The Most Wonderful Time of the Year
I think I’ll go ahead and blame my recent return to the dreaded WARDS for my lack of blogging as of late. A lot has happened since two weeks ago when I last breathed life into this place.
Best Christmas ever? Hardly. But not all together terrible, either. Residency has put a new spin on the holidays. For most years of my life before residency – all years to be honest – the holidays were a time of rest and reflection, of comfort in the familiar, of returning home (or at least to wherever my parents lived at the time). My parents have moved a few times since leaving San Diego. And though those new places were never home to me, there were always aspects of being in a “house that belonged to my parents” which brought with it a certain heartwarming sensation of being steeped in the familiar. Papa Stup sitting on the couch and yelling at the Giants. Mama Stup going way overboard on the Christmas thing – from extravagant wrapping paper to multiple ornate Christmas trees to holiday cookies. Little Mal being little Mal (but bigger each year). I always enjoyed going home.
With residency there has been a shift in the paradigm, a certain step up in the magnitude of the holiday season. My intern year, I was in the midst of my well-documented depression. I was on the cardiology service over the holidays. I worked on Christmas eve until 6 pm. Then I went to the movies, ate popcorn for dinner, and saw a very dreary “Gangs of New York”, alone. I worked Christmas day, from 6 am until 7 pm. Then I went home, opened some presents my family had mailed me, had a beer, stared at my tree for a little while, stared out the window for a little longer, then went to bed. And then got up and went back to work the next day. It was a bad time.
During my second year of residency, I was a resident in the ICU. I was on call overnight on Christmas eve. I wasn’t sure what to expect, but other than a drug overdose and a septic old man, the evening was unusually quiet. On Christmas day, I left the hospital at about noon, went home, took a nap, and then got up and went to my cousin Cynthia’s for dinner. It was nice to have some family around for that. The next day, I went back to work. Better than intern year.
This year, I found myself on the wards. I rolled into work at about 7 am and took the infamous MOD pager. I had some coffee, sat back, and prepared. I thought it might be quiet again. On holidays such as Christmas, the only people who tend to come in are the very sick and the depressed. And the very sick tend to go to the ICU.
The morning was quiet, and some other residents and I tooled around and shared some laughs about “the most wonderful time of the year”, indeed. (All can relax, for jukebox Mick was in full swing with the Christmas carols while working that day). Good old Pete’s Taint was the ICU resident for the day.
At about noon, things started heating up. I was consulted on a couple of patients and then the ER started calling. By 3 pm I wasn’t able to stop moving and it turned out to be a very busy day. At about 9 pm, I had missed dinner and kept circling between the ward, the resident area, and the emergency room. As expected, most of the patients who came in were either really sick (I admitted 3 people to the ICU) or mildly ill with some depression (the so-called “social admits”). There were plenty of those. By 2 am, the ER had calmed down and I began catching up on paper work. At about 4 am, I was too exhausted to keep typing and I went and laid down. Up at 6 am, worked until 1 pm, then drove home and took a nap.
Gwen was waiting at home when I got back. I took a nap, and then we got up, exchanged gifts, and went to Cynthia’s again and had a nice dinner with the gang and some red wine. We stayed probably later than we should – I had to work at 8 am on Sunday morning as well. I was tired, and despite the workload, this was the best Christmas of my residency. And that’s basically because of Gwen. It was a good feeling – to come home to her now familiarity after a long night at the hospital. A very good feeling. Like coming home.
But not all was rosy. My ward team was kind of a mess this weekend. We see a lot of tragic things in the hospital setting, but they can carry a special weight around the holidays.
There is a 21-year-old kid on my team. He is in the hospital for his second recurrence of leukemia. This new onset was accompanied by a brain tumor, which he had excised surgically. The neurosurgeon also left a CSF reservoir in his head, so that he could receive intrathecal chemotherapy (intrathecal = directly into the cerebrospinal fluid). So he has a small bump on his skull – under the skin there is a reservoir for CSF that taps into his “brain case” and therefore the spinal cord. He has received several treatments of powerful and toxic chemotherapy. As a result, his blood cell counts are garbage. He is anemic, unable to fight off infections, unable to taste anything, unable to clot his blood effectively, and more. He’s a mess, but he keeps in decent spirits. Being 21 years old is a bonus when trying to fight cancer (and when trying to fight cancer therapy, for that matter).
