I'm the luckiest. Lucky (blessed) to have the friends that I do. I just got home from the wedding weekend of Greg and Jen England which also turned out to be a Cedarville friend renunion. By the way, I was either going to title this post "the luckiest" or "wish those annal fissures didn't hurt so much." You definitely had to be there at the "wish" table to get that one.
Greg and Jen had a beautiful wedding ceremony. Truly, it was beautiful. The service focused on the grace of God and what a perfect example of marriage we have in Christ and the Church. This was delivered by our very own "pastor Dave," and what a special thing for one of Greg's best friends to perform their ceremony. Greg and Jen wrote their own vows, and I was so touched by what they said. Especially Greg, after knowing him for so many years, and hearing how this woman has changed his life, how much his heart is committed to her and to God, and what an impact he has had on Jen's life. I know I'm not his mom or anything, but I'm so proud of him.
This morning we got together at Ang and Ryan's for a late brunch. It reminded me of how many of our places we've been to together, all the trips we've taken, cooking for a big group and just hanging out. So many fun times.
One of the countless things I love about my college friends is that we always laugh so much together. I love hearing Eric laugh, and Ryan, who was the first to marry into our group, is somehow the ring leader of our shananagans. Our table was having such a good (i.e. loud) time that I think people probably thought we were the abnoxious drunk relatives that come out of the wood work at weddings, except that we're not related and we weren't even drunk. We seamlessly pick things up like not a day has passed apart. And as sappy as this sounds, I'm going to say it anyways- I'm just so completely happy when I with them. Being with friends who you've lived with for 4 years, day in and day out, who know all the bad along with the good and all your idiosyncracies, it's like being with family, being able to be your real self. And yet being with them makes me want to be my best self. They make me better. I know you're laughing but I'm mean it :)
In addition to Greg and Jen's wedding, we had more news to celebrate. Aaron is getting married to Katie! Another wonderful thing we've experienced as friends is welcoming spouses and children and siblings into the group. It was great to see Deb (remember when you visited Cedarville?), and the boys are all so grown up with their wives. I think us girls should stop "the boys" thing and maybe call them "the guys" now. Jen, Lauren, Katie, Annie, and April are all awesome girls and I look forward to getting to know them better through the years. Our guys sure are lucky!
God has been so good to all of us. I love seeing how He has led each of our lives and all the things my friends are doing and have become. I count you as one of my greatest blessings. I do feel like I'm the luckiest.
So in my imaginary perfect world, we all live the same cool city, go to the same church, and get together once a week at our places for Bible study and snacks. We hang out on the weekends and don't have to do a whole lot to be entertained. Until I can somehow arrange everyone's live to fit my dream world, college reunions (Oct 2008!), frequent trips and girls weekends in Chicago, and weddings will have to do. Thank goodness that Aaron and Katie are getting married this summer, I only have 6 months to miss them all!
Sunday, January 27, 2008
Wednesday, January 16, 2008
I bit my tongue, hard
People really do amaze me. We are all imperfect and utterly flawed, and even knowing this I am still amazed. You see, you take sick, frusterated, stressed, sleep deprived and over tested patients, and you put them in a building with stressed, sleep deprived health care professionals who are under a lot of pressure and responsibility and taking care of multiples of the above described patient, and you get situations similar to mine last night on call.
I admited a young female last night, close to my age, who is suffering from a chronic degenerative disease. She's young and otherwise healthy, has her whole adult life ahead of her, and yet has spent the last 5 years in and out of the hospital with likely much of the same in the years to come. She doesn't work and spends most of her time in bed. That is a very difficult lot to be had. Who would ever blame her for feeling frusterated, even sad for herself, and who would blame her for not necessarily being the "best version of herself" each time she is forced to come into the hospital?
