The Wards – Day 19
I have the day off today. It was supposed to be next Wednesday but things got switched around for various reasons. This past Wednesday was a call day. It was surprisingly light as I took only 3 patients over the entire 24 hour period including the night float. (This is amazing). It was truly fortunate, too, as I had gone into the call with 12 patients. Yikes. Not too much new to report. Work continues to be busy, call day or not. Yesterday I had clinic in the afternoon, which is a whole different beast. One of my patients was from England and told me all about being 6 years old during the battle of Britain. She said she remembered being outside and watching dog fights between the British and German planes in the skies overhead. Her brother helped point out which plane was from which country and kept saying “we’re going to beat em!”. She watched a bunch of planes get shot down and people parachute. (This story was awesome, and we quickly stopped talking about her high blood pressure). After the story, she said how amazing she thought Churchill was and she wished today’s leaders could be more like those in World War II. I laughed and agreed with her. (Churchill more charismatic and a better speaker than “W”?!? No way.)
Last night I went to the movies with Gwen because I got today off. We saw Mystic River, which I had wanted to see for awhile. (I was unimpressed, see Mick Flicks). The rest of today will likely be filled with errands and bills as I’ve lagged on these things for some time. Tomorrow I’m on call overnight. Only 3 calls to go. I’m getting tired of the wards, though. Each day is a little harder to get up on time. I have no more days off until next Sunday, which will officially signify the end of the ward month (I took the last day off). So 8 days on the wards left and counting.
Time to go clean my house and get my oil changed.
The Wards – Day 15
Post call. I left the hospital at 3:45 pm today after working since 7 am yesterday. Call was steady. Not too heinous (and nothing like last weekend’s call), but steady. There was a lull after 2 am and I got 2 hours of sleep from 3:30 to 5:30 this morning! Then the regular buzz of Monday morning activity arrived and we put our heads down and did some work. (There was some coffee required). Its funny, but you definitely hit the wall sometime around 3-5 am of the night you are on call. But then morning arrives, and your body gets a surge of cortisol (a self-made steroid) with sunrise, and you wake up a little no matter how tired you are. This makes the post call mornings a little easier to deal with than the on call middle-of-the nights sometimes. The post call afternoons, however, are when you become completely useless. (One’s circadian rhythms switch into a physiologic equivalent of “Siesta” mode – which is why there is actual medical data that says its smarter to do things the European way, i.e. start a work day a little later, take a break after lunch, and go strong a little later into the early evening – I’m not kidding)
So I went into call with about 7 patients, and I left the hospital today with about 13 patients. I admitted about 8 or 9 patients yesterday and we discharged a couple today. So 13 patients. One of my interns has the day off tomorrow.
I came home and mucked around on the computer for about an hour. Then I fell asleep on the couch. Now I’m up eating a little dinner and typing this. I feel greasy. After this, I’ll shower, and go to bed. Then I’ll get up and go to work. The next call day is Wednesday, which seems way too close. The good news is that I’m now officially half way done with this ward month. I’ve done 5 of the 9 calls. Only 4 to go. Next week the official countdown to being done will begin. Finally, at the end of the last call day, I may just wander down to the ER, jump on to the main consultant’s counter, throw down my white coat, and belt out “I’m still standing…” by Elton John. It would be a musical-type performance, with a lot of high knee stepping, hip-shimmying, exaggerated head shaking, and prancing - all the while pointing directly at stunned ER physicians. That would be fun.
Before I forget, I should mention that Saturday night was fun. Gwen and I went and saw David Cross up at the University of Washington, and he was hilarious. Sheer genius. He covered lots of topics, but basically he spent about an hour and a half bashing George Bush, right wing Christianity (and religion in general), republicans, and the myriad of heinous country songs that “emerged” circa September 11th. He read a parody of MLK’s “I have a dream” speech as George Bush might, and it was awesome. He ended with a parody of that awful “Proud to be an American” song which was funny beyond words. All was scathing and hilarious. An excellent night. I officially thank Eryn for bringing the man into my life.
And I’m spent.
Post call. I left the hospital at 3:45 pm today after working since 7 am yesterday. Call was steady. Not too heinous (and nothing like last weekend’s call), but steady. There was a lull after 2 am and I got 2 hours of sleep from 3:30 to 5:30 this morning! Then the regular buzz of Monday morning activity arrived and we put our heads down and did some work. (There was some coffee required). Its funny, but you definitely hit the wall sometime around 3-5 am of the night you are on call. But then morning arrives, and your body gets a surge of cortisol (a self-made steroid) with sunrise, and you wake up a little no matter how tired you are. This makes the post call mornings a little easier to deal with than the on call middle-of-the nights sometimes. The post call afternoons, however, are when you become completely useless. (One’s circadian rhythms switch into a physiologic equivalent of “Siesta” mode – which is why there is actual medical data that says its smarter to do things the European way, i.e. start a work day a little later, take a break after lunch, and go strong a little later into the early evening – I’m not kidding)
So I went into call with about 7 patients, and I left the hospital today with about 13 patients. I admitted about 8 or 9 patients yesterday and we discharged a couple today. So 13 patients. One of my interns has the day off tomorrow.
I came home and mucked around on the computer for about an hour. Then I fell asleep on the couch. Now I’m up eating a little dinner and typing this. I feel greasy. After this, I’ll shower, and go to bed. Then I’ll get up and go to work. The next call day is Wednesday, which seems way too close. The good news is that I’m now officially half way done with this ward month. I’ve done 5 of the 9 calls. Only 4 to go. Next week the official countdown to being done will begin. Finally, at the end of the last call day, I may just wander down to the ER, jump on to the main consultant’s counter, throw down my white coat, and belt out “I’m still standing…” by Elton John. It would be a musical-type performance, with a lot of high knee stepping, hip-shimmying, exaggerated head shaking, and prancing - all the while pointing directly at stunned ER physicians. That would be fun.
Before I forget, I should mention that Saturday night was fun. Gwen and I went and saw David Cross up at the University of Washington, and he was hilarious. Sheer genius. He covered lots of topics, but basically he spent about an hour and a half bashing George Bush, right wing Christianity (and religion in general), republicans, and the myriad of heinous country songs that “emerged” circa September 11th. He read a parody of MLK’s “I have a dream” speech as George Bush might, and it was awesome. He ended with a parody of that awful “Proud to be an American” song which was funny beyond words. All was scathing and hilarious. An excellent night. I officially thank Eryn for bringing the man into my life.
And I’m spent.
