rayofdiana

05:15 pm: Moving
So, obviously I don't write here much. I do read a lot, and I'm glad I can use this to keep up with people I might not otherwise keep up with.

If y'all want to keep up with me, I think I'll be writing more here:
http://whitecoatknitter.blogspot.com

It'll be more knitting, with bits of life thrown in. I won't be offended if you're turned off by the knitting.

08:30 pm: Moving
In two weeks, I'll be mostly moved into a new home. It's the bottom floor of a house, so we have a porch, yard, our own washer and dryer, and all of those other amenities we could only afford in Cleveland. And it's walking distance from our favorite pizza place, the one where you can get goat cheese and whole roasted garlics. Me, Brandon, Ganymede, and a new kitten who is probably getting herself born right about now.

I hate moving. I hate carrying and sweating and not knowing where things are and living off of paper plates. But this move won't be as bad as the last one. I'm not alone in planning it this time, and I know the area. We have lots of friends who are not moving, so they'll come out and help us (and then we'll buy them pizza). I just have to keep remembering how much better my quality of life will be. Instead of passive-aggressive, or psychotic, or clueless-at-life roommates, I'll have this wonderful, responsible man who I know and love. And our kitchen is going to kick ass. And Ganymede will have a little sister.

Come and visit!

(Ooo...Marie, if you're driving across country using 90, you should hit up Cleveland on your way.)

01:09 am: This is what I do when I get a weekend off
I haven't written anything about Virginia Tech before because it seems trite and because I don't exactly know what to say.

However.

I kind of want people to know that it means something. I lived in Blacksburg from the ages of one to five. I don't remember a lot, but I know both of my parents worked at VTech. And I know that the preschool I went to was on campus, in the child psychology department. I remember when the mascot (a Hokie - a sort of giant chicken thing) came to the preschool classroom and I was very scared, but I liked the pompom I got from the Hokie. I remember the "Duck Pond," which might have been its name or might have just been what I called it. But there were ducks and we would throw bread to them, and at one part there were lots of catfish. There were people who I went to elementary with (in another smallish town in Virginia) who went to Virginia Tech. I don't think I know anyone involved, but I know the town. I know the places, the buildings somewhere in the back of my memory. I recently learned my parents sometimes think about retiring there. When I talked to my dad, he said, "You know, this happens in Iraq every day," but I know he's pretty shaken.

So, yes. Nothing profound. Nothing all that meaningful. But it's there.

09:47 pm: Learning
In general, I'm a pretty compassionate health practitioner. I'm not good at building that professional distance. I worry. I worry about the recreational drugs my patients are doing. I worry about their financial states. I worry about the safety of their homes when I send them out of the hospital.

However.

I'm not good with mental status problems. I don't like it when patients are so out of it that they don't know what's going on and can't communicate what hurts. It scares me. I think I've managed to convince myself that my intelligence is all I can rely on no matter what, and seeing these patients makes me realize how false that assumption is.

There's a woman on our service. I can't say details due to privacy, but suffice it to say, she's been having mental status problems because of her medical problems, and they're getting worse. Much worse. Every day. Today we had to put a nasogastric tube in her to do tube feedings because she isn't eating or drinking by herself. While we did it I held one of her hands, the resident held the other, and my intern put in the tube. We were holding her hands both to calm her and to keep her from pulling the tube back out. I'd been kind of scared of this woman before; she was so unpredictable and embodied my fear of losing control. But I found myself patting her hand and talking to her to try to calm her. And I learned this compassion for this woman, whose situation was so alien to my own. It might be natural for most people, but for me, it took letting a certain guard down: admitting that we weren't so different, which is terrifying.

07:41 pm: They let me do things....don't go to a teaching hospital
Today I took out a jugular central line. A central line is a catheter that is threaded from a major peripheral vein (jugular, subclavian usually...sometimes femoral) into the right atrium of the heart. It allows for delivery of meds straight to the heart in massive volumes.

It's a really simple procedure: take off the tape, take out the sutures, yank it out, apply gauze. But it's wild when you have it in your hand afterwards, and you're thinking, this used to be in this guy's heart. IN his HEART. And now it's in my hand.

11:03 pm: mood elevating
We went to the Cleveland Film Festival tonight and saw "World's Best Commercials."

Check out this:

http://youtube.com/watch?v=fVjP3rsSrxY

and this:

http://youtube.com/watch?v=vR5thHKSF9Q

Probably better on a movie screen, but still pretty funny small.

05:09 pm: Thwarted
Why do I always pick advisors who are impossible to get ahold of?

How hard is it to email me back? Or give me a phone number that's current?

