Ok, since everyone likes to ask if my life is like Grey's Anatomy-
The answer is yes and no.
"No" to the parts about- sleeping with attendings/patients. Sex in storerooms (I WISH!). Underwear on the bulletin board.
"yes" to dealing with egos, crazy patients/co-workers, drama, and shitty hours.

But the best part ever was when they were talking about izzie being all fucked up and lying on the floor in her dress, and they tried to explain that after being in school for so long and never really getting to have a life- it's like she's still (socially) 17.

So fucking true.

And that is my excuse from now on.

I'm still 17.

---

The funny thing is- the character on the show that is the closest to my actual job is Bailey.

Which just cracks me up.

That is who I am supposed to be.

The mean bitchy "nazi" chief, barking orders and yelling at people.

I should take lessons from her.

Instead I am meek and mild and let my interns walk all over me.

For example- last night I was on call. My intern was this girl... I think she's older than me. She's going into anesthesia, and doesn't really care about surgery. But there are two patients on my team having surgery today. So yesterday I asked her to make sure that they are ready.
That involves:
nothing to eat after midnight
IV fluids after midnight
Make sure the consent is signed
make sure the pre-op labs are normal
check a chest xray
check the ekg
Then write a note in the chart summarizing all of the above.

This is standard intern fare. Saying "make sure those patients are pre-opped" should be adequate.

But she... how do I put this... isn't always the most reliable. So I paged her to make sure everything was under control. At like 5pm. She said "yup, it's all set. Just waiting on the chest xrays and ekgs, and I'll check labs in the morning."

Umm, ok, not sure what's actually done then.

I said "let's check the labs tonight, in case anything is abnormal and we need to work on it."
"ohhh. ok."

But it was early, she had plenty of time.

The rest of the night was pretty quiet.

I checked the labs myself.

This morning on rounds checked the charts.
No comments about the chest xrays.
So I asked her-
"how were those chest xrays?"
And she said 'oh... I didn't get a chance to look at them."

Didn't get a chance?
what the fuck were you doing all night?

• I* was busy in the ER seeing patients, but I just took care of that myself and with the junior resident, didn't bother her- figured we could handle it ourselves and she probably had enough work of her own to do. (for the record, that was nice of me. I could have just said "I don't CARE if you're busy. I am the chief. Go see these patients in the ER, write them up, come up with a plan, and then call me." But no. I tried to be nice.

So when she told me that she "didn't have a chance" to see the xrays, after I specifically shielded her from the ER all night, I could/should have said "why not? that's unacceptable. When I ask you to do these things, I need to know they'll get done. I have to be able to depend on you."

(a chief told me that and made my cry my first month of internship after a patient forget to take his meds and it was somehow my fault because I didn't call him at home the night before surgery to remind him (a grown man) to take the medication like we'd talked about in clinic, and written down on paper)

Instead I just said "oh... ok...." and walked away, fuming.

WTF.

Because the thing is- it's ultimately MY responsibility, and MY ass on the line if these things don't get done.

I think I will have a new motto:
WWBD.
What would bailey do?

I need to start cracking the whip!!

oops.
sorry for the rant.
again.

time for a nap so I am nice and un-cranky for y'all tomorrow!

So I still have the much-too-expensive new tivo box on the brain.
And I found out that if I WERE to get it, I'd be able to get rid of two cable boxes, in exchange for 2 tiny little cablecards. Which would actually DROP my cable bill by $20/mo. But I would lose on-demand stuff. But it would help reduce the embarrassingly over-large pile of A/V components I have by the tv. I could also probably pack up my VCR that I haven't used in 5yr.

My brain is trying to tell me that that justifies this purchase.

Why am I such a whore for cool gadgets, or as I call them, toys?

Ugh.

I think I need a no computer (or at least no internet) time-out. For like two weeks. Imagine all the stuff I could get done that I never "have time" to get around to.

What a terrible thought. I would go insane.

I am at work and bored and tired.

But that is better than at work and swamped.

13hr down, 14 to go. (ugh).

A nurse just came over and gave me a mini kit-kat. Said I looked like I needed some sugar. She must have seen me drooling on the chart I was "reading". Ok not quite, but my eyes were heavy.

PMT what do you need/want for your house? Are you kitchen-y/cook-y guys? crap.

hey i haven't changed my user song in forever. I don't even know what it is right now. maybe I'll do that tomorrow.

Ok, back to work before I bore you all to death. See you sat!

My dad just sent me this pic. The black things are actually just the shadows.

Ok, this is probably exactly the kind of thing I do NOT want circulating the internet- but somehow I can't not post it.

This is a picture of a picture that has been on a refrigerator magnet at my parents' house for probably 10 years.

Have a good laugh. :)

(the new userpic is from the fridge, too. That's at the beach, about age 4).

-J

Ok, I tend to avoid discussing politics, but I just saw this next to the elevator. I have no idea who wrote it or who posted it, (though the usual flyers are ads for "save little johnny" fundraisers/chinese auctions (I still don't know what a chinese auction is), overnight shopping trips to NYC, and gospel/urban community events (for lack of a better term)) but it pissed me off and I took it down.

This one says:

MEDICAID CUTS ARE WRONG!!!!!!!!

