I’m more tired than I have ever been in a long time, and it’s all because of the damned PICU.  My first day, I got there ridiculously early to learn about my patients; the second day, I ended up staying until 9 pm; the third day, I stayed until 7:30 pm; I was on a nightmare call over the weekend, and I started a ridiculously busy Monday feeling exhausted already. (But I’m surprisingly not violating any work hour rules!)

My feet hurt and my head hurts all the time. Also, I got a haircut that makes it impossible to put my hair into a ponytail, and it bugs me all day long.

Whine whine whine whine, I know, pauvre bebe.  Even at home when I could be sleeping, I can’t because I can’t relax.  My body is too hopped up on the adrenaline of being in an ICU, and my mind is racing because I’m constantly thinking about patients.

The thing that kills me, though, is that I know I’m not managing that many sick kids, and I feel lame because I don’t know that much  — my internal medicine friends are managing 20 cardiac ICU patients ALONE on call nights, AND doing procedures (which is rare in pediatrics) so I feel like a really lame resident.  The weakest link.  Bah.

I’m making myself a rib eye steak tonight to cheer myself up.

It’s a big, important deal that our President-Elect is black, but I never look at photos in the news, and think, “Wow, that Obama, he’s a black person!”  It’s not as if race or color is something I’m actively looking for all the time, but for some reason, it was a palpable feature of our vacation to Martha’s Vineyard this weekend.  As we were waiting for all the passengers on the return trip to unload from the ferry boat before we boarded to head to the island, Joe pointed out to me, “hey, have you noticed that everyone getting off the boat is white?” I was scanning the crowd, feeling very provincial and weird, and Joe put his finger on exactly what that weird, provincial feeling was.  It bugged him, too.

It wasn’t that there weren’t people of color at MV; in fact MV has been known to be a vacation place for African-Americans since the 1940’s or possibly earlier (granted, it was segregated, but what area of the U.S. hasn’t been touched by segregation?)  Even so…it is the off-season in MV, and we were bumming around parts of the island where locals go, and I noticed the distinct look of the aspiring-to-be-affluent teenagers there: the Ugg boots, the black North Face fleece, the long, blond-or-brunette perfectly messy ponytails.  And the off-season visitors had “the look”, too: the ArcTeryx winter coats casually paired with designer denim and their matching adopted Guatemalan babies (don’t get me started on the Guatemalan babies issue).  Granted, style is easily the peripheral-most aspect of ethnicity and race, but all of it, from the people around town to the little art stores and Lilly Pulitzer boutiques lining the streets, made me feel conspicuously not white.

Of course, I doubt people were looking at me, thinking, “Oh, look, an Asian person,” because I want to believe that’s not how people think.  But then again, I was looking at them, thinking, “Oh, look, white people.”

We headed back to the mainland and made a pit stop at Ikea for some dishes and a new chair for Joe.  I felt more at home amongst the cheap furniture because we saw black families, Latino families, white families, Asian families all in search of cheap wares named Blörg or Ektørp.  We decided on a chair named Pöang, a strangely pseudo-Scandinavian-Thai-ish name, and I felt happy: this is the American melting pot, this is the bizarre consumerist land we live in, where children and furniture will have a vague semi-post-modern feel and unidentifiably ethnic heritage.

Since I spent the better portion of the month pouring over the news and following the polls, the question last night for me wasn’t so much “who’s gonna be our next president?” but “how many votes is he going to win by?”  So I wasn’t as nervous as I could have possibly been, although I was definitely nervous about the silly propositions in California and for Joe’s aunt’s campaign (congratulations, Aunt Pam!)  To recap all the oddities of the couch-side analysis:

• What was up with those stupid funnel graphs on the huge iPod-like screen on CNN?
• It was a toss-up between Wolf Blitzer’s humongous TV versus John King’s cool touch screen TV…which one would you want?
• The best commercial by far last night: The Iron Gym!