The Wards – Day 12
A lot has happened since the last entry. On Tuesday night, the hallowed ER vs Medicine Hoops game went down. The format was a best of three game type – each game to 15 points, win by 2, self officiated. As I mentioned, the last match in November had the department of medicine winning, 2-0. Both were close games. We held the trophy. This time, the ER came out tough. They shot the lights out in game 1 and we lost, 15-9. The second game became a slugfest, with poor shooting on both sides. We were down 12-9 or so but then we got hot, and ended up winning 16-14. With the games tied and it getting late, several players on both teams had to leave. We were both left with 5 apiece. Unfortunately, our best player took off and it fell to me to guard the “big guy” (aka Mr. BYU, Division 1 240 lb 6-6 guy), who had been tough to stop all day. This proved difficult. The game was long and tiring, and in the end, we lost. 15-13. The ER now has the trophy. Boo that.
On Wednesday, my team was pretty manageable, and by the end of the day we got our census down to 4 patients! (this is amazing). Wednesday I got out of the hospital around 3:15 or so and drove 2 hours down to Portland to see my friend Alexi from med school. He had flown in for a couple of days so he could interview with OHSU’s cardiology fellowship program. I got there around 6 pm or so and he, Leah, and I went out to this amazing sushi dinner (I now have a new favorite sushi place in P-town). It was good to see old Alexi, whom I hadn’t seen since graduation. He’s a funny bastard and the 3 of us (including Leah) were busting up left and right at dinner and having a good old time. Hopefully he’ll be interviewing up at University of Washington as well in the next couple of months. Sadly, I had to take off after dinner. This was about 10:30. I drove the 2 hours back up toward work and crashed at my friend Pete’s house (he lives close to work) so that I could be closer the next day. I got to bed around 1 am. Got up at about 5:45, took a shower, and headed to work. It was a call day. I should have gotten more sleep.
Yesterday was crazy (as these call days tend to be). I got to work about 6:45 and was handed 3 patients from the night float check out. I took the sassy MOD pager from John (the night float) and pretty much didn’t stop moving until about 8 pm that night. It was a wild and interesting day with a lot of phone calls, a lot of scurrying around the hospital, a lot of patient work-ups, and finally a lot of paperwork and loose end type stuff to finish at the end of the day. All on about 4.5 hours of sleep. I downed a ton of coffee and diet coke all day to keep moving. There was a tragically unfortunate black lady who is 35 years old with metastatic breast cancer who came in with what looked to be a blood clot in her lungs. The tests proved negative, but we confirmed in the process that she has metastases in her brain. This is horrifically depressing. Her prognosis, with two daughters, 8 and 12 years old, is terrible. There was another guy who is 53 years old who came in with severe abdominal cramping and peeing blood. Some lady from the clinic with diabetes had been throwing up all week. Another 83-year-old lady with dementia and about 7 other medical issues had been found wandering outside of her house in the neighborhood with minimal clothing on and without her supplemental oxygen on. She was a mess. Another 45-year-old man had intractable nausea and vomiting for unknown reasons. Another huge diabetic woman had passed out and been found with a heart rate of 30 at home (this is really low) – she went to the ICU. Near the end of the call, I had to work up this 44 year old alcoholic, schizophrenic guy who had this nasty rash all over his body – it was a red flaky, dried out, oozing sort of thing that was nasty beyond description. And it was everywhere. I walked in his room and he was picking at it while taking in a few pieces of fried chicken. Nasty. All these, and a few more patients, and at the end of the day I found myself staring at “the board” (the big dry erase board where all three medicine teams have all the names of their patients written) and under my team there were 12 patients. Knowing I had today off, I stayed really late (Until 10:30 pm) and finished up a ton of work, mostly paperwork, after we were off the clock at 6 pm that night. That’s a busy 16-hour workday on 4.5 hours of sleep. Got it.
It is really hard to describe the chaos of a call day to someone who doesn’t do this sort of thing. There is absolutely no stop in the madness until some point late at night. As I concentrate on doing one task, there are three or four more tasks piling up and the end of the line. Rinse, repeat. Finally, at about 6 pm, tasks stop piling up and you can finally buckle down and grind out the last things on the list and see where everything settles out.
Here is what one admission to the hospital entails:
A patient walks into the ER. They are sick. The ER does all the initial work up. They talk to the patient (quickly), begin to get preliminary tests, studies, etc. They page me. I get the name and social security number and they tell me that they want me (i.e internal medicine) to come see the patient. I am being consulted. So, we hang up – they keep doing their thing. And I start digging into records. I look up the patient, all their past medical history. All their labs and studies from recently to years past. All their clinic notes. Unarchive all their last several admissions (some people have many, some have none). This takes about 10-30 minutes, depending on the patient. Then I go see the patient. In the ER, I take a look at all their paper work. I look at the EKG, then the chest X-ray (good thing they’re all digital now). Then I talk to the patient, make them repeat themselves and tell me the whole story. I spend time confirming their past issues as well. I write down their medication list. Finally, I do a physical exam and lay hands and all that. All the while I’m thinking about what is going on and what sort of problem they have. Then I decide if they need to be admitted (i.e. get them into the hospital overnight). If that’s a go (and it usually is if I’m consulted), then I start writing orders (all their meds, what happens to them on the floor, how often I want vital signs checked, what daily labs they need drawn, etc). I page the hospital bed manager to reserve a bed. I finish the orders and hand them over. Finally, when I have time, I have to sit down and write a “History and Physical” which is a big long document describing the patient’s story, labs, and exam. It always ends with the “assessment and plan” which is sort of me saying what I think is going on and what I’m going to do about it. To write one of these, it usually takes a good 20-60 minutes depending on the patient.
So all of that is to admit one patient. Now, on a call day, as I’m working on the first patient, my pager keeps going off. I usually have to stop and answer the page. (I try not to do this while actually talking to the patient). New patient consults are added on. Sometimes radiology calls me to tell me the results of a certain scan, or whatever. I may get 3 more patient consults while working on the first one. This ends up creating a whole long chain of work that seems insurmountable until finally I am “off the clock”. So I keep grinding through patient consults all day. At some point, I have to page my staff physician and tell him about the patients too. Sometimes he’s in the ER with me to help admit them. At my side are two trusty interns who help me do a lot of this work. Often they will write the History and Physical which also saves me time. But I have to write notes on every patient. And I still have to see every patient (obviously), as I’m sort of their supervisor. And at night (when I’m on call overnight), I have no interns helping me. So all that work is on me.
