A trash can full of egg shells

Tonight, while cooking, I decided that a trash can full of egg shells is a good indicator that a Jewish holiday is rounding the corner.  Tonight has been about studying peds, finishing abstract proposals, and sorting emails.  It also involved as making 3 apple cakes & 2 butternut squash kuggles.  I'm a bit overwhelmed at how full my calendar is for the next few weeks.  I'm also suddenly struck with the realization that my pediatric rotation is over halfway done and the shelf exam will be here SOON.  I have no doubt that my performance on this shelf exam will directly correlate to whether I simply pass the clerkship or I surpass it with a high pass or honors.  However, with the sweet smell of the new year coming from the oven and cooling on the counter tops, I'm feeling much more ready to celebrate the chagim.

l'shana tova umetukah!

Grumpy but still loving peds!

The past few days have been a bit of a mess.  Yesterday, I managed to literally make a mess.  I had the brilliant idea to change my insulin pump right before starting a new pediatric service.  Within 3 hours of getting to work, I was ketonic due to a kinked site.  I caught on early, changed my site, and sincerely hoped that I was in the clear so that I could stay at work.  Bad decision.  I should have just gone home.  The embarrassment of looking like I can't control my diabetes is far better than the embarrassment that came from vomiting acidic-ketone-filled loveliness all over the house-staff bathroom.  The wonderful pediatrician & NP?  They looked at me with sympathy (instead of with disgust) and sent me home for self care, as well as for a shower.

Then, today, while pre-rounding on the newborn well baby service I managed to royally upset a grandmother.  We had been taught by the resident yesterday that gloves were not necessary for a well baby exam as long as we wash our hands well and work in a specific order (mouth first, diaper last).  The grandma came out to inquire why I wasn't wearing gloves and so I apologized profusely.  I refrained from mentioning that the resident and attending had both done the same thing during the exam yesterday.  The grandmother made sure to make her frustration with me known to everyone on the service.  I hadn't met today's attending before, so when she showed up I introduced myself and immediately informed her of the situation.   Her amazingly calm response?  She rolled her eyes, said not to worry about it, told me a few anecdotal stories about how she's upset caregivers in her career, and did proper damage control. 

Lastly, I had the astute realization this afternoon that the chagim [Jewish holidays] are a week away.  I'm anxious about how to balance the holidays with clerkship responsibilities.  However, I'm on peds!  People are being really great about honoring excused absences and letting me travel to my second home for sukkot.  While I very much wish that more of the chagim could be spent with friends and family, observing the holy days in proper form, it could be so much worse [if I was on surgery].

the dark side of peds

Over the past few days I've increasingly been exposed to the dark, depressing, and horrid side of pediatric care.  Parents who abuse their children either directly or through neglect.  Caregivers who can't look up from texting long enough to answer my questions.  Parents who ask how soon they can go home with complete disregard to the fact that their child is sick enough to warrant being admitted to the hospital.  Caregivers who overtly, and horrifically, abuse their children. I want to scoop up all these children and protect them.  A tiny infant, a sweet little toddler, a loquacious mini person, all of them.  I want to wrap my arms around them and bring them into my home.  I want to be able to promise them that there is better out there, that they deserve to be loved and have the right to be a child. 

I seriously envisioned myself adopting the sweetest little 2 year old yesterday, a 2 year old that will be spending way too many days in the hospital for the horrors he has already experienced in his too short life.  I imagined myself sitting by his bed day in, day out, as he overcame this event and regained a childhood.  I had a vision of what my life might be like if I did take him home.  In that moment, a decision was made.  I will foster and/or adopt children at some point in my life.  There are way too many little ones, and not so little ones, that need safe and loving homes.  There are way too many horrible parents and caregivers out there and not nearly enough safe refuges. 

My heart hurts.  I'll never forget the signs of evil that draped this small child's body.  I hope I also don't forget the angles who took him in.  I'm seeing the good and the bad of the system.   Currently, it seems the bad is winning, and I'm quickly growing jaded.  My faith in humanity is becoming scared by the abuse case that never surmount to anything, with the child being placed back into an unhealthy environment because there is no where else to put him.  The parent who is unable to afford a necessary medication, even when it is on the cheap generic list, but is fully occupied by her very expensive phone.  The disengaged parent who is depriving their child of maximal growth and development through their lack of interaction.  The child that was abused in foster-care; the place that is supposed to be safe after experiencing neglect or abuse in their biological home.  How am I supposed to pick myself up from all of this?  How can I make a positive difference in this world with such a cruel reality?

Pretty colors highlight sad truth.

 Taken from http://www.remappingdebate.org/map-data-tool/growing-set-state-abortion-restrictions-visualized?page=0%2C0.

A very colorful, yet very humbling, chart was created by remappingdebate.org to provide visual imagery to the increase in abortion legislation.  Go to the website.  It has a lot of really good data on there about what bills have passed in which states, how many providers exist where, and more.  I find it so devastating to know that women's bodies are being this heavily regulated and that access to safe care is becoming exponentially harder to access right before our eyes.  I will NOT sit quietly and watch as women have to revert to coat hangers & back-alley butchers while conservative white men* get their way, forcing their morals on the rest of us and then leaving us to bear the brunt.  Abortions shouldn't have to be a common event but they do have to be safe, accessible, de-stigmatized, and offered without undo burden to all women.