12:28 am: done?
Today I finished:

Step I of the USMLE (scores expected in 3-6 weeks)

and

my Icarus shawl in black, lace weight alpaca.



I'm way more excited about the shawl.

Tomorrow: San Diego. Zoo!!!

08:44 pm: Better than the alternative?
So, my new roommate, who is quite nice, is also a touch odd. And naive. She's been here a week and a half, so we're starting to get settled. She's nice, her boyfriend is nice, all is pretty much well. Especially after the chaos of the previous roommate.

However.

She was this tendency to talk about me as though I'm not in the room... When the only two people in the room are us. For example, the other night I was cooking at the stove, and she was putting groceries away. We'd been small-talking when she opened the tea/coffee/snack cupboard. "Ooo!" she exclamed. "She has marshmallows!" (I guess it's really the tea/coffee/snack/marshmallow cupboard?) "Yes," I responded, assuming that the she was me, since I do keep marshmallows in there. "They're kind of stale, but you're welcome to them."

Things like this happen a lot.

11:55 pm: I live here
Like everyone else, I'm getting all reflective about holidays and what this new year means...blahblahblah. Things change, and I think this time highlights the changes. Maybe it happens this way because we see our family and old friends and get our old selves reflected back at us in expectations. And we find that the old self is different.

Things that change:

I took down Christmas this year. By which I mean I undecorated the tree, put away the creche and the santas, and took the extra leaves out of the dining room table at my parents' house (with Dad and Brandon's help, but I was Team Leader). My mother flew to China the morning of the 3rd, so she wasn't going to be around to do it, and I didn't want to leave my father to do it alone. I've helped put up Christmas for quite a while now, but this is the first time I've been such a main part of taking it down. There was something sobering and unpleasantly adult about it.

Brandon came to Minneapolis. Not only is this the first time someone I'm dating traveled to my parents' house to stay with my family, it's the first time my parents didn't make an issue out of sleeping arrangements. I can't tell if this reflects a new comfort level for them or if it's just a sign that my mom really, really wants grandkids NOW.

My two aunts and I went to the liquor store together. Something about buying alcohol for your parents always seems weird.

One of our close family friends is an otolaryngologist (ear, nose, throat). We've done Thanksgiving with their family half a dozen times. My parents travel with them. We're close. The day after Christmas, I followed this doctor friend around the OR and his clinic. We straddled the relationships of attending-med student and family friends. He started to treat me as a colleague, which was excellent but also weird.

At one point I was hanging out with people I knew in high school. And I remembered how overtly sexual I used to be. And how flirtatious. They expected me to be like that. And I realized that although I still kind of think of myself that way, I'm not. As much. The sexuality is a little more veiled, and the flirtation is more focused and appropriate. I think it's a good progression.

Other events: visiting Northfield, seeing Ris, Lauren, Rachel, Dana, Grant, Meredith, Kaaren, Em, meeting Rachel and Lauren's adorable kitty, finding that two of my favorite cheap restaurants closed (sigh...Las D and Tibet's Corner...), and starting the Icarus shawl in a black laceweight alpaca.

Happy New Year.

02:29 am: Not sleeping
I was all irritable and having trouble sleeping, so I decided to watch the L Word.

You people did not tell me that Dana dies. Not cool. So, she died, and then I was all upset, so I had to watch another one. Only, that one was all about the Dana memorial services and the creepy weird Alice/Lara thing. Not cool.

So now I'm really tired, it's just past 2:30 a.m., I'm still pretty irritable, I have class in less than 5.5 hours (and it's pharmacology...not good), and my day is packed solid tomorrow. No napping. But, hey, interviewing criminals with psychiatric problems while on no sleep sounds smart. And safe. (No, seriously, that's what I'm doing tomorrow afternoon. Fun.)

Maybe next time I'll try warm milk or something.

11:55 pm: My nerves are unsure of what to do
So...I didn't mean to be tipsy. My bigmeanexam is on Wednesay. I've been studying my ass off. The only times I'm really not studying is when I am in transit or in the shower. Anyway. Apparently my fooling around with birth control has resulted in me being a huge lightweight. Huge. As in, this much wine should not do this to me. Anyway.

I found a new coffeeshop to study at. And by "found," I mean some people recommended it to me and then B suggested we go. So we went (after buying an external hard drive and the fall Vogue Knitting! Fun!). And it was fabulous. It's called Phoenix, which is a promising start. They have a record player, and they let us pick out records. I'm not sure if we tipped well (we did) or if they felt bad for us for our frantic studying. We chose from Dylan and the Beatles and Bruce Springsteen and also Let a Frown be Your Umbrella by Sesame Street. And they have TWO unisex bathrooms which are very prominently, purposefully unisex. And in those bathrooms they have quotes by Emerson and Lily Tomlin and such written on the walls. They have real food and homemade soups and french press coffee. The lighting is bright enough but not glaring, and there are many outlets. Basically, it's a lovely new study place where I am reminded of bits of me that I've been ignoring for awhile.