On top of all this, I still have my regular (non-call, everyday) pager on as well. This thing goes off everyday – usually it’s the nursing staff, the social workers, the ward clerks, the pharmacy, radiology, the clinic, or other residents calling. While we admit new patients, the old ones are constantly requiring attention and problems arise. Little fires have to be put out. The interns help with this as well. But it can get crazy. When both pagers are going off and 16 tasks have to get done and you just keep adding tasks to the back of the long line. Sometimes there are inappropriate consults, which are frustrating. Sometimes it’s not the ER but other services (i.e Surgery, or OB/Gyn, or Orthopedics) who consult you because one of “their” patients has an internal medicine type of issue that needs addressing. Occasionally there are emergencies, i.e. a patient stops breathing or goes into a cardiac arrest. A “Code” is called overhead and you stop what you’re doing and run over there and work on that until things stabilize (or the patient dies, sadly). Then there are lectures and conferences scattered about the day you are supposed to attend (luckily we’re excused from most of these on call days). At some point all of this becomes comical and you start high-fiving your fellow residents in the hall and laughing about everything.
We have a little “medicine resident area” with a bunch of computers and our desks. We do a lot of paper work (and our typing) there and so at the end of the day there are a bunch of residents sitting around, typing stuff, laughing or bitching about things. At the end of the day, I throw off the scrubs, put on my clothes, and stalk out of the hospital. It’s a lot of work, but right now I’m doing OK with it, I guess. I surely can’t deny at the end of these days that it feels like I’m making good use of myself and my time. Even as frustrating and stressful as it can be some days. There really is no better feeling than getting home after a super long day, cracking a beer, and throwing the Beatles on or something. Ah, the wards.
Anyway, that’s a little piece of what I do, at least on call days. On weekends, I stay overnight one of the three days. (Sunday night this week). Today is my second day off (of four). I woke up at 12:30 pm today. (Apparently my body needed sleep). My next day off is not next Wednesday but the Wednesday after that. That will be a painful stretch.
Anyway, I guess that’s the way it goes.
“Woke up….fell out of bed…dragged a comb across my head…went downstairs and drank a cup, and looking up, I noticed I was late…”
A lot has happened since the last entry. On Tuesday night, the hallowed ER vs Medicine Hoops game went down. The format was a best of three game type – each game to 15 points, win by 2, self officiated. As I mentioned, the last match in November had the department of medicine winning, 2-0. Both were close games. We held the trophy. This time, the ER came out tough. They shot the lights out in game 1 and we lost, 15-9. The second game became a slugfest, with poor shooting on both sides. We were down 12-9 or so but then we got hot, and ended up winning 16-14. With the games tied and it getting late, several players on both teams had to leave. We were both left with 5 apiece. Unfortunately, our best player took off and it fell to me to guard the “big guy” (aka Mr. BYU, Division 1 240 lb 6-6 guy), who had been tough to stop all day. This proved difficult. The game was long and tiring, and in the end, we lost. 15-13. The ER now has the trophy. Boo that.
On Wednesday, my team was pretty manageable, and by the end of the day we got our census down to 4 patients! (this is amazing). Wednesday I got out of the hospital around 3:15 or so and drove 2 hours down to Portland to see my friend Alexi from med school. He had flown in for a couple of days so he could interview with OHSU’s cardiology fellowship program. I got there around 6 pm or so and he, Leah, and I went out to this amazing sushi dinner (I now have a new favorite sushi place in P-town). It was good to see old Alexi, whom I hadn’t seen since graduation. He’s a funny bastard and the 3 of us (including Leah) were busting up left and right at dinner and having a good old time. Hopefully he’ll be interviewing up at University of Washington as well in the next couple of months. Sadly, I had to take off after dinner. This was about 10:30. I drove the 2 hours back up toward work and crashed at my friend Pete’s house (he lives close to work) so that I could be closer the next day. I got to bed around 1 am. Got up at about 5:45, took a shower, and headed to work. It was a call day. I should have gotten more sleep.
Yesterday was crazy (as these call days tend to be). I got to work about 6:45 and was handed 3 patients from the night float check out. I took the sassy MOD pager from John (the night float) and pretty much didn’t stop moving until about 8 pm that night. It was a wild and interesting day with a lot of phone calls, a lot of scurrying around the hospital, a lot of patient work-ups, and finally a lot of paperwork and loose end type stuff to finish at the end of the day. All on about 4.5 hours of sleep. I downed a ton of coffee and diet coke all day to keep moving. There was a tragically unfortunate black lady who is 35 years old with metastatic breast cancer who came in with what looked to be a blood clot in her lungs. The tests proved negative, but we confirmed in the process that she has metastases in her brain. This is horrifically depressing. Her prognosis, with two daughters, 8 and 12 years old, is terrible. There was another guy who is 53 years old who came in with severe abdominal cramping and peeing blood. Some lady from the clinic with diabetes had been throwing up all week. Another 83-year-old lady with dementia and about 7 other medical issues had been found wandering outside of her house in the neighborhood with minimal clothing on and without her supplemental oxygen on. She was a mess. Another 45-year-old man had intractable nausea and vomiting for unknown reasons. Another huge diabetic woman had passed out and been found with a heart rate of 30 at home (this is really low) – she went to the ICU. Near the end of the call, I had to work up this 44 year old alcoholic, schizophrenic guy who had this nasty rash all over his body – it was a red flaky, dried out, oozing sort of thing that was nasty beyond description. And it was everywhere. I walked in his room and he was picking at it while taking in a few pieces of fried chicken. Nasty. All these, and a few more patients, and at the end of the day I found myself staring at “the board” (the big dry erase board where all three medicine teams have all the names of their patients written) and under my team there were 12 patients. Knowing I had today off, I stayed really late (Until 10:30 pm) and finished up a ton of work, mostly paperwork, after we were off the clock at 6 pm that night. That’s a busy 16-hour workday on 4.5 hours of sleep. Got it.
It is really hard to describe the chaos of a call day to someone who doesn’t do this sort of thing. There is absolutely no stop in the madness until some point late at night. As I concentrate on doing one task, there are three or four more tasks piling up and the end of the line. Rinse, repeat. Finally, at about 6 pm, tasks stop piling up and you can finally buckle down and grind out the last things on the list and see where everything settles out.