But because I wasn’t nervous, there was none of the tremendous relief, the tears of joy, the giddy excitement that I wanted to feel after the news started to call it for Obama.  And then, seeing the news about prop 8 in California…damn, sunshine state, why you gotta be such a killjoy?  It’s incredibly painful to see rights taken away from citizens of our country.  The speeches that both Obama and McCain gave last night were rousing calls to support our new president and come together as a country and work hard to serve our nation, but we’re still an incredibly divided country.  It’s like…we can finally maybe accept a racially diverse America, as symbolized by Obama’s win, but we can’t yet accept gender orientation and gender preference-diversity in America…oh, America…little baby steps for you.
Weirdly, the thing that I got most excited about was seeing Obama’s kids on stage and the promise their dad made about a Whitehouse puppy.  How cool is that?  And it’s not like he can go back on his promise, either, since he made the promise in front of the ENTIRE NATION.  I bet Sasha and Malia are already doing the research on what kind of dog to get, and what they’ll name the puppy, and all those awesomely exciting things that have to do with pet ownership.  What kind of puppy are they going to get?  This is the pressing question that the nation wants answered.

Yesterday morning, I awoke at 5:30 AM with a sudden worry about the economy, not finding a job, losing our house, and I felt a warm lump on my throat, panicked, got scratched in the face by that warm lump (which was not, as it turns out, a biophysiologic metaphor for my anxiety but a 7 pound cat), then I fell out of the bed. That got me up and out for a run.  The stars were still out and I watched my breathe turn the black air gray in small puffs.

I guess I’m responding viscerally to the economic downturn and listening to too many NPR news stories on Marketplace.  I just don’t get money.  You earn it, put it in the bank, spend some of it, save some of it, and earn some more.  Except that there’s all this stuff you can do to make it grow and stretch for you with the use of loans, investments, expected future earnings, blah blah blah [insert here stuff I don’t get].  Joe bought us a house and figured out all the financing for it, and I pay a portion of the mortgage: we figured out much of my paycheck could go towards monthly payments, and it just automatically gets deducted from my account the same way rent would work.  Much the same thing happened for my med school loans: someone figured out for me how to consolidate some of my loans under a reasonable interest rate, figured out the rate at which I could afford to pay it back, and that’s the chunk that automatically gets deducted from my account.  Someone told me to put away X percentage of my earnings into a “403b,” which almost sounds like “401k” and I think that has to do with saving money for old age, so I also do that.  For all I know, alien space monkeys on computers might be taking this money from me and donating it to the Republic National Committee.  Even the paper statements I get in the mail somehow don’t quite reassure me that all the money I’m supposedly sending and saving is going to the right places.  Gollum might be hoarding my money in a dark cave, crooning “my precious” to it, and here I am forking over lump sums to what I think might be car insurance; but no, it’s probably Gollum.

“Whatever happens, you’ll have a job,” Joe pointed out to me as I started panicking that he might lose his job (which he reassures me will be highly unlikely…but still, you never know!)  Can my job sustain our current MO?  The answer is…no.  We are about 3-to-4 paychecks away from brokedom if Joe ever loses his job.  Residents are educated and very employable, but we’re cheapy-cheap-cheap-cheap.  If clocked by the hour, I earn roughly half of minimum wage.  And while I might not have to live on a resident’s salary for long, I will end up living on a fellow’s salary (possibly even less than what I make now) for another three years…it almost makes me want to do hospitalist work (a “normal” job) for a while after residency, which would allow us to bulk up on some savings, and I would get lots of (much needed) experience in my job, which is always useful.

If anything, the crappy economy is actually making me learn more about money, so I guess that’s a good thing.  If things were still like several years ago, with real estate prices booming, stocks going up and up, gas prices staying at a relatively fixed price…I would probably still be treating my income like my second grade allowance, which was stored in a pink-and-blue velcro Smurf wallet.  Damn, that was a really good wallet.

