Fixed up

During my 4th year of med school, I reeked of desperation. Any woman who was within a 100 yard radius wisely avoided any prolonged exposure to me. I was so lonely and so empty and I wanted something to fill that up or at least dull it. And of course, there was nothing there. I couldn't get a date to save my life.

Now, life's a little different. I'm much happier with who I am. I've come to terms with who I am and what I want out of life and that, holy crap, what's the rush? Life is hard enough without me adding more stress to the picture.

So, on top of all this, a friend of mine threatened to fix me up. I say threatened because it has the feel of a threat. You know, meeting someone on your own has this giddy pleasure. The fix up, it has a palpable sense of doom, because if something goes wrong, it has the potential of fucking up more than just a couple dates.

Last year, I would've jumped at a fix up. I actually asked more than a few people to help me out with that stuff. So I find it very amusing that I couldn't scare up any interest a year ago when I would've jumped at the chance, but now, with a tangible offer in place, I feel... reluctant.

Maybe it's the idea of a fix up that's a little spooky. There's so much potential to go wrong, and it's hard to get a sense if anything right is there. Maybe it's just the thought of trusting my taste in women to another person. Or maybe it's just me and the overriding thought that I probably have the requisite amount of self-loathing to fuck it up just to prove to myself that I'm still a loser.

What is my type?

I was out with F and S today, enjoying a very fine afternoon. I don't have a lot of free time. The whole 4 days off a month really starts to eat at your soul, so it's nice to get away from it all, when I get the chance.

The fun thing about doing anything with F is that the world's open. We're comfortable drinking beer and eating onion rings, or having a fancy meal at a classy restaurant. Our man dates are beginning to get elaborate.

What was nice though was that I had a chance to bounce something off of F that's been bothering me. I don't know what my style is. What I mean is that when I got dressed in the morning, I didn't know what to wear. I settled on jeans and a cream color sweater and tennis shoes, but that's not really my style. It's the dress code for people that don't care what they're wearing. The malls are full of these people.

During high school and college, my style was shorts and t-shirts, like the rest of college-attending America. Once I got to med school, I realized that I needed a look, a collection of clothing that was me. Except I didn't know what that was, and I'm still not entirely sure.

Along with this, I don't know what kind of car guy I am. I like sedans that are small and zippy, like the Saabs and the BMWs, but is that me? I got my Honda because it was expedient, not really because I loved it. I've grown to love it, but that's a far cry from being a Honda guy.

And this sort of tops out with the fact that I don't know what my type of girl is. I honestly don't have a good handle on what I want in a woman. I know I want someone with some brains, someone with some class and refinement, but beyond that, I can't say.

So, I've been spending time lately trying to figure out what kind of a guy I am, and what kind of a girl I want. It's somewhat taxing, trying to figure this stuff out. I mean, it's hard enough to shop. It's even harder when I don't know what I want. And that sort of exemplifies my romantic life: it's hard enough just dating, but when you don't even know what you're looking for, it's that much harder.

I remember when I was 13 and was in Macy's and saw a green fall coat on a rack for $80 that I had to have. It was sheer happenstance. I was going up the escalator and it was in view. I walked right up, grabbed a green one off the rack, and that was it. Sometimes, I wish that the rest of my life could line up so easily.

The mother of all incidental findings

The nice thing about being on call is when you get an admit for chest pain, rule out MI. The work up is the same every time and it's an easy in and out, usually less than 24 hour hospital stay.

Every now and then though, you get something interesting, and that's the enjoyable part about medicine sometimes. You'll get something that surprises even yourself. My last call, I was examining a chest pain rule out patient and I found an undiagnosed abdominal aortic aneurysm. It was hard to miss: it was large and in charge. And I informed the patient of the risk of rupture and such.

But what really shocked me is that she's known that it was there for months now, and in that time, she's seen doctors and no one's caught this before. I mean, it's bouncing out of this patient's abdomen and how can I have been the only person to catch it? It's certainly not causing the chest pain. The patient's lucky that there was non-cardiac chest pain needing R/O MI so that we could find this AAA.

Of course, lucky is a subjective term. Risk of rupture is big and the surgery of AAA is about as high risk as they come. I am guessing that it's probably the riskiest 'normal' surgery, elective or not. So maybe there's something to living in blissful ignorance and dropping dead. So you tell me who's lucky.