Here is what one admission to the hospital entails:
A patient walks into the ER. They are sick. The ER does all the initial work up. They talk to the patient (quickly), begin to get preliminary tests, studies, etc. They page me. I get the name and social security number and they tell me that they want me (i.e internal medicine) to come see the patient. I am being consulted. So, we hang up – they keep doing their thing. And I start digging into records. I look up the patient, all their past medical history. All their labs and studies from recently to years past. All their clinic notes. Unarchive all their last several admissions (some people have many, some have none). This takes about 10-30 minutes, depending on the patient. Then I go see the patient. In the ER, I take a look at all their paper work. I look at the EKG, then the chest X-ray (good thing they’re all digital now). Then I talk to the patient, make them repeat themselves and tell me the whole story. I spend time confirming their past issues as well. I write down their medication list. Finally, I do a physical exam and lay hands and all that. All the while I’m thinking about what is going on and what sort of problem they have. Then I decide if they need to be admitted (i.e. get them into the hospital overnight). If that’s a go (and it usually is if I’m consulted), then I start writing orders (all their meds, what happens to them on the floor, how often I want vital signs checked, what daily labs they need drawn, etc). I page the hospital bed manager to reserve a bed. I finish the orders and hand them over. Finally, when I have time, I have to sit down and write a “History and Physical” which is a big long document describing the patient’s story, labs, and exam. It always ends with the “assessment and plan” which is sort of me saying what I think is going on and what I’m going to do about it. To write one of these, it usually takes a good 20-60 minutes depending on the patient.
So all of that is to admit one patient. Now, on a call day, as I’m working on the first patient, my pager keeps going off. I usually have to stop and answer the page. (I try not to do this while actually talking to the patient). New patient consults are added on. Sometimes radiology calls me to tell me the results of a certain scan, or whatever. I may get 3 more patient consults while working on the first one. This ends up creating a whole long chain of work that seems insurmountable until finally I am “off the clock”. So I keep grinding through patient consults all day. At some point, I have to page my staff physician and tell him about the patients too. Sometimes he’s in the ER with me to help admit them. At my side are two trusty interns who help me do a lot of this work. Often they will write the History and Physical which also saves me time. But I have to write notes on every patient. And I still have to see every patient (obviously), as I’m sort of their supervisor. And at night (when I’m on call overnight), I have no interns helping me. So all that work is on me.
On top of all this, I still have my regular (non-call, everyday) pager on as well. This thing goes off everyday – usually it’s the nursing staff, the social workers, the ward clerks, the pharmacy, radiology, the clinic, or other residents calling. While we admit new patients, the old ones are constantly requiring attention and problems arise. Little fires have to be put out. The interns help with this as well. But it can get crazy. When both pagers are going off and 16 tasks have to get done and you just keep adding tasks to the back of the long line. Sometimes there are inappropriate consults, which are frustrating. Sometimes it’s not the ER but other services (i.e Surgery, or OB/Gyn, or Orthopedics) who consult you because one of “their” patients has an internal medicine type of issue that needs addressing. Occasionally there are emergencies, i.e. a patient stops breathing or goes into a cardiac arrest. A “Code” is called overhead and you stop what you’re doing and run over there and work on that until things stabilize (or the patient dies, sadly). Then there are lectures and conferences scattered about the day you are supposed to attend (luckily we’re excused from most of these on call days). At some point all of this becomes comical and you start high-fiving your fellow residents in the hall and laughing about everything.
We have a little “medicine resident area” with a bunch of computers and our desks. We do a lot of paper work (and our typing) there and so at the end of the day there are a bunch of residents sitting around, typing stuff, laughing or bitching about things. At the end of the day, I throw off the scrubs, put on my clothes, and stalk out of the hospital. It’s a lot of work, but right now I’m doing OK with it, I guess. I surely can’t deny at the end of these days that it feels like I’m making good use of myself and my time. Even as frustrating and stressful as it can be some days. There really is no better feeling than getting home after a super long day, cracking a beer, and throwing the Beatles on or something. Ah, the wards.
Anyway, that’s a little piece of what I do, at least on call days. On weekends, I stay overnight one of the three days. (Sunday night this week). Today is my second day off (of four). I woke up at 12:30 pm today. (Apparently my body needed sleep). My next day off is not next Wednesday but the Wednesday after that. That will be a painful stretch.
Anyway, I guess that’s the way it goes.
“Woke up….fell out of bed…dragged a comb across my head…went downstairs and drank a cup, and looking up, I noticed I was late…”
The Wards – Day 9
Today is my day off. I have another on Friday. After that I go about 12 days or so without another one. Yesterday was the “mini call”. We didn’t do too badly, though unfortunately most of my pages came at 3 pm or later ensuring that the workload would go well past the time when my team was off the clock (6 pm). We ended up taking 4 new patients and 1 new consult. I admitted 2 other patients to the ICU team. When I left at about 9 pm last night, we had about 12 patients on our board. Some of them should go home today in my absence. Which will be nice.
Other than that, I woke up at about 11 am today (ahhhh) and drove down to the Harvester in Tacoma for some breakfast. Then I ran a few errands and got my hair cut. (Exciting, I know). Finally, I’m home and gearing up the big hoops game tonight – Department of Medicine versus the Emergency Medicine Department. You know how I hate all those ER pages? Well here’s my (and the other medicine residents’) chance to get ‘em back. We played back in November and it was fun. Everyone took it pretty seriously. It was funny, though, when “Rowdy” Rod, a colleague of mine, went out and bought purple shirts and colored head bands for us to wear during the game. (The ER docs at our hospital all wear purple scrubs while they’re working and different color arm bands for whatever team they are with that day – we call them the Barney Brigade – they look quite foolish) – so we came out like some mock-ER squad. We won the first set of games and took home the trophy (yes, there’s a trophy – a little Dr. Guy with a basketball bobble-head and a plaque that says DEM vs. MOD champs [DEM = Department of Emergency Medicine and MOD = Medicine Officer of the Day (which is the official title of the medicine resident on call]). They were good games. The ER guys have a resident who played undergrad at BYU. He’s a little older and out of shape now, but he’s still big and knows how to play. Our best player is the chief resident. (But I like to think I contribute…)
Anyway, we’re all fired up to play again and defend our trophy. So root for me out there tonight, in my purple UW T-shirt and green headband, running around like a vintage version of Boy’s Club Mick (only without the horrific carpet and accompanying ankle injury – hopefully). I miss the old college days when I would play pick up hoops for about three hours a day…Ah, to be young again.
Today is my day off. I have another on Friday. After that I go about 12 days or so without another one. Yesterday was the “mini call”. We didn’t do too badly, though unfortunately most of my pages came at 3 pm or later ensuring that the workload would go well past the time when my team was off the clock (6 pm). We ended up taking 4 new patients and 1 new consult. I admitted 2 other patients to the ICU team. When I left at about 9 pm last night, we had about 12 patients on our board. Some of them should go home today in my absence. Which will be nice.