He has a playstation 2 in his room. I went and saw him on Christmas eve. We talked about his fever curve, his latest antibiotic issues, and some other medical things. Then we talked about video games for a while. He likes RPG’s and first person shooters. When I walked out of the room, I thought about how crazy it was – this kid was like anyone else. He liked video games and DVD’s and sports. Only, he has this horrible cancer and has undergone neurosurgery for a brain tumor and now has this what can only be described as sci-fi device essentially in his brain. And oh yeah, it was Christmas. And by next Christmas he may not be alive. Sad.
Another patient I have is worse. She is 35 years old. Back in June she found a lump in her breast. She had a surgeon look at it and had an Ultrasound. Apparently, it looked like an “inflamed lymph node”, so they decided to watch it for a while. In the late summer, she began having back pain. While shoveling snow in Alaska (where she and her family lived), she fell backward and fractured one of her vertebrae. The reason? That bone was full of metastatic tumor – it had crumbled like paper. It turns out the breast lump was cancer, and it had metastasized to her bone. She was flown to our medical center from Alaska for emergency spine stabilization surgery (again with our neurosurgeon friends). Afterward, we biopsied her breast mass and did a full body CT scan. She has breast cancer, and it has spread to her spine, liver, jaw, ribs, and skull. The prognosis is terrible. Now she is on my service undergoing daily radiation therapy to shrink some of the tumors and help reduce the pain. The treatment is palliative.
On Christmas eve, I walked in the room and she was there with her husband and her three kids. The oldest child is 5. The tone was hard to describe – like a subdued somberness. The patient and her husband were trying to feign joy for the sake of their children on Christmas while suppressing a near overwhelming sadness because of the inevitable. Man, was that a tough scene. Her kids are adorable. And this is very likely the last Christmas they will even spend with their mother. Fucking brutal.
I suppose that’s how crazy my job can be sometimes. Very satisfying and rewarding at its best. Emotionally crippling and incredibly stressful at its worst. And occasionally with that extra sense of being unreal. Like in that room on Christmas eve. Hard to believe. And harder to prepare for.
And despite that, and despite the crazy near-sleepless night that ensued that Christmas eve, and despite the depressed people that rolled through the ER that night, there was some joy there.
There is an energy to Christmas for me which is palpable. Similar to one’s birthday, there’s just an under the surface feeling of something reassuring and powerful. I suppose I can trace it back to elated memories of childhood – running downstairs at dawn or earlier on Christmas day, tearing into presents and then spending the day just happy as a clam with my family. I was euphoric. They were happy to see it. Good times. There is a residual power to the holiday that I hope never goes away. And despite the craziness I had witnessed in the hospital that day and night and following day, that power was still there on this Christmas. I still felt good driving home – even though I was tired as hell.
Happy Holidays.
Another Weekend in the Books
Gwen was out of town this weekend, leaving me a full 48+ hours of time to myself. Without beating around the bush, I'll go ahead and say that I colossally wasted nearly every hour of it.
Here's my Friday Night.
Got home from work. I stopped off at Best Buy on the way home at about 5 pm to let the traffic could die down. I walked around the store, fought the urge to buy everything in site (and yet did NO X-mas shopping), and wasted some time playing with Mike Vick and the Falcons on the display Madden 2005 game.
Got home about 7 pm. I heated up some leftovers, then went to town, playing 4 online Madden games (2 wins, 1 loss, 1 internet cut-out), a game of online chess (I didn't realize it was a 3-minute per side timed game and hence I lost rather quickly) and then 2 hours of Counter Strike. Not a bad waste of a Friday night by ANY stretch.
Saturday
I got up and drove out to suburban Redmond (15 minutes NE of Seattle) and met some of John boy's work boys out for some pick up touch football for the second weekend in a row. Despite John boy actually NOT being there this weekend (he had a playoff soccer game), it was the highlight of my weekend. A crisp beautiful clear day, some muddy football, and all was well. Pick up football may be the most fun thing ever.