But that's not the entire story. My first encounter with this girl was fine. She thanked me for my help, and when she asked for a cup of water, instead of telling her to turn her call light on I went down the hall and got it myself. I was called back to her room later that night because she had gotten into it with the nurse and said she wanted to be transferred to "a real hospital." The room smelled, it couldn't have been cleaned before she arrived. She complained that she had to wait for her toiletries to be delivered. I told her that I would get them for her and she said that well the nurse did bring them eventually. She complained that her boyfriend wasn't allowed to spend the night. I told them that he could. (He ended up leaving to go home a hour or so later.) She complained that she didn't get a hot dinner (she had just told me she had no appetite), and I apologized that the kitched was closed. We got her a shake and a sandwich instead. I convinced her that it would be in her best interest to stay, because if we tried to arrange a transfer at that hour, she would probably not get any sleep and feel worse. She calmed down, and they thanked me again. She told me that I was the only professional person she had met.
The next morning I received a call that she was yelling and swearing at the nurses, was refusing meds, and had been throwing things all over the room. Her floor was soaked with water and juice and applesauce which she had thrown all over the place. She pulled her IV out. She didn't think her nurse knew how to take a blood pressure, at least not to her liking. She said that she spent all night crawling back and forth to the bathroom because she didn't want to call the nurses for help. She was irrate, she couldn't be reasoned with. I told her that after the attending had seen her that we could try to arrange for transfer to another hospital. Well things post call never work out as planned, so this of course turned out to be my job.
So instead of going home after a 26 hour shift, I stayed to arrange this girl's transfer out of our hospital. After several phone calls, additional charting, and an hour later, I went to her room to let her know that she would hopefully be leaving later today. I had a STRONG notion to also explain, "off the record," that although I can sympathize with her frusteration of having to be in the hospital and that unfortunately she sometimes has to deal with attitudes from nurses, poor nurses, whatever, that if she tried to get along with those trying to take care of her (or another way of putting it, act like an adult), she would most likely be happier with the care she received.
That's not what I said. I told her she was waiting for a bed to open up at the other hospital and walked out of the room and she calmly thanked me. I felt like she was trying to trick me with her new found composure into believing that none of her previous poor behavior had happened. I'm sure she felt justified.
So what would she have done if I HAD said what I wanted to? Would it have "reached her," since she said so herself that I was the only nice and professional person there? Would it have made her all the more upset, just one more thing and person to complain about? Would it have made the rest of the day more unbearable for the people left to take care of her in the coming hours? I'd like to think that whatever her initial reaction that she would have at least thought about it later with some degree of reflection and regret. But I don't think that would have happened.
And that's medicine. Patients do and say whatever they please, and the health care professionals bite their tongues. But I have questions.
Isn't there a difference between what some would call "judging" and addressing unacceptable behavior? Do people ever benefit from being talked to like the adults they are rather than the children they are acting like? Does it benefit people to pretend there is no personal responsibility for the way that they act? When people behave as this girl did and no one says anything, is that the same as enabling and reinforcing that kind of behavior? Would it have been wrong of me to tell her that it's inappropriate behavior to trash the room and swear at nurses, that she might receive better care if she was more pleasant to the nurses, that if she was that unhappy she could walk out on her own and show up at someone else's ER (please, save me the work)? Do social rules/norms that I think apply in the real world not apply to medicine? Is this as screwed up as I think it is? Is there something wrong with me that this bothers me so? Or should I just not expect patients to behave with what in my mind is basic human respect, courtesy, and manners? Or at least not surprised when then don't?
I think medicine should be paternalistic. I think health care professionals should be able to talk to adults like adults. I came this close to calling this girl on the carpet in a professional manner that I think could have been justified. But I didn't. Now I am done with her, oh no, unless she's still there tomorrow morning. Next time I'm in a similar situtation, I'm not sure what I will do.
I admited a young female last night, close to my age, who is suffering from a chronic degenerative disease. She's young and otherwise healthy, has her whole adult life ahead of her, and yet has spent the last 5 years in and out of the hospital with likely much of the same in the years to come. She doesn't work and spends most of her time in bed. That is a very difficult lot to be had. Who would ever blame her for feeling frusterated, even sad for herself, and who would blame her for not necessarily being the "best version of herself" each time she is forced to come into the hospital?
