stew told us 3 historical stories and 1 anecdotal story (that was originally past on by none other than Stew Jr.).,

Stew’s story telling ability also consisted of the recitation of these stories complete with awkward, forced pauses for dramatic affect. (Note: these pauses were often ill-timed and just long enough to be annoying). Let’s just say, it wasn’t exactly “enthralling.” In fact, it was boring enough at certain points that, believe it or not, my friends and I become... ummm... disruptive?... Literally, I think it took about 2 minutes before my first obnoxious comment. It went something like this...

Stew takes roll of all the people who have paid to be on the tour, and the following exchange occurs (a picture I took during the tour of the renovated basement of a building 2 stories above where a pirate dungeon used to be).

Stew: I would like to welcome you a tour of historic Charleston. Charleston was founded in 1670, and consists of (rattles off statistics about the number of original buildings that exist from the 1700’s, 1800’s and early 1900’s). Do any of your have any guesses about what the most historical city in the U.S. is?
Simultaneous - Everyone in the group with a pulse: Ummm... Charleston?...
Simultaneous - The Lady without a pulse: Ummmm....
Stew: I’d also like to remind everyone of the city of Charleston’s motto, Aedes Mores Juraque Curat (She cares for her temples, customs, and rights), but she does not care for her sidewalks, roads, pavements, alleys or paths. And believe you me, this tour is a lot better vertically, than it is horizontally. So please be careful as you walk this evening, and watch your step so that there aren’t any injuries due to stumbling or falling.... (one of the soon to become patented pauses)....
Me: Wow!... That’s a long motto...
Everyone but Stew: Laughing....
Stew: Still pausing...

Who says you can't enjoy prison?...

Residency is hard... I am currently in the middle of a string of 20 days without a day off. Obviously it’s not ideal... Most of the time, it’s not even all that fun. I mean, I spend the bulk of my time doing paperwork, entering orders in the computer, reading/preparing to get “pimped” about anything from skin cancer to drug interactions to home health arrangements. A lot of times, I feel like the guys in this picture... However, there is a brightside to all of this (and it certainly isn't the money)...

To prove it, I submit the following stories. We’ll mark them Exhibits A and B.

Exhibit A. As an intern I don’t operate much So when I do get to the OR it’s very, very exciting. Last month, I met a patient with an occlusion in the artery to the leg. The patient came in with a lot of leg pain, and the patient's first morning in the hospital I listened closely and changed the patient's pain medicines (super small decision... but ended up making a big difference to the patient). When it became clear that the patient wouldn’t respond to medical therapy we decided to amputate the occluded leg... After talking to the patient about the procedure the patient still seemed unsure of the procedure but said, “I don’t care if that tall blonde guy is the worst surgeon in the hospital... I want him to do it...” I of course responded with, “Ummm, my hair is NOT blonde...” And we took the patient to the operating room.

It’s a simple procedure, we didn’t have any complications and I got to do a lot (which basically means it was the blinding brilliant light from heaven on an otherwise craptastic day). We finish, and as we’re leaving the operating room I had the following exchange with my chief resident:

Chief: Alright I’ll take the patient (PS we don't refer to everyone as the patient... it's just my way of keeping the patient's story private... see there I go again) to recovery, can you go talk to the family?...
Me (never one to allow complete ignorance or lack of skill to stop me from doing something), Sure.... yeah.... ummmm... anything in particular you want me to talk to them about?
Chief (quizzically): Why don’t you start with the surgery and see where that takes you?
Me: Oh... right...

I walked up stairs to the waiting room, and nonchalantly asked the patient's family to step out into the hallway (good or bad news I feel like it should be private)... Because I wasn’t sure where to begin, I started with, “Well we finished the surgery

and everything went well.” Thinking that would be a sufficient explanation of a relatively routine procedure, I opened a huge can of worms with, “Do you have any other question?” They in fact had exactly one million questions about how the procedure was carried out, what exactly we did, and how the patient tolerated the procedure... It only took about 5 minutes, but the calming influence seen on their faces while hearing an explanation of a relatively routine procedure is really why I do this.

Exhibit B. One night on call I was covering the burn unit (usually not a lot of big issues... more just little things throughout the night), but occasionally you have to “admit” someone. Meaning you go see them, get the history and examine them. This can be more or less involved depending on the degree of the injury. While on call an elderly patient was transferred in from an outside hospital following a really bad burn. It became apparent right away that the patient would not live through the night. The doctor in charge spoke with the family over the phone, and they quickly realized that nothing could be done. They said they would be on their way and hoped their relative would make it until they arrived....