There's kind of a funny dynamic at this particular game. A couple of peeps come together for 3 on 3 or 4 on 4 and there is definitely some competitiveness there that I think arises in the office. Two guys in particular, were going at it all day long. When the guy on MY team got beat by his rival for a sweet TD catch, he came running back to the huddle saying things like "Man what a PERFECT throw - I was SO on him!" He couldn't accept he had been bested (even on a SINGLE play in a pick-up football game) and sort of demanded validation from everyone else with his remarks. This sort of thing went on all day - totally blaming everything besides himself in a classic, Hurtado-esque sort of way. Fun stuff.
Saturday night, I played another Madden game online and won. After that, I foolishly started toiling with the "Create a player" mode where I wound up spending most of my weekend. Needless to say, the WCD will be back in semi-short order. There is so much intricacy to designing a team and players - it took me hours. In fact, I wasted many hours on that exact task Saturday night.
At 10:30 pm, (feeling guilty about wasting 4 straight hours on create-a-player in Madden - most of is spent giggling while I adjusted everyone's stats and laughed about it) I walked downtown solo-style and caught a showing of "Oceans 12" at the local AMC 12. The movie was visually appealing (look, movies stars!) and intellectually annoying. More on Mick Flicks soon - maybe. I got back and then tweaked with more Madden stuff until 3 am. Essentially another sweet use of a weekend night.
Sunday
I woke up, got breakfast, and then wasted the ENTIRE day doing nothing except watching football, checking stat tracker, and tweaking with the WCD Madden team. I did absolutely nothing else (except for a portion of the Seattle Times Sunday crossword). At 7 pm I walked a block and got some pizza. A total waste of day. And here I am.
Things I wanted to do this weekend but didn't get done:
-Buy Gwen's birthday presents (Dec 19)
-Buy everyone's X-mas presents online (Dec 25)
-Pay bills
-Buy my new snowboard with that sweet Proform
-Do at least 2-3 hours of medicine reading
-More exercise
Oh well, at least I played football. All in all, not a bad weekend, but I'm definitely feeling some guilt over wasting so much time on seemingly menial tasks.
I will also say that now that Gwen and I are together, I feel no pressure to be super social. When I stop and think about that, that thought actually seems a little odd and even a little sad. I'm pretty sure that the only reason I'd want to go to a bar NOW would be to meet up with someone I hadn't seen in a while and get a few drinks and talk. But the good old "getting a few drinks with the guys from work" routine is sort of over - at least while I'm seeing somebody. There's just no point to it, for some reason. I'd rather stay home and read a book, catch up on my Netflix rentals ("Barry Lyndon" has been in my house for months - it came with me from the old apartment for Pete's (taint's) sake), or simply completely waste time on video games. I'll have to think about this some more. It all seems a little wrong to me...to be continued I guess.
Anyway, bedtime - Monday approaches.
Gwen was out of town this weekend, leaving me a full 48+ hours of time to myself. Without beating around the bush, I'll go ahead and say that I colossally wasted nearly every hour of it.
Here's my Friday Night.
Got home from work. I stopped off at Best Buy on the way home at about 5 pm to let the traffic could die down. I walked around the store, fought the urge to buy everything in site (and yet did NO X-mas shopping), and wasted some time playing with Mike Vick and the Falcons on the display Madden 2005 game.
Got home about 7 pm. I heated up some leftovers, then went to town, playing 4 online Madden games (2 wins, 1 loss, 1 internet cut-out), a game of online chess (I didn't realize it was a 3-minute per side timed game and hence I lost rather quickly) and then 2 hours of Counter Strike. Not a bad waste of a Friday night by ANY stretch.
Saturday
I got up and drove out to suburban Redmond (15 minutes NE of Seattle) and met some of John boy's work boys out for some pick up touch football for the second weekend in a row. Despite John boy actually NOT being there this weekend (he had a playoff soccer game), it was the highlight of my weekend. A crisp beautiful clear day, some muddy football, and all was well. Pick up football may be the most fun thing ever.
There's kind of a funny dynamic at this particular game. A couple of peeps come together for 3 on 3 or 4 on 4 and there is definitely some competitiveness there that I think arises in the office. Two guys in particular, were going at it all day long. When the guy on MY team got beat by his rival for a sweet TD catch, he came running back to the huddle saying things like "Man what a PERFECT throw - I was SO on him!" He couldn't accept he had been bested (even on a SINGLE play in a pick-up football game) and sort of demanded validation from everyone else with his remarks. This sort of thing went on all day - totally blaming everything besides himself in a classic, Hurtado-esque sort of way. Fun stuff.
