No time for prose

I'm making it. I'm actually done with my first rotation as of tomorrow at noon. Sadly, my second rotation starts tomorrow at 6 p.m.

As with anything, there's the good with the bad.

The bad:
-the hours: doing this in 14-27 hour shifts is not ideal. If I could do this in 12 hour shifts, my life would be good.
-being an intern: we are the bottom of the totem pole, which means we do the unpleasant stuff (post-partum rounds at 5am, "foreign body removal," responding to the call line).
-never being rested.
-never having enough time at home.

The good:
-the beauty of 4:45 am light, driving over the river with the skyline on one side and the bay on the other.
-the people who are in this with me.
-a husband who is really taking care of me.
-patients who remember me and ask for me by name.
-being there for the patients, in the good and bad moments.
-and, of course, guiding the slimy, squirmy new lives into the world.

The good really does win out in the end.

Starting to feel "real"

Remember in the Velveteen Rabbit? How you know when things become real because the get all beat up and whatnot? Yeah, I'm pretty sure that's what it's like when one becomes a "real" doctor.

It's been a hard 6 days (only 6? yikes...). But I'm starting to get it. A lot of the struggles are systems based: who to call for what, what I'm expected/allowed to do without an attending/who's nice/who isn't, etc.

Yesterday, a nurse paged me:

"Dr. G, I'm calling about Patient X. Dr. F came up earlier today to evaluate her bleeding. She gave Pitocin. But the patient is bleeding again. A lot. Gushing."

My stomach jumped to my throat. I pulled it together, asked about her vital signs, asked if she had an IV and what was running. And then I said I'd be right up.

When I walked into the room, the nurse gave me a run down of the patient's bleeding. She'd had a Cesarean section 11 hours earlier, and she'd been alternately trickling and gushing ever since. She was tired, pale, and still bleeding. I took a breath, and reached for a pair of gloves while asking for a fluid bolus and a stat CBC. I did an internal exam and found a few small clots, which I removed. Suddenly, I felt something shift inside me, and the "real doctor" in me came out. I turned to the nurse manager who had joined us, and asked for 2 mg of morphine, because I knew that whatever I was going to do next was going to be painful. Because the patient was "stable," I knew I could wait for pain relief. But I also asked for more meds, some of which I planned on inserting in the patient's rectum (yeah, no one likes that, but it works). Once the morphine was in, I did the most aggressive exam I've ever done, medicated the patient, inserted a speculum, and removed about 200 ml of clot from the uterus. Then I watched the cervix, saw that it truly wasn't bleeding, and felt the uterus contract into the firm ball that we love.

I'm still not sure how I knew what to do. It was almost an out of body experience. I kept communicating with the nurses and the patient, telling everyone what I was going to do and why. I know that I told the patient over and over again that we were going to take care of her, that she was going to be fine. I heard my voice, calm and steady, even though my thoughts were frantic: please stop bleeding pleasepleasepleaseplease. But she did. I did the right things, and she stopped bleeding. And she didn't even need a transfusion.

And later, in my inbox, I found an email from the nurse manager to me, my chief, and my program director, telling us that I was very impressive, both "professional and patient centered in a somewhat hectic situation." And I felt like a real doctor.

Dear Pharmacist

Despite the fact that I do not feel like a real doctor yet, my DEA number is real. It is not a "pseudo-DEA number" just because I'm an intern. My patient would really appreciate it if you didn't give her such a hard time about her pain meds. It is not her fault that she is indigent and sees an intern for care. She's still a person.

Worst first day of school ever

I've been busy. For a while, I was busy doing this.

Then there was the graduating and the Italy (and the wine and the olive oil and the pasta) and the moving to Providence.

Now I am "orienting" to my new job/role/identity/life. I am practicing saying, "Hi, I'm Dr. G," with a straight face.

Thank goodness I kept my maiden name for the doctor world. One of my co-interns didn't, and she commented that when she introduces herself as "Dr. B" she has no idea who that woman is. At least the "G" bit is familiar to me.

The people here are amazing. I'm so happy with my co-interns and senior residents. Everyone seems really, truly happy here, despite the hours and the stress. I start on Wednesday. Wednesday at 4:30 am. Yeah, I'm not so excited about the hours. But it's pretty great. On Sunday, I shadowed for about 9 hours and delivered a baby for the first time since last September. I like babies.

Today someone asked if they could put a patient on my schedule for staple removal. My schedule? Oh, my clinic schedule. MY CLINIC. I have patients that are going to be mine (they don't know it yet, but they will be). Only easy patients right now (i.e. staple removal...something I've been doing for a couple of years now), but they will be my patients. And I will be their doctor.

Hijacked by life

Back! Not sure for how long!