The patient’s family arrived, and the patient passed shortly after. In the midst of an insane night on call, I had to go to the intensive care unit and pronounce the patient’s death. The exam itself isn’t hard, but explaining the procedure to the family, asking them to step out of the room, examining her and then speaking with them about the pronouncement was definitely something that makes you pause and think. I won’t get into everything it makes you think about, but it certainly makes you miss the family and friends you have at home. It also makes you grateful that even on those busy nights, when you don’t think you have time to breath, you still get to come into people’s lives at a moment they’ll never forget and be a positive influence. So I guess if I’m going to be stuck somewhere doing something... it might as well be something that gives me opportunities like this every day...

When good advice goes bad....

Saddest story: (and this is for my sister-in-law’s mom... she loves sad stories... she’s probably never read my blog, but if she’s anything like my brother describes she’ll probably start reading based on this story alone...). I was on call last week, and I was covering the transplant service. When you cover the transplant service if someone comes in over night for a transplant and you have to admit them (write a history and physical and put in their orders). So of course someone comes in over night... now healthy people don’t get transplants, so if someone comes in for a transplant it can dramatically improve their life, saving it a lot of times. Of course it’s not without risks... sometimes transplants don’t work... sometimes surgery doesn’t work... (I know... I’m giving away the ending). The sad part is this... a guy comes in with his huge family for the pretransplant admission. While I was interviewing them, they asked me, “If this was your mom or your sister what would you do?” I said that I would want her to go through with the transplant... and I absolutely meant it. Sadly, this man has not done well, to the point where they had to remove the transplanted organ (now every transplantable organ is very important.... that’s why they transplant them, because without them you die... see where I’m going?) and his poor family is holding a vigil outside the ICU (mostly crying), just hoping that another organ becomes available within the next few days (because again, you don’t last long). I walk by every day and look them in the eye, they don't look mad, or even sad really, they look helpless and afraid. I smile at them and nod, but it’s tough... it honestly breaks my heart. It's been an intense reminder of how much people rely on your answers for direction in the most vulnerable times of their lives. It's what makes my job the best and the worst job in the world, but knowing that there are ups and downs doesn't make it any easier when it's the worst job in the world...

At this point My sister-in-law’s mom can stop reading that’s where the sadness ends...

Crankiest Story: On a completely different note, I am slowly gaining a reputation as... how do I say this... someone who can sometimes, on rare occasion, not have a lot of patience. I know... I know... it’s hard to believe. The running joke is, “M, who in the hospital haven’t you yelled at?” (the short answer is... everyone at my level or below...) Well sometimes the rants become outrageous, but I honestly don’t think of them as outrageous at the time. I am just frustrated, and this is how my particular frustrations manifests itself... as an example, the computer system at the hospital was just changed. They “updated” our old system and we are having several “unexpected” problems (really?... we overhauled a computer system and we didn't foresee any problems?... really?). Because it’s only an update, it still looks like the old functional system. This only adds to my frustration, it's like a flashlight with a dead battery.... it looks like it should work, it feels like it should work, but it could not be any more useless... I guess that makes it more like a Democrat (but that’s neither here nor there). So after my work comes to a grinding halt for at least 2 hours on one particular day... I call the complaint desk, and the following exchange occurred:

Me: Umm... the charting program is down...
Her: What seems to be the problem?...
Me: Umm... the charting program being down isn’t enough of a problem?...
Her: What do you mean down?
Me (feeling myself getting snippier... see how I make it seem like I can’t control it? I'm like the incredible hulk of snarkiness): Ummm.... what part of down is confusing to you?... awkward silence... I mean, the program isn’t responding. And frankly, it’s really frustrating...
Her: I understand, but hopefully it won’t be down much longer...
Me: (avoiding the urge to ask her what she means by down) Ummm... Much longer?... are you kidding me?... This is ridiculous! How am I supposed to work if my sole means of accomplishing my job is taken away from me by circumstances out of my control...
Her: I understand sir...
Me: I’m not so sure you do!.... how would you feel if every day I came into your job turned off your computer, unplugged your phone, and stared at you for hours at a time? How much work would you be able to accomplish?... Well that’s how I feel right now... and it’s not a pleasant feeling....

The conversation of course ended with me apologizing for the problem not being this particular person’s fault and saying I didn’t mean to be mean to her. But man... I was on a roll... And yes, I’m trying to be nicer... but sometimes mean things just come out, I mean you should have heard what I said to the guy who runs the pizza line in the cafeteria...

UPDATE: After three long days (roughly 45 hours for me... and about 3,287 passes by the crying family outside the ICU) the guy finally got another organ... which he received and is doing great now... so long story short the family cries less...