But that's not the entire story. My first encounter with this girl was fine. She thanked me for my help, and when she asked for a cup of water, instead of telling her to turn her call light on I went down the hall and got it myself. I was called back to her room later that night because she had gotten into it with the nurse and said she wanted to be transferred to "a real hospital." The room smelled, it couldn't have been cleaned before she arrived. She complained that she had to wait for her toiletries to be delivered. I told her that I would get them for her and she said that well the nurse did bring them eventually. She complained that her boyfriend wasn't allowed to spend the night. I told them that he could. (He ended up leaving to go home a hour or so later.) She complained that she didn't get a hot dinner (she had just told me she had no appetite), and I apologized that the kitched was closed. We got her a shake and a sandwich instead. I convinced her that it would be in her best interest to stay, because if we tried to arrange a transfer at that hour, she would probably not get any sleep and feel worse. She calmed down, and they thanked me again. She told me that I was the only professional person she had met.
The next morning I received a call that she was yelling and swearing at the nurses, was refusing meds, and had been throwing things all over the room. Her floor was soaked with water and juice and applesauce which she had thrown all over the place. She pulled her IV out. She didn't think her nurse knew how to take a blood pressure, at least not to her liking. She said that she spent all night crawling back and forth to the bathroom because she didn't want to call the nurses for help. She was irrate, she couldn't be reasoned with. I told her that after the attending had seen her that we could try to arrange for transfer to another hospital. Well things post call never work out as planned, so this of course turned out to be my job.
So instead of going home after a 26 hour shift, I stayed to arrange this girl's transfer out of our hospital. After several phone calls, additional charting, and an hour later, I went to her room to let her know that she would hopefully be leaving later today. I had a STRONG notion to also explain, "off the record," that although I can sympathize with her frusteration of having to be in the hospital and that unfortunately she sometimes has to deal with attitudes from nurses, poor nurses, whatever, that if she tried to get along with those trying to take care of her (or another way of putting it, act like an adult), she would most likely be happier with the care she received.
That's not what I said. I told her she was waiting for a bed to open up at the other hospital and walked out of the room and she calmly thanked me. I felt like she was trying to trick me with her new found composure into believing that none of her previous poor behavior had happened. I'm sure she felt justified.
So what would she have done if I HAD said what I wanted to? Would it have "reached her," since she said so herself that I was the only nice and professional person there? Would it have made her all the more upset, just one more thing and person to complain about? Would it have made the rest of the day more unbearable for the people left to take care of her in the coming hours? I'd like to think that whatever her initial reaction that she would have at least thought about it later with some degree of reflection and regret. But I don't think that would have happened.
And that's medicine. Patients do and say whatever they please, and the health care professionals bite their tongues. But I have questions.
Isn't there a difference between what some would call "judging" and addressing unacceptable behavior? Do people ever benefit from being talked to like the adults they are rather than the children they are acting like? Does it benefit people to pretend there is no personal responsibility for the way that they act? When people behave as this girl did and no one says anything, is that the same as enabling and reinforcing that kind of behavior? Would it have been wrong of me to tell her that it's inappropriate behavior to trash the room and swear at nurses, that she might receive better care if she was more pleasant to the nurses, that if she was that unhappy she could walk out on her own and show up at someone else's ER (please, save me the work)? Do social rules/norms that I think apply in the real world not apply to medicine? Is this as screwed up as I think it is? Is there something wrong with me that this bothers me so? Or should I just not expect patients to behave with what in my mind is basic human respect, courtesy, and manners? Or at least not surprised when then don't?
I think medicine should be paternalistic. I think health care professionals should be able to talk to adults like adults. I came this close to calling this girl on the carpet in a professional manner that I think could have been justified. But I didn't. Now I am done with her, oh no, unless she's still there tomorrow morning. Next time I'm in a similar situtation, I'm not sure what I will do.
Friday, January 4, 2008
Math Quiz
What does a long list of patients to see by myself, 2 complications, 3 discharges, 1 rude and out right mean nurse, 1 lost lab result, 1 missing surgeon, 1 really bad sign out, 10 directions being pulled in; minus lunch and getting to go to the bathroom; multiplied by my baseline level of frusteration and distaste for general medicine; squared by the fact i'm on call 30 hours tomorrow and have much of the same to look forward to on monday......equal?