John Faso and Tom Suozzi are running for Governor of New York State and they both say Medicaid is an expensive program that NY can not afford. They feel we need "health care savings accounts". Health care savings accounts are money we are supposed to save out of our money. Are these two idiots? Most of us can not afford the co pays for our prescriptions. Most of us are scrimping by and they want us to get blood out of a rock. health care is a necessity not a luxury. After all politicians have the best healthcare and we pay for it. We must be heard, Medicaid should be preserved not cut. Thel imits should be raised so more people can qualify. We should have universal healthcare. Every man, women [sic] and child would have health insurance coverage. Make sure you are registered to vote. Write letters to the Buffalo News and politicians. Let them know no more cuts. Tell them Medicaid preservation must be at the top of their list.
Call: [list of reps]
Tell them no cuts to Medicaid. Once MEDCAID [sic] is gone it will be gone. Can you afford to pay for your own healthcare? Most of us can not. Please make the calls and write the letters and vote.

The election is right around the corner and they want your vote. They work for us and they need to start acting like it. Let them know we count. Also remember to let them know we can not afford so called health care savings accounts. MEDICAID MATTERS. We matter and we need to stay healthy!

I don't even know where to start. First of all, I applaud whoever wrote this for being an involved citizen and taking action. It's better than being apathetic (like I am). So that's good.
But... I just hate the fact that no one seems to want to take responsibility for anything.
Yes, health care is expensive. It's a crisis in this country. I understand it's hard to pay for meds. And medicaid IS an expensive program. But there's also something called personal responsibility and accountability. No such thing as a free lunch. Work for what you want. etc etc etc. I just don't get this attitude- "what?! PAY (part of) the cost of my meds?! Outrageous! how dare anyone suggest that!" I disagree that "health care is a right not a luxury". Don't get me wrong- I don't think you should be turned away from the ER b/c of insurance/money/lack thereof. BUT I also don't think it's unreasonable to be asked to pay a little something. Especially when it's a totally frivolous ER visit, as many of them are. Like calling the ambulance because you're drunk and hungry, then saying 'um... my leg hurts I think it's broken' (so the docs are obligated to check you out and get xrays) 'ok can I have a sandwich now?' (No, I am not exaggerating). Racking up a $1000 (at least, probably 10,000) ER bill, in order to get a "free" sandwich. Yeah, that's an efficient use of health care dollars.
People act like medical bills are just garbage and they can ignore them. Why is that?? You get yourself shot and are in the ICU for 2 months and have a 2 million dollar bill... obviously you can't pay it, I understand that, but who is supposed to? I just wish people would make a good faith effort. "Ok, I obviously can't afford 2 million, but here's the $10 I can afford."
I just don't understand why everyone thinks all their meds/surgery/etc should be free. Who do they think SHOULD pay for all this?

sorry for ranting, but this has always pissed me off.

In med school I spent some time working at Charity Hospital in New Orleans (RIP!). It was, as you might guess, a county hospital that served mostly the indigent population. Yet they still had a plastic surgery clinic. I never understood that. So we'd see all these people... and one of the most requested procedures was breast reduction. Now, breast reduction is considered a cosmetic procedure, and this is NOT covered by insurance, most of the time. BUT, if you meet certain weight/height/breast size criteria, sometimes it is considered "medically necessary". So when these giant obese women came in asking for their free breast reduction, the first thing we would do is check their height/weight on a chart and see if they qualify. So one day I had to tell this woman that she had to lose 50lb to qualify. (and these are NOT very strict weight guidlines- you do not have to be a stick. But 5'1 300lb doesn't cut it.) So she got ALL pissed. And yelled at me "so what are you saying? there's no way i can have this surgery?" And I said "well, like I said if you lose some weight we'll re-evaluate you. or of course if you are willing to pay for it." My god I thought she was going to slap me. How DARE I suggest that my tax dollars not pay for her cosmetic surgery.

Or a few months ago I was looking at the OR schedule at ECMC... and I saw I was assigned to a little case in the procedure room. "excision of skin lesion". That often means skin cancers. So I go to meet the patient... he's a prisoner. Ok, fine, ECMC is where the prisoners go. So I go to check out his 'lesion'- it's a very NON-suspicious looking mole on his nose. NOT worrisome for cancer. But on his face. And he didn't like the way it looked. so we removed it.

EXCUSE ME? Now prisoners get free cosmetic surgery?

My other favorite is when you see a patient in follow up and ask them if they took the medication you prescribed... say, an antibiotic to try to keep their infected toe (due to diabetes/obesity/smoking) from falling off- and they say no, they didn't, because they couldn't afford it. Yet somehow they could afford 2 6-packs a week and 2 packs a day. oh, and could we give them some "free samples" of that, what's it called, lortab? Because they're "allergic" to tylenol and ibuprofen.

Ok, and while I'm ranting...

I saw something on CNN tonight- Bush has proposed a "north american union"- combining the US/Canada/Mexico??? Huh???

And then this one- the ACLU is asking Rhode Island to just "not enforce" immigration laws. Saying it's not fair to send illegal immigrants home. Umm, aren't they called ILLEGAL immigrants for a reason?

haha, see, that is why I don't talk politics much. my views are often too far to the right and I get labelled a rich bitch who doesn't care about the poor.

Which is not true.

But I just hate when people think they are entitled to everything.

So go ahead... flame away...

-J