Being alone is not that lonely

I felt lonely today, and I don't have a good reason why. I just felt lonely. It was very unusual and strange. It was like I needed someone else to be here, not for any good reason other than to not be alone. I spend most of my time alone. When I lived with other people I didn't really hang out a lot. I did pretty much what I do now, but I've noticed things lately.

I spend more time at work than I have to. I've seen and visited patients that I didn't have to. I've seen several patients in the hospital who I'm not taking care of. I just did it because I felt like I should. This sounds very... altruistic, but it's not for them. I know that, if I am willing to be truthful. It's for me.

If you get lonely enough, you find yourself doing things like that. You seek out human contact just because you want someone else to be there. I'll admit that I have a hard time with it sometimes.

And it's not even the standard 'I'm alone in the world and no one will ever love me' deal going on. It's just this feeling in my life that I need some human contact more meaningful than what I'm getting.

Sometimes, I wish that I still lived at home with my mom. I get along well with my mom and I miss hanging out sometimes. She can be frustrating and difficult at times, but you know, that's mothers for you. And I know this sounds so trite, but what I'm looking for in a woman isn't too different from my mom. I want someone who's not me, who has opinions and is outspoken and driven and never afraid to get her hands dirty, but still needs someone to hook up her answering machine.

So anyway, I called my mom and left her a message. I wonder if when I have kids and they're all grown up, I'll get random messages on my voicemail.

the absence of a car

the absence of a car
the absence of a car,
originally uploaded by ifinding.

If you live east of the Mississippi and North of the Mason Dixon line, you know which snowstorm did this. The snow is finally mostly melted today, which is nice. I like the warmer weather. As you can see from the photo, my car was nearly buried, and it took about 15 minutes to dig it out.

There are times I find that I really like the inclement weather aspect of the Midwest. It's nice to have honest to God seasons. But really, I guess that I do miss living in the big city. There's something to be said for not having to dig your car out.

Being Catholic

Sometimes, it's strange being Catholic. There's a certain oddness to living a Catholic life, one full of seemingly endless guilt, but somehow being cheery about it. The funny, and radically different thing about being Catholic is that there's no attempt to save the world. If you ever meet Catholic missionaries, they're not like Mormons or Jehovah's Witnesses. There's no door to door and bible thumping. They do shit. They work with prisoners. They aid the dying. They dig wells and feed children and serve food to the starving.

The one thing about being Catholic is that it comes with a certain mindset. Some might call it apathy, but after being Catholic for... oh... 20 years now, I've come to realize that there is something to being Catholic. You do what you can and let God to the rest.

I can't save my patients. I can't stop the cancer from growing. I can't stop the heart from failing. I can't stop the bacteria from invading every organ. I can only do what I can and let God do the rest.

The thing about being Catholic is it's so blue-collar. Let someone else preach. God's work isn't in talk, it's in deeds. There's something very reassuring about that.

The other funny thing about Catholicism is that it comes with the inherent understanding that the fights that are hopeless, the ones you'll never win, those are the ones that are most important to fight. Maybe that's why it seems like there are so many Catholics in internal medicine... or maybe it's just me.

Even God rested on the 7th day

Today is my first day off in 11 days. I've been working a week and a half straight and let me tell you, it sucks. It's nice to relax for a day, take things easy. Being sick helps, because I don't have the motivation to do anything right now other than watch bad TV movies and sip tea. It's a nice life.

I do feel a little ansy though. I feel like I should be doing things, other than shoveling snow and trying to keep warm. You know, sometimes, stagnation can be a boring place. So I'm trying to clean up a little, get things back into order. It's not working out so well.

It's beginning to dawn on me that in less than 6 months, I'll be a senior resident, and I'll admit, I feel entirely unprepared. I don't feel ready. I'm scared as shit, actually, and that's a motivation that I've never had before. You know, even as a junior, that's not as scary because you know you have a senior looking out for you. Once you're a senior, you're a top dog.

I want to do outpatient medicine. I don't like the hospital. I didn't go into medicine for the action. I didn't choose this for attention or fame or whatever. I like medicine because I get to meet people and play a part in their lives, for the better hopefully. That's what I want. The hospital? Someone has yet to convince me that the hospital is a force for good.

Viral gastroenteritis

If you ever want a day off from work, there's one surefire way to get it, and the answer to your dreams is viral gastroenteritis. Pain, grief, headaches, injuries, they all pale in comparison to viral gastro. There's nothing quite like stuff coming out from both ends to put the fear of God into your co-workers. The only downside? Diarrhea or vomit. You take your pick. And if you're extra special, you can get both at once.