Sometimes (often) I miss my community of GSC folk. We are in short supply here.

02:03 pm: 10 days to go
Neuro continues to beat all of us down. It's just hard. Really, really tough to remember all of the complicated pathways and how they fit together. It's oppressively overwhelming. And since my building is switching from boiler heat to furnace heat there are men putting in duct work all the time and not allowing me access to anything besides the bedroom, bathroom, and kitchen. Which is obviously making the control freak in me go into panic mode. So when the men show up, I go to Starbucks and sit there for 8 hours or so trying to learn these damn pathways. Last night, a group of us drew pathways on the school whiteboards until 1 a.m. It's mind numbing.

I often feel that because memorization of picky details comes more easily to me than most people, I'm not allowed to feel overwhelmed, to complain, to need support. Because the people I'd look to are struggling too, usually more so.

When I was in middle school I won a number of first place ribbons and trophies at the county and state fairs in 4-H food projects (Franklin county, state of Ohio). It wasn't because I was the best cook. Not by far. It was because I was the best at memorizing that an easy way to peel an orange was to immerse it in boiling water for 10 seconds first or that quinoa was rich in both B vitamins and protein (I also won a number of "Nutrition Knowledge" ribbons). Meanwhile, I actually made taboulleh for one of my projects ("Great Grains" - gotta love those cheesy 4-H names). While my competitors made elaborate yeast breads and struggled to keep whole wheat pumpkin pancakes with homemade compote warm for presentation, I waltzed in with a simple recipe of my mother's and grabbed first place with my ability to memorize. Sure, the judges were probably surprised that an 11 year old knew about bulghur, but that only takes you so far.

And there's my fear. Yes, I'm good at memorizing. It's probably genetic, or maybe mom fed me lots of omega-3s or something when I was developing those pathways (damn pathways) as a child. Go, hippocampus. But how far will this take me? What happens when I have to do something with it? Sure, I do okay on multiple choice tests. Unfortunately, that's not life. And in times like this, when I feel like even my memorization skills are failing me, I have to wonder what I'm left with and whether it will be enough.

03:47 pm: It's a Summer and Smoke kind of day
I've been feeling down (school, apartment, various interpersonal challenges), but what made me feel more okay was this theater review in the New York Times: http://www.nytimes.com/2006/09/14/theater/14summ.html?_r=1&8dpc&oref=slogin

It just nails how I feel about Tennessee Williams in general and Summer and Smoke in particular. It speaks to how I felt when I saw the Guthrie production and how I felt most of the time anyone at Carleton tried to do Tennesse Williams (with a few obvious exceptions...some people were made for Streetcar). I love it on the page, hate it acted. Because people always want to go to the melodrama without giving it sincerity.

I'm not sure why I feel better now. But I think I do.

10:32 am: Feeling victorious, despite the pain in my left ankle
I just ran my first 5K ever. Ever. Because, people, I am not a runner. I do not run. Yet, somehow when I saw the Out Run Ovarian Cancer flyers at my gyn-onc research office a month ago I felt inspired. And so I've been "training" for the past month. Brandon got me through the first couple weeks of deargodIhatethisIwilldie time and came with me this morning and ran slow with me even though he totally could have kicked ass if he'd been by himself. Beth, the roommate, came too and ran out ahead of us. My goals were to finish, to only walk when drinking water, and to make it in 40 minutes (which I know is not ambitious, but I needed a time goal I could actually achieve...I'm not built for speed). My momma was super excited for me and mailed me some fancy running socks last week as a good luck gift. She's super cute.

The race went pretty well. I walked for a tiny bit at the halfway water point and made it in 32:03. Which I'm proud of. Really proud, actually. I was the girl running 11, 12 minute miles in junior high and elementary. And only one 11 or 12 minute mile at a time, certainly not 3.1 of them. And really walking most of the mile. Like I said, I do not run. This is pretty amazing for me. Beth got 29:15, because she is awesome. It was both of our first race, and we both feel like we want to do it again. Breast cancer 5K in October, maybe?

Ooo, also, about a minute after I finished I ran into my PI from the summer (a super intense gynecologic oncologist). I definitely earned major points by being there, proving that I care about ovarian cancer in nonacademic ways as well. Also, a lot of her studies are about diet and exercise intervention, so I also proved that I'm on board with the exercise.