Getting the kids ready for Halloween.  I saw these great dog costumes at Petco, and this one was on sale for 4 bucks.  They’re called dog costumes because they’re clearly not for cats: see how happy he is?

On a related note, it’s October already!  I wore a long-sleeve shirt on my run yesterday, oh, the excitement.  There are pumpkins on people’s doorsteps, another subtle hint of fall.  Mind you, I have no interest in carving them, only hacking them open and figuring out various ways to eat them.  After an entire September of apple-related culinary treats (apple pie, applesauce, tarte tatin in various permutations), I’m ready to move on.

These days, I can’t help but reflexively control+tab myself over to the CNN electoral college map, with the election only being several weeks away.  After emptying our coffers out to the Obama campaign, ordering my silly Obama button, and arguing myself into a frenzy with other liberal-leaning colleagues and friends (dude, I live in Massachusetts, I won’t find any other political viewpoints unless I drive myself over to Mitt Romney’s house), I’m not sure what else I can do except ESTABLISH RESIDENCY IN A SWING STATE and GET MYSELF INTO THE ELECTORAL COLLEGE.

The latter might take some time.  The former, however, is not so far off in the distant future.  Joe and I are up for a move in about a year and a half, and I’ve decided that we need to move to: Virginia, Ohio, Michigan, New Hampshire, Florida, Colorado or Nevada.  All relatively nice places to live!  All places where posting an Obama sign on your front lawn might actually be a point of debate, instead of run-of-the-mill lawn decoration as it is in my current city.  In a swing state, I might get to sway the opinion of an Undecided.  I’ve encountered as many Undecideds as I’ve encountered…magic gnomes…so going to the Land of Undecideds would be interesting.  While a move in several years won’t really affect this campaign cycle, I might actually have colleagues who are Undecideds, who I may befriend and share lattes and morning runs with, so I could engage them in Meaningful Debate and Get Informed.
I have some friends who are volunteering to campaign in various swing states, and while that’s nice, it’s impossible to do as a resident (particularly one who is on back-up call for almost the whole frickin’ month leading up to the campaign).  I saw a long-haired Timbuk2-toting Obama volunteer in Harvard Square today trying to register people to vote, and thought, “You’re preaching to the choir! Hurry up and get to New Hampshire!!!”

I didn’t get to enjoy this SNL bit until this morning on YouTube because I was on call last night.  I mean, who would you rather see on TV, Sarah Palin or Tina Fey as Sarah Palin (and Amy Poehler as Hillary Clinton!)?

Update: Fixed the link. That youtube one stopped working –joeo

Baby fever hit last month when I was on a rotation surrounded by little pod babies. Not only was I surrounded by babies, but there seemed to be a lot of women of childbearing age around me, and people who were either talking about getting pregnant, were currently pregnant, or just finished being pregnant, and several thoughts dawned on me: (1) wow, babies are cute! (Except for the ones that pee into your mouth); (2) I like cats, and they’re kind of like babies, and since I’m a good cat mommy, I bet I’d be a pretty good baby mommy; (3) Clomid would be kind of nice - twins, bam! - get pregnancy and labor over with in one shot; (4) except I’d want my babies to have as much of a chance at growth and development in utero as possible; (5) I hate those damn humongous yuppy space strollers; (6) wait a minute - babies are more more logistically daunting than cats because you can’t just buy them kibble and feed them twice a day; (7) I’m hungry…why is there no food in the house post-call?? (8) Feeeeeed me, I’m a baaaabeeeeeee, wahhhhh!

Note: it wasn’t just baby fever, it was stupid fever that also struck last month.