Another plus is the fact that now I know why people advance diet as tolerated. I've had one solid meal in the past 3 days. I like to know what I put people through in the hospital. After all, you should know what you do to people when you write the order, right?

So, I've had a little free time on my hands as a result, and I spent it constructively, watching LoTR: Return of the King, extra special 4 hour version. It's really the only time in life one has to dedicate to watching something so monumentally long in one sitting.

It'd also given me a little time to think, for a change. I spend so much time doing and doing and doing, and not really thinking. I process vast amounts of information. Sodium is 124, BNP is 1520, bibasilar coarse rales are present, 5x5cm stage 4 decubitus ulcer is unchanged in appearance, mood and affect are improved with Zoloft. I spend most of my day just sifting through craploads of information and doing stuff with it. Giving meds, ordering tests, doing procedures.

I don't really think at all. There's no thought to it. It's just GIGO. So it's nice to just think a little, just lie in bed, waiting for my colon to process the Gatorade, and think.

That's DOCTOR asshole to you

Graduating med school, there was about 15 days when I thought it was way, way cool that people called me doctor. It was kind of sexy, in that way you feel good when you've done something that only took the better part of 8 years. I was a doctor. I was better than other people, common people.

That thrill wore off as I drove by the scene of an accident on the highway and people were pulled over, and a car had run into a tree, and I realized as I drove by that they might need a doctor, and that doctor was me.

Thankfully, they didn't need a doctor. I couldn't have been more relieved. But it's about then that I realized, much like everyone else who's in medicine has realized before me, that the only time people call you doctor is when they want something from you. Being a doctor stops being sexy when it's 3AM and the nurses on one floor in particular have paged you every 9 minutes for the past 3 hours.

I think a lot that I don't really want to be a doctor. There's a lot about medicine I don't like. But it's always the same: I can't see myself doing anything else.

Things you overhear in the cafeteria

There are certain things you never really want to overhear in the cafeteria. There's a certain anonymity in the cafeteria, since most of the time, different services have nothing to do with each other, so you can sit next to the OB/GYN team and not know it, and so on.

So, as I was sitting eating my on call dinner, I overheard one of the consultant teams on my patients complaining about us, the medicine team. The worst part about overhearing them? I agree with them. I wanted to discharge my patient, but my attending disagreed and we consulted these poor folk, who think I'm a prize idiot.

I really don't like the thought of people thinking I'm an idiot because of someone else's decision, but it's hard to say where my loyalties should lie.

On the one hand, I should stick with the medicine team, right or wrong. On the other hand, I agree with the consultants; my patient should go home. And then, this horrible nagging thought sneaks in my head: I'm supposed to be on the side of my patient...

You must want to do general medicine

I was talking with one of my attendings about the hospital and how I really don't like inpatient service. It sucks. I hate taking care of people in the hospital. I'd much rather see them in the clinic. In the clinic, I can shuffle things around and do what I like. It's more social. It's more casual. Her reply to me: you must want to go general medicine. No one else likes clinic. Heh, she's right.

I was talking to a medical student today, and somewhat fondly remembering the... fun that was 3rd year. There's something quite adventurous about trying to figure out what you're going to do with the rest of your life. I mean, it's really quite exciting. Now that I'm heading down the path of locked into a career, my life just doesn't seem nearly as exciting. But on the plus side, I actually worked harder during med school than I am now.

Scent of a woman

I saw the movie Scent of a Woman on TV tonight while I was getting ready for bed. It's a really nice movie, because it's a world that I know. Y'know, unless you've lived it, it's hard to imagine a prim and proper world, governed by etiquette and class. It's hard to imagine because it really doesn't exist in reality. It's a collective fiction.

Still, it's nice to see. I miss it sometimes, the formality and the grace. The funny stuff is what gets you sometimes. I was going to church the other day and this little boy ran ahead of his family and held the door for them, and for me. I couldn't help but think that this little tyke was well on his way.

People think nothing of etiquette, and I can't say I blame them, but I think that it's a little sad that it's hard to find a decent handshake anywhere in the Midwest, and that common courtesy seems like a thing of the past. Someone sneezes and I'm the only one who says God bless. Someone cries and I'm the only one to offer a tissue. It's attention to detail. Life, like etiquette, is a matter of attention to detail.

Post call days are guilt free

General Tso's
General Tso's,
originally uploaded by ifinding.