Turns out when I said this blog would be wedding-y, I meant that wedding stuff would take over my life, thus leaving no energy for blogging. But, now that the wedding is 3 (3!!!) days away, I want to throw something out into the ether again.

Tamara tagged me, oh, a month ago in the take-a-picture-of-yourself-right-now-no-fixing-yourself-up blogging thing. Here I am. I had been experimenting with eye makeup, so if you look closely, you can see that one eye has a base of stila Oasis, while the other just has pink with no brown. Yes. You are excited. Also, I wear that blue shirt a lot lately, apparently.

Oh, and speaking of wedding: garter! No, I'm not throwing it, because that is, achem, not my style. No one needs to see my underthings in public. But...there are cute knitting patterns for garters, and I wanted to work with Cascade Fixation, so I did it. Knitty's pattern, ribbon I had laying around.
Also, on Monday I went to my mom's knitting group, where Annie Modesitt told me I would be a beautiful bride and advised starting the drinking early. Ha!

And...yes. People start arriving today. Things are mostly under control. There are still a number of projects (card box, centerpieces, jewelry for the moms), but it'll happen. And tonight we are going here for dinner. Win!

Warning

This blog might be obnoxiously wedding-y for a while. You can't say I didn't warn you.

We got our pictures from the engagement shot we did in mid-March Minneapolis. It was the first warm(-ish) day, so I braved the short sleeved dress. There was still snow on the ground, but, eh, I'm a Minnesotan. I can handle it. I really like our photographer. She's unpretentious and willing to do some creative, offbeat shots.

Today I finished drafting our menu cards, programs, and out of town guest brochures. They still need a few details that we haven't decided yet (i.e. song choices), but once we have that, I can print and cut and assemble! And getting those done will make me feel good for some reason. I like having tangible finished objects.

Also! I'm making jewelry for my bridesmaids, which is an awesome way to get tangible finished objects. Jewelry making is faster than stole knitting. By a long shot. I have 4/5 necklaces done and 0/5 pairs of earrings done. It takes me about 3.5 hours to do a necklace, because they're wire work and double stranded. Earrings will go much faster, so I'm definitely going to finish in time. I'll post pictures once I have a complete set.

Basically, things are coming along well, with one exception. I. Hate. The. Seating. Chart. We have enough people from very different groups that we really do need to have a seating chart. I just wish there was a magical computer program to do it for me. There are a lot of natural groups of 6 and 7 and 9. Our tables seat 8. Yeah. And there are 5 teenagers, who all want to sit together (I made the mistake of asking 2 of them yesterday). But which 3 adults get stuck sitting at the teenager table? I mean, 3/5 are pretty with-it, interesting 16 year olds, but still (the other 2 are 13...I'm not implying that they are not with-it or interesting). Grrrr....

I guess I've had a relatively stress-free planning process thus far. Now is the time to kick it into high gear. Or some other vaguely sports related metaphor.

One month

In one month, B and I are getting married. It actually feels real now. Tomorrow I go pick up my wedding band after getting it resized, and then, really, we have everything we need: each other, rings, license. We just have to get the officiant and ourselves to Minnesota, and we're good! Yeah, there's a lot of other stuff that "has" to get done, but if it didn't, we would still be married at the end of the day. And that's what matters. This is my mantra to keep myself sane.

Unfortunately, we also have to use this time to find a place to live in Providence. We've decided that life is too chaotic to buy right now. If we could invest more time in house hunting, it would probably be worth it. Since we only have a few days to actually look at places, we'd rather risk ending up in a lame apartment for one year than buying an undesirable condo.

Wanna see some wedding stuff? Sure, you do. Look! Flowers! We're DIYing because our date is, you know, the day before Mother's Day. It's better than February 13, but not by much. We're ordering through 2g Roses and Blooms By the Bunch, and we're saving a ton of money. These are our mock-ups, although the bouquet is kind of thrown together using waaay fewer stems than we will ultimately use. I ordered blue hydrangeas, white ranunculus, white and yellow roses, white stephanotis, blue and yellow irises, and white orchids. I think it will be really pretty. I mean, they're flowers: how ugly can they really be?
While we're talking about weddings, we might as well talk about...babies! My friend Jon and his wife Jamie are due...um...a few days ago, but she likes to bake them long, apparently. Baby is still firmly in utero, but I have a sweater for her when she comes out. It's Helena from Knitty in KnitPicks Swish. I really enjoyed working with this yarn. It's cheap, it's merino, it's superwash: what more can you want?

In other knitting...Mirabella (ravelry link) from Interweave made from Nashua Handknits. I'm turning it into a 3/4 sleeve pullover and maybe raising the neck, but the shaping and detail is from the pattern. Yeah, it's heavily modded. That's how I roll lately.



And this is my semi-secret project. So, just a picture for now. Also, I love Malabrigo laceweight.