Monday, October 31, 2011

Surgery call math?

Tonight is my first night of call.  Well, first night of call as a doctor-type since I did it all the time as an EMT, but I digress... It is home call so it only half counts anyway. 

Call + surgery clerkship + Halloween night + stupid people = exciting learning?

Time will tell how this equation ends.

Wednesday, October 26, 2011

First real day of surgery

-Lasted 10.5 hours.  Of which, the majority were spent on my feet and 6 hours were spent in actual surgeries.
-I scrubbed into my first actual surgery and took my proper medical student place as a professional retractor.
-Due to the circumstances of said surgery, I had a lovely vaso-vagal episode in which I had to ask the scrub nurse for a stool so I didn't pass out or vomit on the patient.
-When sitting didn't prove to be enough, I broke scrub and excused myself briefly to re-compose myself.  I ended up being fine.  The rest of the team was fine with it.  Yep.  It turns out that I'm THAT medical student.  The one who nearly passes out & vomits in my first scrubbed surgery.
-I called my lovely girlfriend on my way home to strike a deal.  She's not allowed to break up with me during my surgery rotation, as I am sure that I will be a miserable and neglectful partner for the next 2 months.  Her response: "I bet we wont even talk enough to break up.  I'll have to do it over text message."  I do love her!
-My feet hurt.  A lot.  Disappointed my in well loved, and very old, danskos.  Here is to hoping that my body adjusts.
-Career hypothesis to date: surgery is looking like a no go.  OB/GYN is falling below peds due to the surgery component.

Monday, October 24, 2011

surgery: day 1 (orientation)

Yep, I'm already overwhelmed.  Can I go back to peds?  It is going to be a long 8 weeks!

Monday, October 17, 2011

PICU & peds neuro

My pediatric clerkship is quickly coming to an end, leaving me wondering if this is the specialty I'm destined for.  I've loved a lot of my experience so far.  While I have liked general out-patient peds, was surprisingly impressed by some of the other sub-specialties,  the PICU and neruo have been my favorite though.  It'll be interesting to see how my future evolves as I continue on into surgery, ob/gyn, neuro & family clerkships.  (OB being the clear front-runner when I started medical school.)

A recent NYT article on Dragon Parents was appropriately timed with my experience in the neuro clinic today.  "Conversations about which seizure medication is most effective or how to feed children who have trouble swallowing..." These parents are truly exceptional and have many things to teach the world.  Their hard-earned love, compassion, and understanding of daily blessings should serve as a lesson for all of us parents & future-parents.

Wednesday, October 12, 2011

HR 358 aka the "Protect Life Act"

And the madness concerning women's reproductive rights continues.  While Mississippi is leaving the debate of when life begins to their general pubic [initiative 26], which will have immediate determental effects including outlawing some types of birth control, the US House of Reps is also busy at work attempting to control my body and my choices.  Don't they have better things to do with their time and our money?!!!! 

I'm off to enjoy the first days of sukkot.  Hopefully the world wont go to complete hell in a hand basket while I'm gone.

Re-posting an RCRC action alert, the original can be found here:

STOP this Dangerous & Misleading Bill!
Contact Your Representative Now!

Dear RCRC Advocate:
Congress is not listening to you! Instead of creating new jobs and helping our economy grow, they are attacking women's health in unprecedented ways!
HR 358 aka the "Protect Life Act" will be up for a vote on the House floor this week and you need to tell your Representative that you, as a person of faith, oppose this dangerous bill. It would ban abortion coverage in ALL insurance plans on the upcoming state exchanges, even if a woman uses her own private funds to pay for her insurance.
The "Protect Life Act" would also create a loophole in the Emergency Medical Treatment and Active Labor Act (EMTALA) that would allow hospitals to deny pregnant women stabilizing and life-saving treatments. It also expands already broad conscience protections for providers and entities who do not want to provide abortion services, without any regard for patient safety and protection or for those providers and entities who do want to provide abortion services.
HR 358 violates the hallowed promise of our nation to respect diverse religious views, so contact your Representative NOW and tell them to oppose this far-reaching and harmful bill!
Peace and blessings,
CVeazey signature
Reverend Dr. Carlton W. Veazey
President and CEO

Tuesday, October 11, 2011

10.11.11 in pictures

Happy national coming out day!  
(Not just as queer, but as a cowboy/girl ;-)) 

To quote a friend's facebook status: "happy national coming out day! i know this might come as a shocker to some of you, but i'm totally gay.
And another: "Today is National Coming Out Day! If you would like to Come Out, or if you have already Come Out and would like to offer thanks, here is a lovely prayer written by Rabbi Rebecca Alpert: Nevarekh et Eyn HaHayyim asher natna lee haozmah lazet min hamezarim. Let us bless the source of life for giving me the courage to come out."

Happy 1 year anniversary of adopting Lulav!

Monday, October 10, 2011


I had co-authored a JAMA letter to the editor recently.  Today we received a rejection.  I'm not overly surprised as it was a bit political for JAMA, but I am surprisingly disappointed that it was rejected.   Overall though,  I think I'm just moody and tired.  Trying to balance the month of high holiday while staying on top of my pediatric clerkship and preparing for the upcoming shelf exam has me WAY overwhelmed.  Right about now: being a medical students and being a Jew leaves me sleepy.

Thursday, October 6, 2011

Repeating history

Due to a conversation today on state and federal healthcare spending, which quickly derailed into a conversation about all the issues with the federal budget, I've been thinking a lot about this whole "occupy wall street" thing.  John Stewart's "Parks and Demonstrations" shtick has fueled this thought process.  What if this is the real deal?  Could this be the start of something big?  A slowly growing revolution creating the change that is needed for sustainability and success?