So, after a luscious breakfast, a morning of cartoons, lunch at Wendy's, and a well-deserved nap, I decided that this, my post-call day off (a technical 24 hours outside of the hospital), would best be spent eating take out Chinese and watching "Harold and Kumar go to White Castle." If you've never seen the movie, it's amusing, and also, a window into the world of 2nd gen Asian-Americans. I was happy that this movie got made, because it is to my knowledge the first big budget, non-martial arts/john wu movie that headlined with Asian actors.

We have a little saying in the hospital. Post call days are guilt free. You can't feel bad about anything post-call, because your life sucks enough after spending anywhere from 24 to 30 hours in the hospital.

I'm getting used to blogger, and I'm starting to like it. Maybe I'll stick with this, although flickr is a little... difficult to use.

Tough love in the hospital

You want to know the worst thing you can hear coming out of the mouth of your evaluator? "Well, you seem to do a good job of sleeping through conferences." Panic, panic, panic.

I was outright mean for the last couple days, tough love in the hospital. I mean really, I'm growing more and more intolerant of people that don't have the simple desire to get better. What am I supposed to do for someone who is unwilling to take care of himself? It's rediculous. I spend my mornings telling myself DON'T ROLL YOUR EYES AT THE PATIENT! That's my morning.

So it's been tough love, things like cutting people off from pain meds, kicking folks out of the hospital, stuff like that. And believe me, people are not happy. I've had folks from every end of the hospital giving me a piece of their mind. I remember sometimes that my mom told me that I should be the kind of doctor who is nice and kind and shouldn't be mean, but man, sometimes, mean is what people need. Nice is for pediatricians. I think mean is something valuable to an internist.

Tops were that I've been threatened with litigation a whole bunch of times now. It's to the point where I can't even get worked up about it. I mean, when you know that you didn't do anything wrong, it's hard to get too angry, but man, I'm sick of it. I have a new saying these days: "the sign on the building, it doesn't say 'hotel' does it."

PS - Are you liking this format better than the old way? I also got a flickr account so that we could get the full effect of switching over.

My muse

Zoo coke machines
Zoo coke machines,
originally uploaded by ifinding.

A lot of people have... photography themes. You know, they photo document a theme. For a long time, it really bothered me that I, a self-professed amateur photographer who went digital before it was cool, couldn't think of anything to photo document. It was aggravating. Then, I sort of settled on this idea: vending machines. I do have a sort of unholy fascination with them. So, I thought I'd include this cute picture of a coke vending machine at the zoo. But I haven't really followed through with this, as I don't take pictures of anything these days, calling into question my need for a new d-cam.

What's going on here

It bears mentioning that the reason why this is going on is a test: do you prefer (or care for) one version of the website over the other. The blogspot site is not as... friendly, but it's more likely to be updated regularly, it's more functional, with comments, RSS feed, and other bells and whistles.

I haven't decided yet whether I'll go with blogger or whether I'll go back to manual editing. We'll see. I'm not terribly picky, but there's something rather rewarding about editing a site by hand.

Anyway, I threw this up here so you could get an idea of what this will be like, if I decide to go with it, and whether you'd like the comments and RSS, or if it didn't really matter anyway.

The challenges of firewalls

So, I'm editing the format of this blog, trying to get it simplified and back to the sort of ease of use that I had with my old blog. Ah, I really miss the ease of my lovely manual blog. Technology comes with its troubles.

Worthy of note is the intense hardship of trying to edit this thing from behind the hospital firewall. I'm on call, and that makes trying to edit this thing a pain in the ass. I'm proxied and everything, but Firefox is giving me trouble with the main blogger page, for who knows why.

Anyway, I'm still getting the hang of this, and it's kind of fun, so far at least. Maybe this is the future? Now I need to figure out how I can change the settings for the archives...


An editorial note: 8/29/09

For those of you who may be wondering, in January of 2005, I transitioned from a manually edited blog to Blogger. It was a rough transition, but allowed me to be more prolific. That being said, it also meant that I had two websites: my blog here and my previous blog. And that was fine until I decided to take down my other website in 2008, leaving only my blogger account.

I am currently going through several years of entries (1999-2004) and trying to put up some selected posts that are worth reading, and edit out the ones that reveal entirely too much about myself and have to be censored. But that process is slow and painful, and I'm not even done with 2004 yet. It doesn't help that I was terribly prolific back then.

So if you're looking for older entries, check back periodically.