Other than that, I woke up at about 11 am today (ahhhh) and drove down to the Harvester in Tacoma for some breakfast. Then I ran a few errands and got my hair cut. (Exciting, I know). Finally, I’m home and gearing up the big hoops game tonight – Department of Medicine versus the Emergency Medicine Department. You know how I hate all those ER pages? Well here’s my (and the other medicine residents’) chance to get ‘em back. We played back in November and it was fun. Everyone took it pretty seriously. It was funny, though, when “Rowdy” Rod, a colleague of mine, went out and bought purple shirts and colored head bands for us to wear during the game. (The ER docs at our hospital all wear purple scrubs while they’re working and different color arm bands for whatever team they are with that day – we call them the Barney Brigade – they look quite foolish) – so we came out like some mock-ER squad. We won the first set of games and took home the trophy (yes, there’s a trophy – a little Dr. Guy with a basketball bobble-head and a plaque that says DEM vs. MOD champs [DEM = Department of Emergency Medicine and MOD = Medicine Officer of the Day (which is the official title of the medicine resident on call]). They were good games. The ER guys have a resident who played undergrad at BYU. He’s a little older and out of shape now, but he’s still big and knows how to play. Our best player is the chief resident. (But I like to think I contribute…)
Anyway, we’re all fired up to play again and defend our trophy. So root for me out there tonight, in my purple UW T-shirt and green headband, running around like a vintage version of Boy’s Club Mick (only without the horrific carpet and accompanying ankle injury – hopefully). I miss the old college days when I would play pick up hoops for about three hours a day…Ah, to be young again.
The Wards - Day 7
I worked from 7:00 am until 2:20 pm today. Basically went in and rounded with one intern and the staff physician. (The rest of the team had the day off). As the dust has settled from "Mega Call", we have about 9 patients on our team (we discharged about 5 or 6 patients post-call yesterday which was nice). They are stable, and today we took a good bit of time sort of hammering out a thorough game plan on all their issues. Several will go home tomorrow and most will leave on Tuesday (patients tend to hang around longer in the hospital on holiday weekends because the ancillary services like social work aren't there). Tomorrow is a call day (sigh), but its only a 12 hour call day for my team (our so called "Mini-call") This is to make up for the 36 hour MEGA CALL we did on Friday and thus its the best call day to have as opposed to the previous which of course is the worst. Shouldn't be terrible, but going into call with 9 patients on your team is no joke. Regardless, I'm officially done with 1 week (of 4 total) of the wards and I'm still standing. Tomorrow will suck but Tuesday is my day off (my first of four total days off this month) so I can leave tomorrow night and not go back until Wednesday morning. Which will be nice.
I tallied up all my hours worked this week (we have to keep rigid track given national Residency Committee guidelines) - From Sunday until Saturday I worked 77.5 hours (a normal 9 to 5 work week is 40 hours). And I was off last Sunday. Yeesh. Anyway, we are supposed to be under 80 hour per week or we get in trouble. So, I made it. Yay me.
This afternoon I got home and took a 2 hour nap. Then Gwen came over and she made soup and we watched "Badlands", a Netflix rental. Good movie. Now I am tired and 5am is way too close. I can already hear the alarm...
I worked from 7:00 am until 2:20 pm today. Basically went in and rounded with one intern and the staff physician. (The rest of the team had the day off). As the dust has settled from "Mega Call", we have about 9 patients on our team (we discharged about 5 or 6 patients post-call yesterday which was nice). They are stable, and today we took a good bit of time sort of hammering out a thorough game plan on all their issues. Several will go home tomorrow and most will leave on Tuesday (patients tend to hang around longer in the hospital on holiday weekends because the ancillary services like social work aren't there). Tomorrow is a call day (sigh), but its only a 12 hour call day for my team (our so called "Mini-call") This is to make up for the 36 hour MEGA CALL we did on Friday and thus its the best call day to have as opposed to the previous which of course is the worst. Shouldn't be terrible, but going into call with 9 patients on your team is no joke. Regardless, I'm officially done with 1 week (of 4 total) of the wards and I'm still standing. Tomorrow will suck but Tuesday is my day off (my first of four total days off this month) so I can leave tomorrow night and not go back until Wednesday morning. Which will be nice.
I tallied up all my hours worked this week (we have to keep rigid track given national Residency Committee guidelines) - From Sunday until Saturday I worked 77.5 hours (a normal 9 to 5 work week is 40 hours). And I was off last Sunday. Yeesh. Anyway, we are supposed to be under 80 hour per week or we get in trouble. So, I made it. Yay me.
This afternoon I got home and took a 2 hour nap. Then Gwen came over and she made soup and we watched "Badlands", a Netflix rental. Good movie. Now I am tired and 5am is way too close. I can already hear the alarm...
The Wards - Day 6
I just finished our legendary "Mega Call" (this is every Friday call, the team alternates each week), where my team was the admitting team for 36 hours. The first 12 hours are handled by the night float and he only gave me 2 patients (a very good sign) at our morning check out rounds at 6:45 am Friday morning. This was a good sign for a very manageable team. Unfortunately, the good luck was not to last and I proceeded to admit another 12 patients to my team over the next 24 hours. (This is a heinous amount - plus I sent 2 people to the ICU and had another consult from the surgeons) So basically, I woke up at 5 am yesterday and went to work. I worked from about 6:30 am (Friday) until about 3:40 pm today (Saturday). At 4:40 am when I was trying to type up some documents my eyes glazed over and I thought I couldn't go on. I laid down for 30 minutes and then got back up and finished all my work. Our call was over at 7 am this morning. Then we rounded. Then we put all our plans from rounds into action. Then there was the eternal paperwork to catch up on. I left the hospital at 3:40 pm. I came home, got a little burst of life, and made some food. Its now 6 pm - I'm typing this, then I'm going to get in the shower, then get in bed, pass out, get up at 5 am tomorrow, and go back to work. My next call day is Monday. Ah, the wards.