NOT a great day at the hospital.
NOT a great day at the hospital.
Thursday, January 3, 2008
The year in review
At the stroke of midnight on the 31st, I welcomed in 2008 on the 8th floor resident's lounge with my husband on the phone. He was at home with his pizza. Other than missing my New Year's kiss and a quiet evening with Marc, I didn't mind. I was lucky enough to have Thanksgiving and Christmas off, and as an intern, no room to complain. New Year's has never been a big deal to me. I might have been to 2 or 3 parties my whole life, the rest of the years have been spent with family and sometimes friends at our house or theirs. This year around 7pm I had a moment of "oh my goodness, this year is really over and a new year is about to start and how the times goes on and I need to reflect and what am I going to do different in 2008 and what do I hope this new year brings?" I felt like I needed time to slow down long enough for me to have a thorough examination of 2007 and to figure out what I'm going to commit to in order to make 2008 even better.
I'll start with my year in review:
1. Jan 07- I received news that not only did I match in ophthalmology, but I did so at my deep down first choice, Loyola. I was so overwhelmed and relieved that I cried off and on all day and had to put a bag of frozen vegetables on my face to reduce the swelling. The interview process and awaiting the results was one of the most anxiety ridden situations I've experieced. God was so good to open that door for me.
2. June 07- I graduated from medical school. What a momentous day. I was proud and moved and had it all to share with my family and Marc. How could I have done it without them? Even though I had been studying and working hard for years, I felt as though my professional life began that day. I said good bye to my med school friends who are now scattered all over the US in their residencies. It took a while to get used to Oak Park without them, I only know my life here with them in it. Some memories. I miss them. Even though we're not together in location, we can still understand each other's lives these days better than anyone else.
3. June 07- Marc and I celebrated our one year anniversary. They say the first year is the hardest, and if that's true, marriage has been very good to us. I am so blessed to have Marc as my husband and there are moments when I look at him and I am so filled up with love that I can't tell him how much so. It makes me silly sometimes. We also took a belated honeymoon cruise to the Mediterranean, well worth the wait.
4. I started intern year of my residency. I wore a long white coat with my name embroidered on it. I introduced myself as "Dr. Landes." I carried pagers that actually went off, a lot. I stayed up all night long on 30 hour shifts. I was responsible for lots of details and getting patients home. I intubated. I amputated. I participated in codes. I watched people die. I delivered bad news. I connected with patients. I became irritated with patients. I found medicine to be very frusterating. I found medicine to be very exciting. I met some cool fellow residents who are often the highlight of my day at work. I made it through half of my intern year.
5. Marc, my very very talented trumpet playing husband, decided to pursue another career and went back to school to fulfill pre-requisists for optometry. He rocked his first semester and made me and everyone who knows and loves him very proud.
6. My brother, David, also went back to school to work on his pre-recs for dentistry. He passed all of his classes and is working so hard. David seems older to me this year. He's going to be a fantastic dentist someday.
7. My Mom, Dad, and David went to Ecuador and my parents also went to India. Both trips were medical missions with our church in Hudson, OH. I admire my parents for their willingness and passion to serve.
8. Marc and I made some really awesome, quality friends at church and have so much enjoyed hanging out and studying with them. We were hoping and praying for friends like them through our first year of marriage. We love you guys!
9. I was able to watch tv. At college we didn't have tv's in our rooms. In med school all I had tme for was Alias and Friends. Now that I'm not studying for exams all the time, I have been introduced to a whole new world of entertainment and laziness.
10. My best friend Amy and her husband decided to return home to the states after their second academic year of teaching in the Philippines is over.
11. My best friend Amanda got married and moved to Nairobi with her huband.
12. My best friend Emily got married. I went to spend a weekend with her in the spring and approved of him with all my heart. They have a Cinderella story and had a picture perfect wedding. They are perfect for each other and I am so so so happy for her.
13. I was reunited with my childhood best friend who I had been missing for many years. I felt like part of me wasn't really alive anymore, and when we got in touch that sad part of my heart was revived as memories and inside jokes and the joy and freedom and comfort of having a friend you can completely be your dumb self around flooded in.