It reminds me of all the stories I heard about the Vietnam era.   Stories of organized dissent, public protesting, empowerment of the younger generation.  These were stories I used to ask my parents to tell me over and over when I was little.  I always found myself a bit disappointed that they had such passive roles, envious of friends' whose parents were at UC Berkley and the such at the time.  They weren't the sit-in hippies or the draft dodging rebels.  They were just run of the mill 20-somethings, doing the best they could to stay on their feet, trying to progress their lives while barring witness to history evolving.

If this is the real deal, I imagine the conversation I will have with my future kid(s), G!d willing!
Kid: Mom, tell me about the wall street take over!
Me: Well, I was a 3rd year medical student at the time, busy on the wards and really out of touch with what was going on...

Wednesday, October 5, 2011

Very proud of this CLIPP case

We have to do standardized CLIPP (Computer-assisted Learning in Pediatrics Program) cases for our pediatric rotation.  I was very impressed by the case I did tonight as I've often found my medical education to be awkward on how to do a culturally appropriate and comprehensive sexual health interview.

I appreciate that they use an open question as an example instead of the simple, and awkward "do you sleep with men, women, or both?".  My actual replies to "do you sleep with men, women or both?" in the past have included "this week?" and "why are those my only two options?"  The other issue with being trained to use the both question, is how does the provider follow the response?  In the past when I, as a female, answer women, my doctor immediately and uncomfortably plowed forward without performing a comprehensive sexual exam.  She assumed that I sleep with women = she's a gold star lesbian, therefor she can not be as risk for pregnancy, STIs, sexual violence, and the many other things they should be screening for.  [PSA: STIs CAN be passed between female partners, and same-gender relationship violence DOES occur.] Basically, I believe the both question to be a stinky, outdated, question.   I also appreciate that they clearly explain the purpose of such questions in a way that [nearly] any medical student can understand.

The text below is taken directly from the case.  While not yet perfect, it is the best I've seen so far.  Good work CLIPP!  Way to educate medical students across the country!

"You thank Betsy for being comfortable with you enough to allow her to disclose her history of smoking and marijuana.
You now ask Betsy questions about possible sexual activity, "Are you going out with or dating anyone at the moment?" 
You ask Betsy if it's getting more serious, and have they been thinking of or had sex yet? You find out that she's never been sexually active. Of course, in your initial discussion you correctly did not inquire if she had a "boyfriend" or make an assumption about Betsy's preferred gender of her sexual partners.
Using gender neutral terms is very important in allowing sexual minority youth to feel comfortable with you.  If a teen is sexually active, asking “when you have sex, do you have it with girls, guys, or both” is very important.  Sexual minority youth suffer from society’s pervasive homophobia and often have more difficulties during adolescence than heterosexual youth.
Click here to link a power point presentation that discusses adolescent friendly health services and obtaining a comprehensive sexual history." 
Case 5 was written in August 11, 2002, by Kim Blake M.D., MRCP, FRCPC, Associate Professor of Pediatrics and Director, Pediatric Undergraduate Education, of Dalhousie University School of Medicine. The current case editor is Kirsten B. Hawkins, M.D., M.P.H., FAAP, Chief, Section of Adolescent Medicine, Assistant Professor of Pediatrics, Georgetown University School of Medicine. The section editor for the case is David Levine, M.D., Professor of Clinical Pediatrics, Morehouse School of Medicine.

Monday, October 3, 2011

Being picked up at shul

Nope, I wasn't picked up in the horribly awkward sense of being approached by the strangest, most socially inept, guy (or gal) in the room.  Or worse, by his mother.

I went to shul alone both days in the city that was most recently my home. I split my time between the conservative and the orthodox communities, revisiting my old haunts, and reconnecting with old friends. I didn't decide to travel for rosh hashana until I knew my schedule, leaving me little time to find housing and meal arrangements.  My solution?  I stayed with a non-jewish classmate. I accepted that I would be driving to holiday functions and back for the purpose of having a meaningful holiday.  I packed a box of cereal & refrigeration-free milk as a survival kit. 

It turned out that my survival strategies were unnecessary.  The holiday came filled with blessings beyond expectation.  Sitting in services the first morning, I was approached by the rebbitizin.  She asked if I had lunch plans & if not, would I like some?  I shrugged my shoulders and explained that I was intimidated to show up on someone's doorstep & then have them not be able to feed me.  Since being diagnosed with celiac disease I find myself very anxious at the prospect of last minute shabbos & holiday meals.  Knowing the anthropological song & dance of wanting to feed people who you invite into your home, and being acutely aware of all my food issues (gluten, kosher, semi-veggie, diabetic, etc.), I've evolved into more of an introvert as a way to avoid awkwardness.   Tangent aside, she replied "don't be silly! it'll be fine" and handed me a magical golden (er, green) ticket with a name on the front & directions to their house on their back.  The magic came in learning that the wife, the woman who prepared the marvelous lunch, happened to also be gluten free! Random coincidence = divine inspiration? = rosh hashana meal jackpot!

The rest of the holiday was more subtle, but equally blessed.  I prayed a lot.  I ate a lot.  I listened to and pondered a few really good dv'ra torah.  I spent a lot of time with old friends and people who I don't get to see nearly enough.  It felt like an ideal start to the new year.  May this year continue to be filled with unexpected blessings for all of us.  shana tova u'metukah!