I just finished our legendary "Mega Call" (this is every Friday call, the team alternates each week), where my team was the admitting team for 36 hours. The first 12 hours are handled by the night float and he only gave me 2 patients (a very good sign) at our morning check out rounds at 6:45 am Friday morning. This was a good sign for a very manageable team. Unfortunately, the good luck was not to last and I proceeded to admit another 12 patients to my team over the next 24 hours. (This is a heinous amount - plus I sent 2 people to the ICU and had another consult from the surgeons) So basically, I woke up at 5 am yesterday and went to work. I worked from about 6:30 am (Friday) until about 3:40 pm today (Saturday). At 4:40 am when I was trying to type up some documents my eyes glazed over and I thought I couldn't go on. I laid down for 30 minutes and then got back up and finished all my work. Our call was over at 7 am this morning. Then we rounded. Then we put all our plans from rounds into action. Then there was the eternal paperwork to catch up on. I left the hospital at 3:40 pm. I came home, got a little burst of life, and made some food. Its now 6 pm - I'm typing this, then I'm going to get in the shower, then get in bed, pass out, get up at 5 am tomorrow, and go back to work. My next call day is Monday. Ah, the wards.
The Wards – Day 2
Yesterday signaled the change in the rotation block for residents and now I find myself on the wards, the most painful of all the rotations in residency. (These days, it even topples the mighty ICU). I figured it might help me get through it if I keep a running diary. This entry is very quick as I’m exhausted. Enjoy.
Call day
My day at work, Tuesday, Feb 10th, 2004:
Alarm goes off at 4:45 – I finally get out of bed at 5:15 am. Wet hair and comb it because I showered last night. Eat some oatmeal and out the door by 5:40. Arrive at work at 6:15 am. (Listened to “Paul’s Boutique” on the drive in). At 6:45 the entire team (myself, two interns, one medical student, one nurse practitioner, and the attending physician) all meet to accept the patients admitted overnight by the “night float” resident. There are six of them. Ugh. They combine to my team of 8 patients already and form a super team of 14 patients. We hear their stories for 45 minutes. At 7:30 am we divide up and go see the patients.
The “On call” pager is handed to me from the night float after check-out rounds. It goes off immediately. The ER. I take an intern and go see the newest patient with her. The rest of the team scatters to get work done. The lady in the ER is a mess. She has intractable nausea and vomiting as well as left sided abdominal pain. Her past medical history is chock full of crap. She takes over 20 medicines daily. Her CT scan shows inflammation in the descending colon (aka large intestine). She’s probably infected. We make a game plan, do serious paperwork and admit her to our team. The intern calls the bed manager to reserve a bed. 15 patients. Its 8:30 am.
That intern and I split up do some more work. I go see a patient on a different floor, one of the ones admitted the night before. He is stable. I go to a different floor and see a different patient. He’s ready to go home. I do some paperwork and make about 6 phone calls. I clear the decision with my staff. He gets discharged. 14 patients. 9:30 am
I go see a few more patients. Put out some fires. Nothing too serious. I’m trying to learn all the patients from last night and “eyeball” them. Surprisingly the pager hasn’t gone off in a while. Its 10:30 am. The team meets for rounds again. A plan comes together for most of the patients. The team scatters to do more work. The pager goes off. The ER again with another patient. 11:45 am
I take the initial intern down again and we see the new patient, eating a quick sandwich on the way. He was discharged 4 days ago from a different team. He went home and got worse. He has congestive heart failure. He isn’t breathing very well. His legs are ridiculously swollen. The swelling is in his scrotum as well. We talk to him about “code status”. He wants no resuscitative measures. We outline a treatment plan and do the necessary paperwork. He’s coming in. 15 patients. I leave and go see a different patient upstairs. 12:30 pm.
The pager goes off again. It’s the ER (fuck!). I take the other intern and go see this new guy. He was called in because the radiologist found a blood clot in his leg and his lung after a recent CT scan was done looking for something completely different. He needs anticoagulation, but it can be done as an outpatient. It takes some convincing for the ER to see it this way. But this guy is not sick and does not need to come in. This kind of thing can be treated at home, when someone is this stable. I do some paperwork. Make about 15 more calls. Go talk to the radiologist and look at the CT scans with him. This clot is old news, after we looked at an older scan. He gets to go home. In the middle of that, the pager goes off again. The clinic. I sent my intern to go see the new one while I finish up the guy with the blood clot. 2:15 pm.
After wrapping up his follow up paper-work and putting his meds in the computer, I run down to the clinic. The pager goes off. Some long distance number. I call it and its Whidbey island naval base wanting to transfer a patient. Crap. A truck driver with inflammatory bowel disease having a severe exacerbation. This isn’t fun for anyone involved. I arrange for him to get a bed at our hospital. I clal the naval base back. The helicopter is on the way. 16 patients. 4:00 pm
In the clinic, the lady from the other call is a huge woman with diabetes and some nausea, vomiting and diarrhea. She’s probably infected too. Crap. I spend some time explaining her what I think is going on. The intern starts the paperwork. She’ll be coming in for antibiotics and IV fluids. 17 patients. 4:45 pm.
The pager goes off. The ER (FUCK!!). An old lady has pneumonia. The work up isn’t complete, but she’ll “probably need admission” – they will page back later. I start looking up her computer records. 5:30 pm.
The team meets again. We round for an hour and finalize the day’s plan on everyone. One other patient was discharged by an intern. Another was taken over by the surgery team to get their gall bladder removed. 15 patients. 6:40 pm
We’re officially off the clock and the night resident arrives. The pneumonia lady will go to him. I spend another 2 hours scrambling around finishing paper work and writing orders. Everyone’s tucked in for the night. 8:45 pm 15 patients.
I leave the hospital and drive home. Check email. Check club. Check blogs. Write this. I’m tired, sorry its so scattered and slangy. I have to get up at 5:00 am and go back. Friday is the next call day. It will be like this, only I will stay overnight and admit patients for an additional 12 hours until 7 am the next day. Not fun. Ah, the wards.
10:23 pm
Yesterday signaled the change in the rotation block for residents and now I find myself on the wards, the most painful of all the rotations in residency. (These days, it even topples the mighty ICU). I figured it might help me get through it if I keep a running diary. This entry is very quick as I’m exhausted. Enjoy.
Call day
My day at work, Tuesday, Feb 10th, 2004:
Alarm goes off at 4:45 – I finally get out of bed at 5:15 am. Wet hair and comb it because I showered last night. Eat some oatmeal and out the door by 5:40. Arrive at work at 6:15 am. (Listened to “Paul’s Boutique” on the drive in). At 6:45 the entire team (myself, two interns, one medical student, one nurse practitioner, and the attending physician) all meet to accept the patients admitted overnight by the “night float” resident. There are six of them. Ugh. They combine to my team of 8 patients already and form a super team of 14 patients. We hear their stories for 45 minutes. At 7:30 am we divide up and go see the patients.