Anyway, I'm proud, dammit.

08:37 pm: You know you're in med school
When it's totally normal to look across the living room and see your roommate muttering to herself, alternately staring at the ceiling and peering into the human skull she holds in her hands.

10:00 pm: PR + Neuro
I love that I am sitting on my couch, laptop on the coffee table, no fewer than five text books opened to various pages. And I'm only pretending to study because Project Runway is about to start. Yet, I really do have to learn this stuff. Neuro is hard. The brain, as it turns out is complex.

I love this stuff.

04:48 pm: It's going to be hard to sell Case Med as the best choice right now...
The dean of our med school just announced his resignation, effective September 15. Our "interim dean" is the same guy who you may recognize from his role as "interim president of Case at large." See, the Case president resigned kind of recently due to something about finances, blah, blah. Dean Horwitz (med school dean) was heard saying that if he'd known that the presidency was unstable he wouldn't have come here at all. And then he resigned.

See, he's pretty much the reason I'm at Case. Yes, they offered me more money than anyone else, but the reason I actually wanted to come here, wanted them to want me back, was because of the dean's vision. When I was interviewing, he'd only been here about a year and a half, and already he was making changes. He started a required M.D. research thesis. He cared about public health. He used gender neutral pronouns. He instigated new curriculum change (effective for this year's first year students). He promised to make Case rise in the ranks, to make Case a big name medical school. And now, when the going gets tough, he's bailing.

And where is he going? He's going to Stanford. Instead of staying and working to build a med school with a household name, he's running to the comfort of a pre-made name, leaving the projects he started left without clear leadership. None of his projects have been tested. Who knows what will make it in the aftermath.

I could have gone to Rochester, which isn't a bigger name than Case, but is a tad more committed to the things I care most about. Hell, I could have held out, sent Penn a packet of interest, and almost certainly gotten off their waitlist. And then I'd be at a pre-made name. I'm not saying I necessarily regret coming here, but I do feel a bit robbed, betrayed, fooled. He was a big part of my decision, and now he's leaving. And I'm pissed.

03:40 pm: Dx: Allergic to my birth control
This is an entry about my gynecologic health. If you don't want to know such things, go away.

( Gyno fun )

11:20 pm: I've been thinking a lot about the future. Granted, I've always been one to do that, but this time I'm thinking about it less romantically and more with a sense of anxiety. While in Portland, I bought this book: Flux by Peggy Orenstein. Some of you probably read her book Schoogirls for Lance's class. Anyway, it's about women, primarily college educated women, in their 20s, 30s and 40s and how they negotiate work, partnerships, and children. It simultaneously manages to be both painfully non-scholarly and close enough to home to be terrifying.

This book is heartbreaking. Almost all of the women struggle to earn respect and time - both at work and at home. It's the sort of book I'd almost want to include as part of premarital required reading for a fiance. Basically, the take home message is that if you're an ambitious woman, it's hard to make a partnership work. And if you end up with a man, it's next to impossible to have an egalitarian marriage with regards to childcare and housework. And if you do make it work, he'll probably die first and leave you a widow.

Out of all of the women in the book, there was ONE who made it work. She had a nanny and a housekeeper and a lawn person. When I was talking with my PI recently (an extremely ambitious gyn-onc), she told me that the way she made it work was by having a nanny, housekeeper, and Italian houseman. (When I asked what an Italian houseman was, she responded, "You know. He cooks my dinner?" I still don't exactly understand.) Okay, so I can make being a doctor (potentially a doctor of a two doctor household) work by having a nanny and a housekeeper (we'll keep the Italian houseman out of the picture for now). Am I really okay with that? Both with the hiring out of my parental duties and with the inevitable class issues? I mean, if I didn't work, I'd go nuts, and then I'd be a bad mom. And a nanny would be better than daycare, I think. But am I okay paying someone less educated a fraction of my salary to care for my children? Yes, I'm sure I'd be a good employer (benefits, no tax fraud, high salary, respect, etc.), but there's still something disconcerting about it.

Mom and I talked about it a while the other night, and she seems to think that it makes total sense to have both a nanny and a housekeeper. While it's reassuring to have her support, to know that she doesn't think I'd be a bad mom if I went that way, I'm not sure I think that. I know I have years to think about it, but probably only, oh, minimum of 6/7, maximum of 9/10. It depends on a lot of things: whether I'm partnered, whether I go for fellowship post-residency, whether my residency/fellowship is child/pregnancy friendly, whether I go academic or private practice...

Anyway, at least a friend promised me last night (while she was drunk) that when we both are widowed, we can live together Golden Girls style. Which is why women friends are awesome.