* Yes, I am stereotyping.  But having sat in some of my local house of representative legislation sessions about when to define the start of life, I have seen that there is some truth behind the stereotype. 

Celiac Disease Awareness Day

I heard a rumor on a friend's facebook wall that today is celiac awareness day.  Like any educated person, I therefore felt it necessary to fact check before posting about it.  According to the almighty wikipedia: "A resolution was passed in the U. S. Senate, making September 13 National Celiac Disease Awareness Day. It is the birthday of Samuel Gee." Therefore, clearly, it is in fact national celiac disease awareness day.

Side note as to not embarrass my librarian friends: I promise you that my medical/scientific research is only partially based in facebook, google and the wikiworld.  I do occasionally also use peer reviewed journals for information and decision making. ;-)

In honor of this very special day, I present to you my recent escapades in gluten-free vegan goodness.  

 

Crepes! With chocolate-hazelnut filling.  We also made ones with daiya cheese. 

Peach blueberry birthday cake for the girlfriend.

Cake donuts! Next attempt will be a yeast version, deep fried &/or chocolate frosted- less healthy and more like what I remember.

Peds: day 15

I really like peds neuro.  Or at least, I really enjoyed my experience at the pediatric neurology clinic today.  It is totally humbling to realize how horribly wrong things can go (genetically, congenitally, maliciously and due to accidents) and involves a lot of guts to practice the unknown and unpredictable.  In one day I volleyed between heartbroken and optimistic, hitting on most emotions in between.    I watched one child have an infantile spasm, reassured a mother that her son could play football and could challenge the stigma of his diagnosis, and so much more.

I could imagine becoming a pediatric neurologist.  However, there is a distinct lack of a clear pathway to peds neuro.  It isn't like adolescents or peds cardio or something where you do a general pediatric residency and then do a specialty fellowship.  It isn't like peds surgery where you do a general surgery residency and then a pediatric fellowship.  Also, it isn't like peds psych which has the option of triple boarding, allowing for a single residency match. 

Heck, does anyone have a clear answer on how to become a pediatric neurologist with the least amount of relocating [of location/institution] possible?

3 questions

Today we had a lecture on MD compensation and productivity.  A very wise man, who is the business brains behind one very large local physician group, posed 3 questions to us.  He explained that he posses these same questions to doctors finishing residency and those early in their career.  If they can follow a path inline with their answers, he believes all else will fall into place.  I personally think these questions are good for anyone regardless of your professional track, so please feel free to answer in the comments section!

1) What are you good at?
2) What do you enjoy doing?
3) What do you feel called to do?

PSA for blogger users

I've tried responding to many of your post and it wont go through.  I was having the same problem on my blog and learned that it is due to the response setting style.  (I had googled the issue.) I guess it is an issue that blogger has been having.  You need to change your response setting so that it is in a pop up box or the such, anything other than the in text mode. 

(Solitary diner, I'm specifically looking at you!-  I want your polenta recipe!)

5th Annual Women Leaders in Medicine Awards and Reception

(taken from http://www.amsa.org/AMSA/Homepage/Events/Convention/WLIM.aspx, which is also where the application can be found.)

The submission deadline for nominations is Sept. 9, 2011 at 11:59 pm ET. 

Thank you for your interest!

The Women Leaders in Medicine awards were created by AMSA in 2007 to recognize women physicians and educators who serve as role models, teachers, highly accomplished professionals, and sources of inspiration for women and men who are currently in their medical training. These women deserve recognition for their accomplishments and dedication to fostering tomorrow’s women leaders in medicine.

We are currently accepting nominations for this year's WLIM awards. Medical and premedical students are encouraged to fill out our simple online form and tell us about an inspiring woman who has influenced the student's medical career.

Between four and six women are selected and invited to attend the AMSA National Convention in March to receive their award at a special reception. Many of our past awardees have considered their Women Leaders in Medicine award a truly meaningful honor because it comes directly from the voices of students. At AMSA, we hope to give back some recognition to these amazing women in addition to generating awareness about the importance of fostering leadership in medicine that promotes healthy change and equality in care and professional opportunity for women and men.

This year will be an extra special reception as we celebrate the fifth year of this inspiring event. We hope you will join us at AMSA's Annual Convention for the Annual Women Leaders in Medicine reception as we announce this year’s recipients!

My personal pep-squad

I recived a random gchat message from a random friend today:

"Are you ready to be my vaginacologist yet or WHAT?"

A simple, and lovely, reminder that there are people out there pulling for me to become a doctor.  I may decide not to be a ob/gyn, but finding out this week that I passed step 1, I am now much more confident that I will get through medical school with my degree [and hopefully my head still screwed on].  Thanks ya'll for supporting me through the annoyance of having to retake it. 

Now, if only I can get through the next 7 weeks of my pediatric clerkship without getting sick again...  I LOVE peds but I'm not such a fan of all the bugs the cute kids carry around.

Peds: day 5

I think I caught my first cold from the little buggers.  Either from them, or my roommate who has a pretty nasty cold/sinus infection that she caught during her OB/GYN orientation at the beginning of the week.   Between feeling like crap and closely watching the tropical storm over the gulf coast, I'm feeling pretty awful about this weekend.  I am supposed to be driving out to spend the weekend with my girlfriend when I get off call at 3 which I have been so excited about all week.  However, right now, I have no idea how I'm going to manage the drive when all I want to do is sleep.