The “On call” pager is handed to me from the night float after check-out rounds. It goes off immediately. The ER. I take an intern and go see the newest patient with her. The rest of the team scatters to get work done. The lady in the ER is a mess. She has intractable nausea and vomiting as well as left sided abdominal pain. Her past medical history is chock full of crap. She takes over 20 medicines daily. Her CT scan shows inflammation in the descending colon (aka large intestine). She’s probably infected. We make a game plan, do serious paperwork and admit her to our team. The intern calls the bed manager to reserve a bed. 15 patients. Its 8:30 am.
That intern and I split up do some more work. I go see a patient on a different floor, one of the ones admitted the night before. He is stable. I go to a different floor and see a different patient. He’s ready to go home. I do some paperwork and make about 6 phone calls. I clear the decision with my staff. He gets discharged. 14 patients. 9:30 am
I go see a few more patients. Put out some fires. Nothing too serious. I’m trying to learn all the patients from last night and “eyeball” them. Surprisingly the pager hasn’t gone off in a while. Its 10:30 am. The team meets for rounds again. A plan comes together for most of the patients. The team scatters to do more work. The pager goes off. The ER again with another patient. 11:45 am
I take the initial intern down again and we see the new patient, eating a quick sandwich on the way. He was discharged 4 days ago from a different team. He went home and got worse. He has congestive heart failure. He isn’t breathing very well. His legs are ridiculously swollen. The swelling is in his scrotum as well. We talk to him about “code status”. He wants no resuscitative measures. We outline a treatment plan and do the necessary paperwork. He’s coming in. 15 patients. I leave and go see a different patient upstairs. 12:30 pm.
The pager goes off again. It’s the ER (fuck!). I take the other intern and go see this new guy. He was called in because the radiologist found a blood clot in his leg and his lung after a recent CT scan was done looking for something completely different. He needs anticoagulation, but it can be done as an outpatient. It takes some convincing for the ER to see it this way. But this guy is not sick and does not need to come in. This kind of thing can be treated at home, when someone is this stable. I do some paperwork. Make about 15 more calls. Go talk to the radiologist and look at the CT scans with him. This clot is old news, after we looked at an older scan. He gets to go home. In the middle of that, the pager goes off again. The clinic. I sent my intern to go see the new one while I finish up the guy with the blood clot. 2:15 pm.
After wrapping up his follow up paper-work and putting his meds in the computer, I run down to the clinic. The pager goes off. Some long distance number. I call it and its Whidbey island naval base wanting to transfer a patient. Crap. A truck driver with inflammatory bowel disease having a severe exacerbation. This isn’t fun for anyone involved. I arrange for him to get a bed at our hospital. I clal the naval base back. The helicopter is on the way. 16 patients. 4:00 pm
In the clinic, the lady from the other call is a huge woman with diabetes and some nausea, vomiting and diarrhea. She’s probably infected too. Crap. I spend some time explaining her what I think is going on. The intern starts the paperwork. She’ll be coming in for antibiotics and IV fluids. 17 patients. 4:45 pm.
The pager goes off. The ER (FUCK!!). An old lady has pneumonia. The work up isn’t complete, but she’ll “probably need admission” – they will page back later. I start looking up her computer records. 5:30 pm.
The team meets again. We round for an hour and finalize the day’s plan on everyone. One other patient was discharged by an intern. Another was taken over by the surgery team to get their gall bladder removed. 15 patients. 6:40 pm
We’re officially off the clock and the night resident arrives. The pneumonia lady will go to him. I spend another 2 hours scrambling around finishing paper work and writing orders. Everyone’s tucked in for the night. 8:45 pm 15 patients.
I leave the hospital and drive home. Check email. Check club. Check blogs. Write this. I’m tired, sorry its so scattered and slangy. I have to get up at 5:00 am and go back. Friday is the next call day. It will be like this, only I will stay overnight and admit patients for an additional 12 hours until 7 am the next day. Not fun. Ah, the wards.
10:23 pm
Welcome to the new-look, sassy, links-on-the-side Discoblog. This whole thing, need I remind you, fair reader, is a work in progress. And this new template with more ample sidebar pleases me, for the moment. Its good to be back bloggin’.
My weekend was busy and here it is. It all started last Sunday night I decided to surprise the old San Diego boys and buy a ticket down there for the super bowl weekend. I coordinated the arrival and pick up with Eryn, keeping everyone else in the dark, and things went pretty smoothly. The Thursday before I left, I stayed up way too late playing Battlefield 1942, which has become the latest bane of my existence. I went to bed around 3 am after all the packing and such was done, and I got up promptly at 4:30 am Friday morning to head to the airport. The flights (I had a stop in Sacramento) were a blur as I pretty much passed out for the duration of both. And then San Diego.
My favorite immediate thing to do promptly after landing whenever I return to San Diego is to rush outside and smell the San Diego air. Some of you may complain that its smoggy crap, but I love the smell; it reminds me of many happy years I spent there. That first breath of air and the accompanying sunlight are enough to immediately elevate my mood an echelon or two, and on this trip it proved no different. I always get in a good mood anyway when going to San Diego. Certainly its because I get to see my friends, but also because of the nostalgia of knowing that several of my formative years were spent there. Its tough to call it my hometown, for some reason (I didn’t move there until high school), but it certainly feels familiar, which is always a plus. Anyway, I landed, and was happy and content with the world.
Eryn picked me up at the airport and then we zoomed over to his dream job at Sony, and we got there and once again I marveled at how different our jobs are. I mean, seriously, how completely and utterly different our jobs our. (Be strong Michael – do NOT get started on a job tangent here…) Anyway, it was fun hanging around his office, checking out the latest hi tech stuff. Everyone was pumped on the Super Bowl Pre-game animations and it was fun watching that. Then we checked out another fun game of WCD football, PS2 style, which is always good fun (the write up is still, um, pending).
After work Eryn had arranged for everyone to meet at his place prior to heading to Pizza Port (another favorite nostalgic spot of mine in SD – spent the good half of my 21st birthday there…). Still no one knew I was in town. I had fun surprising people as they came over – Adam’s response was especially funny as I walked in and said, “What’s up?” His eyes got all wide as his brain processed the odd and unexpected information. (Then we made out).
Pizza Port was a blast, complete with pizza and beer (shocking!) – The night cap was spent at Eryn’s playing some game called “Derivation” – it was a good time even though Iwan cheated his way to a win.