Fortunately, I had a really liberating moment a couple of call nights ago when I realized, “Wow, I don’t have to have kids if I don’t want to.” It was weirdly very exciting and very awesome to have this sudden realization that I have a choice in this matter. (Go Democrats! Boo Sarah Palin!) As someone who likes children (duh, I’m a pediatrics resident) I always assumed I’d eventually acquire some of my own. But I am continuously surrounded by children, so why do I need a passel of my own? I get a lot of fulfillment and enjoyment out of seeing other people’s children - without the added aggravation of having them rely on me for every basic and not-so-basic need. My very next thought, though, was, “well, for professional reasons, shouldn’t I have one for the user experience? So I understand parents better?” And the next thought: “Sometimes I wish I didn’t have cats, though.” And: “Oooooh no, I’m a bad cat parent for thinking that! I’ll probably be a bad human parent because you can’t say that to your kids, ever!” And: “I can’t even keep plants alive because the cats eat the plants!” And: “Maybe the cats will eat the babies, too!” And then back to this: “No babies. Cats win. They can’t stand having plants or babies around.”

Note: cats trump logic.

All the internal energy I’m expending thinking about the baby thing is, apparently, in no way related to what Joe thinks or wants, because he just rolls his eyes at me and says, “whatever. It’ll happen when it happens.” Which goes to show what different creatures we are. (Another example: our comparative experiences in Mrs. Smith’s fifth grade class. Joe remembers some bitchy girl who rejected the ugly paper cranes he folded for the Sadako and the Thousand Paper Cranes project that she orchestrated because the cranes weren’t folded right. All I remember is that I had this great idea that if our class folded a thousand paper cranes, we could understand the experience of the book, and as an incentive, I promised the class a pizza party at the end, which we ultimately were not allowed to have. Only this year did Joe and I realize that I was that bitchy girl, and he was that unfortunate kid who folded the ugly cranes made of newspaper. But I digress.)

Regardless, I’m glad my mental energy is now focused on something else, because this baby-mama-drama is going no where inside my head.

After going to a meconium delivery, eating a leisurely breakfast while chatting with the attending, and checking on the intern in the ED, I went to drop my backpack in the call room and found this book on the night stand. I read the first four chapters, and then realized, “wow. I’m reading about another resident’s stories about being on call while I’m on call.” It’s like watching yourself on TV watching TV. Except not really. Because this resident’s stories are craaaaazy, and I’m snacking on almond butter and reading a novel.

Getting peed on is one of the hazards of pediatric practice - when the diaper is off for more than 20 seconds, what do you expect when you’re examining a freshly circumcised dongle or palpating for a reducible inguinal hernia?

It’s not like I hadn’t been peed on by a tiny tot before but I have never until last night been peed on and had the pee land in my mouth. (Pause for collective horror, then for a piece of you to die inside, then go brush your teeth, floss and gargle in defense.)  The neonate had a money shot straight into my open mouth as I turned to talk to the nurse. The irony of it all is that I was wearing a face mask all night long because I have a small cold brewing, and momentarily pushed the mask aside and forgot to put it back on when I examined this kid. Serves me right.

The nurses at a good laugh at me because clearly, I am so awesome. All I can say is that wee tastes exactly how you’d imagine wee to taste. (Pause for more collective gagging and dying inside).

All the reading I’m not doing.

This summer, I decided to institute the q4 day dessert rule - since I’m on call every fourth day (in doctor fake-o Latin speak, “q” is short for “quaque,” meaning “each, or every” fourth day).  Thus, I’m trying to limit my dessert intake by not inhaling a heaping pile of cake, pastry, or ice cream every day, but only on my call nights - I figure since I’m on call, I need little things to look forward to - like dessert.  There is usually a nurse or other staff member who has a birthday or something to celebrate, which means the staff buys ice cream cake, and I’ve managed to eat more ice cream cake on this rotation than in the past five years of my life.  That said, my call nights aren’t bad.