Saturday night, I played another Madden game online and won. After that, I foolishly started toiling with the "Create a player" mode where I wound up spending most of my weekend. Needless to say, the WCD will be back in semi-short order. There is so much intricacy to designing a team and players - it took me hours. In fact, I wasted many hours on that exact task Saturday night.
At 10:30 pm, (feeling guilty about wasting 4 straight hours on create-a-player in Madden - most of is spent giggling while I adjusted everyone's stats and laughed about it) I walked downtown solo-style and caught a showing of "Oceans 12" at the local AMC 12. The movie was visually appealing (look, movies stars!) and intellectually annoying. More on Mick Flicks soon - maybe. I got back and then tweaked with more Madden stuff until 3 am. Essentially another sweet use of a weekend night.
Sunday
I woke up, got breakfast, and then wasted the ENTIRE day doing nothing except watching football, checking stat tracker, and tweaking with the WCD Madden team. I did absolutely nothing else (except for a portion of the Seattle Times Sunday crossword). At 7 pm I walked a block and got some pizza. A total waste of day. And here I am.
Things I wanted to do this weekend but didn't get done:
-Buy Gwen's birthday presents (Dec 19)
-Buy everyone's X-mas presents online (Dec 25)
-Pay bills
-Buy my new snowboard with that sweet Proform
-Do at least 2-3 hours of medicine reading
-More exercise
Oh well, at least I played football. All in all, not a bad weekend, but I'm definitely feeling some guilt over wasting so much time on seemingly menial tasks.
I will also say that now that Gwen and I are together, I feel no pressure to be super social. When I stop and think about that, that thought actually seems a little odd and even a little sad. I'm pretty sure that the only reason I'd want to go to a bar NOW would be to meet up with someone I hadn't seen in a while and get a few drinks and talk. But the good old "getting a few drinks with the guys from work" routine is sort of over - at least while I'm seeing somebody. There's just no point to it, for some reason. I'd rather stay home and read a book, catch up on my Netflix rentals ("Barry Lyndon" has been in my house for months - it came with me from the old apartment for Pete's (taint's) sake), or simply completely waste time on video games. I'll have to think about this some more. It all seems a little wrong to me...to be continued I guess.
Anyway, bedtime - Monday approaches.
QUICK HIT
New post on Mick Flicks, from Tuesday evening. Not too much else is new. Rare blogging from work. Went to a "tumor board" this morning. It was of the "cardiothoracic variety", meaning it was mostly lung cancers. It's where the pulmonologist, the CT surgeon, the radiologist, the pathologist, the medical oncologist and the radiation oncologist get together, discuss every aspect of a patient's particular case (i.e. there lung mass on a chest CT, the likely extent of disease, etc) and decide that patient's best treatment and hence their fate. Kind of crazy.
But unlike House MD, it's not all that dramatic. (Man it would be fun if just one day at work played out like a House MD episode. Turn down the lights. Overdramatacize everything in site. Physicians disagreeing left and right while voices get raised.) Good stuff.
More later.
New post on Mick Flicks, from Tuesday evening. Not too much else is new. Rare blogging from work. Went to a "tumor board" this morning. It was of the "cardiothoracic variety", meaning it was mostly lung cancers. It's where the pulmonologist, the CT surgeon, the radiologist, the pathologist, the medical oncologist and the radiation oncologist get together, discuss every aspect of a patient's particular case (i.e. there lung mass on a chest CT, the likely extent of disease, etc) and decide that patient's best treatment and hence their fate. Kind of crazy.
But unlike House MD, it's not all that dramatic. (Man it would be fun if just one day at work played out like a House MD episode. Turn down the lights. Overdramatacize everything in site. Physicians disagreeing left and right while voices get raised.) Good stuff.
More later.
LOST TIME
So it's been a couple of weeks. I was hoping to put out some sort of mammoth post to encompass the time. Sadly, I haven't gotten around to it.