Saturday I slept in until about noon (always trying to catch up on sleep) – then Eryn and I hit the Pancake house and finally hiked Torrey Pines with Adam, Diana, and Heather (That’s right – I was fifth wheel). That night we ate some dinner at Calypso’s, a chic place somewhere in Encinitas – the food and wine were really good, and chalk up another 50$ plus dinner for me. (I average about one a week). There was some fun conversation with Sara Martin and the others and I had a good time staring at attractive southern California women scattered about (and working in) the restaurant. There was also a table full of rich, La Jolla looking older women complete with ridiculous sized wedding rings who were out on the town and supplying me with plenty of amusement in the process. Following that, we headed out to the Shanty to play some pool which translated into me feeding a couple bucks into a horrible juke box while we watched Iwan play some “bar guy” for rights to the pool table so that the whole lot of us could eventually play (down to Eryn, Heather, Iwan, and myself by this point). Iwan succeeded (without cheating this time) and we played some pool for a while.
Sunday was the Super Bowl and we all headed to Eryn’s Dad’s ummm “house”, which of course was unreal. The game was fun to watch, and good old Gabe Buhr showed up so we could chat face-to-face one last time before he becomes a dad. The game was a blast – its funny how easily I fall back into the same old routine of watching TV with that group of friends. Everyone eyed me with vast amusement when a typically horrible Super Bowl commercial ended, all aware of how much those fucking things burn me up inside. This year the Jimmi Hendrix commercial was particularly disgusting. The Super Bowl halftime show was complete with tits (or tit), and I’m already tired of the uproar generated over this thing – I found my dad’s annoyed reaction particularly funny and typical of prudish Americans. (I’m surprised they didn’t cut away to some horrifically violent movie promo or something similar to quickly flea from the “dirty, filthy, scarring” sight of a female breast and save the minds of our children. What a statement that would have been.) Following the super bowl we headed to Adam and Diana’s house for fun game of “Dungeons and Dragons Clue” which was won by me! Then it was good bye, and back to Eryn’s, and off to bed, and to the airport in the morning.
And back to the gray skies of Seattle. Being in San Diego for a mere weekend and then coming back here seriously reminds me of how much I miss the sun in the winter here. Within hours of return, my mood had already settled back into the residency-related mush of gray. Where it remains.
[modified]
“The world is a vampire….”
My weekend was busy and here it is. It all started last Sunday night I decided to surprise the old San Diego boys and buy a ticket down there for the super bowl weekend. I coordinated the arrival and pick up with Eryn, keeping everyone else in the dark, and things went pretty smoothly. The Thursday before I left, I stayed up way too late playing Battlefield 1942, which has become the latest bane of my existence. I went to bed around 3 am after all the packing and such was done, and I got up promptly at 4:30 am Friday morning to head to the airport. The flights (I had a stop in Sacramento) were a blur as I pretty much passed out for the duration of both. And then San Diego.
My favorite immediate thing to do promptly after landing whenever I return to San Diego is to rush outside and smell the San Diego air. Some of you may complain that its smoggy crap, but I love the smell; it reminds me of many happy years I spent there. That first breath of air and the accompanying sunlight are enough to immediately elevate my mood an echelon or two, and on this trip it proved no different. I always get in a good mood anyway when going to San Diego. Certainly its because I get to see my friends, but also because of the nostalgia of knowing that several of my formative years were spent there. Its tough to call it my hometown, for some reason (I didn’t move there until high school), but it certainly feels familiar, which is always a plus. Anyway, I landed, and was happy and content with the world.
Eryn picked me up at the airport and then we zoomed over to his dream job at Sony, and we got there and once again I marveled at how different our jobs are. I mean, seriously, how completely and utterly different our jobs our. (Be strong Michael – do NOT get started on a job tangent here…) Anyway, it was fun hanging around his office, checking out the latest hi tech stuff. Everyone was pumped on the Super Bowl Pre-game animations and it was fun watching that. Then we checked out another fun game of WCD football, PS2 style, which is always good fun (the write up is still, um, pending).
After work Eryn had arranged for everyone to meet at his place prior to heading to Pizza Port (another favorite nostalgic spot of mine in SD – spent the good half of my 21st birthday there…). Still no one knew I was in town. I had fun surprising people as they came over – Adam’s response was especially funny as I walked in and said, “What’s up?” His eyes got all wide as his brain processed the odd and unexpected information. (Then we made out).
Pizza Port was a blast, complete with pizza and beer (shocking!) – The night cap was spent at Eryn’s playing some game called “Derivation” – it was a good time even though Iwan cheated his way to a win.
Saturday I slept in until about noon (always trying to catch up on sleep) – then Eryn and I hit the Pancake house and finally hiked Torrey Pines with Adam, Diana, and Heather (That’s right – I was fifth wheel). That night we ate some dinner at Calypso’s, a chic place somewhere in Encinitas – the food and wine were really good, and chalk up another 50$ plus dinner for me. (I average about one a week). There was some fun conversation with Sara Martin and the others and I had a good time staring at attractive southern California women scattered about (and working in) the restaurant. There was also a table full of rich, La Jolla looking older women complete with ridiculous sized wedding rings who were out on the town and supplying me with plenty of amusement in the process. Following that, we headed out to the Shanty to play some pool which translated into me feeding a couple bucks into a horrible juke box while we watched Iwan play some “bar guy” for rights to the pool table so that the whole lot of us could eventually play (down to Eryn, Heather, Iwan, and myself by this point). Iwan succeeded (without cheating this time) and we played some pool for a while.
Sunday was the Super Bowl and we all headed to Eryn’s Dad’s ummm “house”, which of course was unreal. The game was fun to watch, and good old Gabe Buhr showed up so we could chat face-to-face one last time before he becomes a dad. The game was a blast – its funny how easily I fall back into the same old routine of watching TV with that group of friends. Everyone eyed me with vast amusement when a typically horrible Super Bowl commercial ended, all aware of how much those fucking things burn me up inside. This year the Jimmi Hendrix commercial was particularly disgusting. The Super Bowl halftime show was complete with tits (or tit), and I’m already tired of the uproar generated over this thing – I found my dad’s annoyed reaction particularly funny and typical of prudish Americans. (I’m surprised they didn’t cut away to some horrifically violent movie promo or something similar to quickly flea from the “dirty, filthy, scarring” sight of a female breast and save the minds of our children. What a statement that would have been.) Following the super bowl we headed to Adam and Diana’s house for fun game of “Dungeons and Dragons Clue” which was won by me! Then it was good bye, and back to Eryn’s, and off to bed, and to the airport in the morning.
And back to the gray skies of Seattle. Being in San Diego for a mere weekend and then coming back here seriously reminds me of how much I miss the sun in the winter here. Within hours of return, my mood had already settled back into the residency-related mush of gray. Where it remains.
[modified]
“The world is a vampire….”
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