But sticking to a q4 dessert schedule has not worked out because there are so many friggin’ good FRUIT PASTRY ITEMS TO BE HAD when you shop the seasonal fruits here.  Blueberries are only available in July and August? Quick, snap ‘em up and make blueberry cobbler EVERY WEEK!  Peaches on sale now? PEACH COBBLER! Strawberries ONLY available in the summer? Strawberries and creme fraiche every night until the bushel of strawberries I bought is gone.  The same goes for corn - somehow, corn is big in the summer here, and we end up eating corn-on-the-cob QoD (that’s quaque other day, folks) because, OH NO, if you don’t buy the 3 ears for $1.00 this week, they will be $8.00 an ear in September!!!  Eating seasonally only makes me eat more because in my reptilian brain, I worry that the food will disappear come fall, which is fast approaching. 

Of course, I could just eat the fruit straight-up, which would be a healthier alternative than baking it into a sugary-buttery-floury-pastry shell, but why buy bushels of shiny, juicy, amazing fruit without fiddling with it? 

Recipe for the best blueberry cobbler crumbly top EVER.

I bike past this place occasionally, and it fills me with hope:

As if there were in fact, a tiny rock star, waiting to be released from the depths of my occasionally beleaguered, utterly tuneless soul.  Oh, if only!  My inner rock star probably plays a synthesizer and wears a piano tie.

I haven’t had the urge to post anything in a long time because I’ve been both enjoying myself and being miserable at the same time. Miserable because I have the cold from hell - it’s as if I let my guard down one minute too soon, and the opposing team (i.e. pediatric population at large) rallied one huge offensive strike against my nearly victorious self (i.e. being at the end of intern year). A kid managed to cough and spray a fine viral mist on my face on my final day as an intern in the Emergency Department. However, with great misery comes great joy because this has truly felt like the end of an era, bookmarked neatly by a trip to Maui, a trip to California, a test, a wedding, and rigorous house-cleaning. Witness, my new best friend:

His name is Oreck, and while we’ve had him for several months, it is only now that I’ve gotten better acquainted with him, and he’s lovely. Solo and Manzie have been shedding their winter coats for what seems like forever (more likely that they’re just fuzzy automata that continuously convert kibble into fur and poop) and so vacuuming has become a very routine task - about once every several days, I’ll run Oreck. He’s only 8 pounds (half as much as Solo weighs), so lugging him up and down our multiple sets of stairs is not a problem. He magically turns what appears to be a light-grayish-red carpet into a bright red carpet. He comes with a sidekick that sucks dust easily out of vertical blinds. I don’t know what’s wrong with me, but I really like vacuuming. And I like sweeping - it’s really satisfying to throw into the dust bin a small pile of dust and fur the size of Manzie-cat. Fast results. Watch out, cats, Oreck is cleaner and at this moment slightly more cute than you!
In addition to housecleaning, I forgot how much I enjoy reading. During the year, I fall asleep during a chapter, then have to re-read the whole chapter because I forgot what happened, and then the whole process gets tedious because I can’t really get through a book without having to tab things, and then I feel like, damn, I should be getting paid to do this. So I’ve read five books during this break that I’ve started at some point throughout the year and never managed to finish: Into Thin Air, The Great Gatsby, The Wind-Up Bird Chronicles, The Namesake, and Grayson. Also managed to get through a backlog of New Yorker and Bon Appetit magazines.

The only thing missing from this tableau is tennis or golf lessons, then I complete the housewife picture!  I’m almost itching to do it.

I can’t believe I didn’t notice this store - I’ve passed it every day on my way to work for the past two weeks! Incidentally, it means something else.

One of the supposed perks of becoming a physician is free stuff from drug companies.  This, of course, is completely unethical and crass, but we got a package in the mail, and I was upstairs when I heard Joe go “Yes, free doctor stuff!” as he opened up this downstairs:

Next, I heard him thundering upstairs to show me, shouting, “Ewwww gross.” I kind of think they’re pretty.  I’ve only used the white one and the blue one before to dig stuff out of kids’ ears, but the yellow one and the purple one seem enticing.