Since the last time, Adam and Diana have come and gone, Thanksgiving has come and gone, and so has a full week of work. Some of the highlights:
Wednesday, November 24th - Friday, November 26th
These dates are highlighted by Adam and Diana's visit. Overall, it was a great time (see his blog to the right for details). I enjoyed seeing the team up in my neck of the woods. More importantly, I'm glad they got a chance to meet and hang out with Gwen. All went well. One of the things that has been really nice about being with Gwen is how well she's "fit" with all my old friends when they have come to visit. (Cameron, Adam, Diana, Eryn, Jon, etc). This was certainly reinforced by Adam and Diana's visit.
Thanskgiving was spent at cousin Cynthia's in company of my merry band of somewhat distant relatives up here. Again, see Adam's blog for ze-tails.
Friday, November 27th
Hung out with Gwen and saw "Garden State". Review at Mick Flicks forthcoming.
Saturday, November 28th
Didn't do too much. Breakfast at Rosebud. Played some Half-Life 2. Eventually I went out and got drunk and hung out with my cousin Heath at Club Medusa in Seattle. I was out until about three in the morning. Moderate hangover the next day. I've realized that having a "girlfriend" means that going out to clubs simply isn't as fun. It's not like I've ever been a lady killer or the like at clubs in the past or anything, but the mere possibility that I could meet (and hook up with) some nice young lass while I stood there people watching and enjoying a vodka tonic made the whole club outing thing a lot more interesting. Without that, it's just another place with too much smoke that's too loud. And I could be home playing Madden online... I'll have to come back to this notion and some thoughts in a future post.
Sunday, November 29th
A dark day. The Giants lost to the Eagles, and badly. Both my fantasy teams lost and my playoff races (especially in Mick's League O' Micks) became VERY jeopardized. Furthermore, the Giant's loss ensured I would have to spend a night out in the future at a bar wearing overalls and a wife beater. (That's right - I made that bet. And the Giants lost. And I'm paying for it.) I was in SUCH a pissy mood that afternoon. It was the first time Gwen experienced the "Giants aren't doing well and they lost to the Eagles, who should really all DIE" Mike - this can be a very disconcerting Mike to be around. Sometimes I hate the Eagles so much I can't stand it. As the Giants seasons wanes here in the coming weeks, I will be focusing all my energies into rooting against the Eagles at all costs. I hate that effing team. I don't know how else to say it - I just hate them and never want them to succeed at anything.
And furthermore, that Sunday, by being depressed and hungover I flaked on meeting up with my high school ex Nicole. She was in town and had finished the Seattle marathon that morning while my boys were getting beat upon. I feel bad about it. But I really blame the Eagles.
Monday-Friday, November 30th - December 3rd
A full week of work. It was a week back after a week off. It was depressing and tiring. I'm not exercising as much as I should be. Which leads to increased stress, which leads to exacerbations of my body dysmorphic disorder, which leads to me getting bummed out. I have to remember to sleep enough and get enough exercise. And eat right. I swear those three things should be the cornerstones of everyone's life (before children, and even after children keep 2 of the 3). If everyone did these things, the world would be a happier place. I'm basing this on personal experience here.
Saturday, December 4th
Not a bad day off. Woke up and got some Rosebud (favorite breakfast place). Then met one John-boy Clemmens and some of his work boys and played some touch football for about 3 hours in 41 degree rainy weather. It was a blast - and I'm feeling it today. Got home, showered, and took a nap. Got up, got a burrito for dinner, and the I played 5 straight hours of Counter-Strike. Eryn played with me for the first hour and then the last hour. By the end I was seeing double. But I was starting to get some of the old skills back. A big waste of time. But I can't complain too much - the game is fun.
Sunday, December 5th
Here we are. Watched football. Ate dinner. Typed this. Yada yada.
And there it is. This is a quick and terribly written, vastly unedited post because I need to get to bed. (See my rules above). There are a lot more things I'd like to discuss and maybe I'll do that this week in more meaningful, more superiorly crafted posts. I hate the quick and dirty type narratives I've been putting up here.
God damn this blog has become a source of guilt. Ugh. Like I need more of that.
Anyway, till next time.
So it's been a couple of weeks. I was hoping to put out some sort of mammoth post to encompass the time. Sadly, I haven't gotten around to it.