14. I seriously became obsessed about getting a dog, and then I got unobsessed.
15. My best college girlfriends gathered in Chicago for the best girl weekend ever. We stayed up way too late talking- about all things including what we want to name our children- ate the biggest piece of chocolate cake you've ever seen, and went on a mad shopping marathon. We had SUCH a great time together. I realized again how special and intimate these friendships are.
16. I started a blog, joined facebook, and bought an iPod. I'm catching up.
I'll start with my year in review:
1. Jan 07- I received news that not only did I match in ophthalmology, but I did so at my deep down first choice, Loyola. I was so overwhelmed and relieved that I cried off and on all day and had to put a bag of frozen vegetables on my face to reduce the swelling. The interview process and awaiting the results was one of the most anxiety ridden situations I've experieced. God was so good to open that door for me.
2. June 07- I graduated from medical school. What a momentous day. I was proud and moved and had it all to share with my family and Marc. How could I have done it without them? Even though I had been studying and working hard for years, I felt as though my professional life began that day. I said good bye to my med school friends who are now scattered all over the US in their residencies. It took a while to get used to Oak Park without them, I only know my life here with them in it. Some memories. I miss them. Even though we're not together in location, we can still understand each other's lives these days better than anyone else.
3. June 07- Marc and I celebrated our one year anniversary. They say the first year is the hardest, and if that's true, marriage has been very good to us. I am so blessed to have Marc as my husband and there are moments when I look at him and I am so filled up with love that I can't tell him how much so. It makes me silly sometimes. We also took a belated honeymoon cruise to the Mediterranean, well worth the wait.
4. I started intern year of my residency. I wore a long white coat with my name embroidered on it. I introduced myself as "Dr. Landes." I carried pagers that actually went off, a lot. I stayed up all night long on 30 hour shifts. I was responsible for lots of details and getting patients home. I intubated. I amputated. I participated in codes. I watched people die. I delivered bad news. I connected with patients. I became irritated with patients. I found medicine to be very frusterating. I found medicine to be very exciting. I met some cool fellow residents who are often the highlight of my day at work. I made it through half of my intern year.
5. Marc, my very very talented trumpet playing husband, decided to pursue another career and went back to school to fulfill pre-requisists for optometry. He rocked his first semester and made me and everyone who knows and loves him very proud.
6. My brother, David, also went back to school to work on his pre-recs for dentistry. He passed all of his classes and is working so hard. David seems older to me this year. He's going to be a fantastic dentist someday.
7. My Mom, Dad, and David went to Ecuador and my parents also went to India. Both trips were medical missions with our church in Hudson, OH. I admire my parents for their willingness and passion to serve.
8. Marc and I made some really awesome, quality friends at church and have so much enjoyed hanging out and studying with them. We were hoping and praying for friends like them through our first year of marriage. We love you guys!
9. I was able to watch tv. At college we didn't have tv's in our rooms. In med school all I had tme for was Alias and Friends. Now that I'm not studying for exams all the time, I have been introduced to a whole new world of entertainment and laziness.
10. My best friend Amy and her husband decided to return home to the states after their second academic year of teaching in the Philippines is over.
11. My best friend Amanda got married and moved to Nairobi with her huband.
12. My best friend Emily got married. I went to spend a weekend with her in the spring and approved of him with all my heart. They have a Cinderella story and had a picture perfect wedding. They are perfect for each other and I am so so so happy for her.
13. I was reunited with my childhood best friend who I had been missing for many years. I felt like part of me wasn't really alive anymore, and when we got in touch that sad part of my heart was revived as memories and inside jokes and the joy and freedom and comfort of having a friend you can completely be your dumb self around flooded in.
14. I seriously became obsessed about getting a dog, and then I got unobsessed.
15. My best college girlfriends gathered in Chicago for the best girl weekend ever. We stayed up way too late talking- about all things including what we want to name our children- ate the biggest piece of chocolate cake you've ever seen, and went on a mad shopping marathon. We had SUCH a great time together. I realized again how special and intimate these friendships are.
16. I started a blog, joined facebook, and bought an iPod. I'm catching up.
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