There’s not much else going on to really provide this blog with updates.  I get up.  Go to work.  Learn stuff.  Oh, wait, I do have something to mention: I’m getting old!  There have been a couple of times when I catch a glimpse of myself in the mirror and have noted the fine, reticular pattern of wrinkles slowly starting to accumulate around my eyes.  My mom laughed at me when I told her this, but Joe peered at my face and said, “Yeah, you’re wrinkling up.”  He explained to me his theory that Asian people age in phases rather than gradually: you look like you’re 15 years old for a long time, then suddenly you look like you’re 35 years old for a long time, and then suddenly you look like you’re 65.  And the shift is dramatic and can occur any time between those respective ages.  So my husband is implying that I look middle-aged.  Read the rest of this entry »

I’m in the NICU these days. I can’t stop watching this video. Premies living the phat life.

Yes, it’s disgusting that I’m putting this up but this is Joe’s bright idea in progress.  It would be really great if we could actually train the animals to use the toilet - think about how much money you could save on litter every year if you didn’t have to buy it. 

Manzie actually gets it - she hops up onto the toilet, does her thing, then quickly leaves.  It’s Solo who’s protesting the whole potty-training idea.  He loves the whole process of burying his treasure - the digging, the scratching, the whole bloody process.  So going from a huge litter box full of litter to a tiny little container of litter (on a toilet, no less), to being partially litter-less has been painful for him.  Our morning routine now involves a billion steps: meow in Miranda’s face a bunch of times, wake her up to go get food, get fed, have some window-time watching the kingdom outside while waiting for the gastro-colic reflex to kick in, then get locked in the bathroom with some encouraging words (I have to pet him kindly and tell him, “you can do it!”), and when he does, in fact, “do it,” reward him with some more kind words and a treat.  Otherwise, he’ll try to poop in the paper recycling bin.  We have even put a night-light in the bathroom with extra-serene blue mood lighting. 

I’m irritated because while this was Joe’s inspiration, it somehow has become my job.  It so infuriates me that if we ever have children, they will be wearing diapers until they are 18 because I do not want to go through this ordeal again. 

There should be something here on this website to signify the month of February came and went…the above picture is the pedi intern call room. Not bad, eh? Notice the pristine well-made bed.  Wish I had actually slept there that night.

I’m in the newborn nursery now - there were a ton of babies born on this very special day, and I tried making the joke to parents that their babies would only age one-fourth as fast as other babies - this was mostly lost on a lot of parents due to my poor execution of the joke, the hormones that are adling all the new moms’ brains, and the fact that my joke isn’t particularly funny, either. Hardee-lame-har.

One of the major call night issues is the issue of odor.  Imagine all the bodily odors you have known (and some you have never ever known), and mix ‘em all together, put ‘em in a box and seal it up real tight…and that is the smell of the pediatric surgery intern call room.  Added to the fact that every time I decide to mosey on down there, there is someone sleeping in the pedi surg intern bed who is NOT the pedi surgery intern (i.e. me), and who is some other surgical resident who likes to take their SHOES and SOCKS OFF.  This only adds to the mix of odors retained in that odor box.  All I have seen of said non-pedi-surg resident is his or her bare feet sticking out of the bottom of the bed. 

That said, I decided FOOT odor is part of the call-room odor issue (in addition to bad ventilation).  I happen to change my socks at least 2-3 times on call.  But THIS TIME, I brought not 3, but 6 pairs of socks to work today.  I figure I should be changing my socks q4-6 hours.  We’ll see if this helps the situation tonight.  That, and hopefully someone won’t be sleeping in my call bed. 

It was a great vacation minus the fact that we got stuck in Reno when our flight was randomly cancelled…and as storms chased us out of California.

The airline recognized their mistake and put us up at Circus Circus for one night, with meal tickets for dinner and breakfast.

We wandered around the smoky casinos all afternoon long.  I drank two Manhattans and called a bunch of friends from the Keno lounge.  We had steaks on the meal tickets.  Joe won some money at the blackjack table.  And we left Reno none the poorer but still smelling like we had dipped ourselves in a pot of cigarette ash.