Since the last time, Adam and Diana have come and gone, Thanksgiving has come and gone, and so has a full week of work. Some of the highlights:
Wednesday, November 24th - Friday, November 26th
These dates are highlighted by Adam and Diana's visit. Overall, it was a great time (see his blog to the right for details). I enjoyed seeing the team up in my neck of the woods. More importantly, I'm glad they got a chance to meet and hang out with Gwen. All went well. One of the things that has been really nice about being with Gwen is how well she's "fit" with all my old friends when they have come to visit. (Cameron, Adam, Diana, Eryn, Jon, etc). This was certainly reinforced by Adam and Diana's visit.
Thanskgiving was spent at cousin Cynthia's in company of my merry band of somewhat distant relatives up here. Again, see Adam's blog for ze-tails.
Friday, November 27th
Hung out with Gwen and saw "Garden State". Review at Mick Flicks forthcoming.
Saturday, November 28th
Didn't do too much. Breakfast at Rosebud. Played some Half-Life 2. Eventually I went out and got drunk and hung out with my cousin Heath at Club Medusa in Seattle. I was out until about three in the morning. Moderate hangover the next day. I've realized that having a "girlfriend" means that going out to clubs simply isn't as fun. It's not like I've ever been a lady killer or the like at clubs in the past or anything, but the mere possibility that I could meet (and hook up with) some nice young lass while I stood there people watching and enjoying a vodka tonic made the whole club outing thing a lot more interesting. Without that, it's just another place with too much smoke that's too loud. And I could be home playing Madden online... I'll have to come back to this notion and some thoughts in a future post.
Sunday, November 29th
A dark day. The Giants lost to the Eagles, and badly. Both my fantasy teams lost and my playoff races (especially in Mick's League O' Micks) became VERY jeopardized. Furthermore, the Giant's loss ensured I would have to spend a night out in the future at a bar wearing overalls and a wife beater. (That's right - I made that bet. And the Giants lost. And I'm paying for it.) I was in SUCH a pissy mood that afternoon. It was the first time Gwen experienced the "Giants aren't doing well and they lost to the Eagles, who should really all DIE" Mike - this can be a very disconcerting Mike to be around. Sometimes I hate the Eagles so much I can't stand it. As the Giants seasons wanes here in the coming weeks, I will be focusing all my energies into rooting against the Eagles at all costs. I hate that effing team. I don't know how else to say it - I just hate them and never want them to succeed at anything.
And furthermore, that Sunday, by being depressed and hungover I flaked on meeting up with my high school ex Nicole. She was in town and had finished the Seattle marathon that morning while my boys were getting beat upon. I feel bad about it. But I really blame the Eagles.
Monday-Friday, November 30th - December 3rd
A full week of work. It was a week back after a week off. It was depressing and tiring. I'm not exercising as much as I should be. Which leads to increased stress, which leads to exacerbations of my body dysmorphic disorder, which leads to me getting bummed out. I have to remember to sleep enough and get enough exercise. And eat right. I swear those three things should be the cornerstones of everyone's life (before children, and even after children keep 2 of the 3). If everyone did these things, the world would be a happier place. I'm basing this on personal experience here.
Saturday, December 4th
Not a bad day off. Woke up and got some Rosebud (favorite breakfast place). Then met one John-boy Clemmens and some of his work boys and played some touch football for about 3 hours in 41 degree rainy weather. It was a blast - and I'm feeling it today. Got home, showered, and took a nap. Got up, got a burrito for dinner, and the I played 5 straight hours of Counter-Strike. Eryn played with me for the first hour and then the last hour. By the end I was seeing double. But I was starting to get some of the old skills back. A big waste of time. But I can't complain too much - the game is fun.
Sunday, December 5th
Here we are. Watched football. Ate dinner. Typed this. Yada yada.
And there it is. This is a quick and terribly written, vastly unedited post because I need to get to bed. (See my rules above). There are a lot more things I'd like to discuss and maybe I'll do that this week in more meaningful, more superiorly crafted posts. I hate the quick and dirty type narratives I've been putting up here.
God damn this blog has become a source of guilt. Ugh. Like I need more of that.
Anyway, till next time.
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