Monday, October 24, 2016


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This is a bit of a departure from my usual somewhat snarky posts, or at least I hope it turns out to be such. Almost anytime I begin a post, I don't always know where it's headed, and this particular blog is no exception in that regard. Writing has always been that way for me. (Perhaps it shows in each final product, though I hope not.) Even when I was in high school and in college, I never followed the recommended format of creating an outline for what I planned to write about, and then more or less using that outline as a blueprint for my composition. I created the outline if it was required, but not until after I finished my composition. No teacher or professor ever complained, so my method must have worked out acceptably --  either that, or what the teacher or professor had to read and evaluate from my peers was so dismal that my failure to stick to an outline was the least of his or her concerns. Writing in general, and the mechanics of writing in specific, are not the strength of my generation, albeit with some very notable exceptions.

My ninth-grade English teacher, Mr. Guest,  taught a poem by writer and editor Douglas Malloch. I still recall the work verbatim, though I won't anesthetize you by quoting all four stanzas here. The poem is not one of my favorites -- it's a bit trite for my tastes (which perhaps sounds odd coming from someone who admits to admiring the work of Dr. Suess) but still, I think there's something worth pondering within it..

It starts with these lines:

     If you can't be a pine at the top of the hill
     Be a scrub in the valley . . . but be
     The best little scrub by the side of the rill;
     Be a bush if  you can't be a tree.

Mr. Guest had a captivating lesson to go with these verses. He  was a nature boy and a hiker,  a respectable amateur photographer and videographer, and an adept user of technology before were most teachers of his time.. He used his talents to create photo montages and videos captured in the wild or in not-so-wild settings in attempt to create interest in the literature he was compelled to teach us. Kids of nine years ago (was it really nine years ago? it seems more like last week when I sat in the metal-and-plastic combo desk-chairs in his classroom), like kids of today, were far more visual than auditory. When my parents went through school, simply telling a kid something, or maybe writing it on the board as well, sufficed as teaching. Today (and probably nine years ago as well) a literal picture at the very least is needed. A video is better than a still photograph. The real thing is better than either a still or moving picture, but such isn't always feasible.

The final stanza of the poem was:

     If you can't be a highway, than just be a trail.
     If you can't be a sun, be a star;
     It isn't by size that you win or you fail . . . 
     Be the best of whatever you are!                       
Most of us would agree that the poem is hackneyed -- perfect for the twelve-to-seventeen-year olds (my brother and I were the twelve-year-olds in the class; the other students were sixteen or seventeen). Mr. Guest was given a somewhat fixed curriculum and was charged with introducing it to us, so I cannot entirely place blame upon him. We paid attention for the most part, though not on a sit-on-the-edge-of-one's-chair sort of way. Then, for most of us anyway, we promptly forgot it.  I let it drift from my conscious memory, but I'm stuck with lines upon lines of verbatim poetry that will probably never be erased from my memory unless I develop some major form of dementia, and possibly not even then. I'll be sitting in an old-folk's home sixty-eight years from now reciting Ozymandius or something meaningless by T.. S. Eliot to an audience of a blank wall.

Something -- I think it might have been footage of a beaver building a dam I saw while channel-surfing last night --  made me think of footage shot by Mr. Guest, and then of the poem associated with the footage.  It all came back, but not in the positive "the world is yours; you just have to reach out and grab it" sort of way that Mr. Guest probably intended, but in a much more negative sense.

Will I ever be the best I can be at anything? Right now I don't  know what it is at which I might want to be the very best. I don't mean better than everyone else in the world. I wonder, merely, if I will or even can be the best I could ever be at any given thing. Is it possible? Do I have inside me what it takes? And how important is it, anyway? For me, is it more important to do a lot of things well than it is to be the best at any single thing?

I play the piano very proficiently. I play the violin well. I'm learning to play the viola well. As much as I love the sound of the cello and will always play it because I love the sound so much, I'll never be the best I can be at it because the bowing action hurts my right hand. It would have been nice, perhaps, for the cello to be that thing at which I excelled to my capacity, but it isn't going to happen. I'll have to be satisfied with getting out my cello and producing very nice sound for  few minutes until it hurts my hand to play it any longer. As far as the other musical pursuits are concerned, am I taking unnecessary time away from my future profession by using them in any way other than as a diversion?

And what about medicine? I haven't firmly decided upon a specialty. Should I choose something that goes along with what my dad is doing and the foundation he has built up, or should I blaze my own trail in an entirely different field of medicine, knowing just enough about what it is that he does that I can effectively supervise the employees we hire once my dad is out of the picture if my brother and cousin and I all decide on branches of medicine that have nothing to do with oncology or hematology, assuming we don't sell his business. I hate to refer to my dad's foundation as a business, but with the money it brings in, that's what it really is -- an altruistic one, but a business just the same.

And where does family comes in, if I even have one? I picture myself as someday being a mother, but is bringing children into this world the best thing to do if they're going to live in a world in which nations are at war with one another over something so basic as water?  And, presuming I even  find a suitable father for any children I might attempt to produce, am I a suitable vehicle for bringing children in this world?  While many people struggle with more far physical and mental drawbacks than those with which I have been cursed, I have a midsection the size of the average girl of twelve years, six months. (My height is in my legs and neck.) I am aware that Warren Jeffs and his Band of Merry Pedophiles have been conceiving babies with girls approximately twelve years, six months of age, give or take a month or two, since long before I contemplated the prospect, but that, in and of itself, does not make the practice optimal.The midsection is where a baby grows. Is it fair to a baby (or babies; I'm genetically predisposed to twinning) to have to survive in such cramped quarters until birth? After the child is born, a sane person wouldn't place the child in a shoe box created to hold ballet slippers made for a five-year old. That's essentially what I would be doing to the poor baby (or babies) before it (they)  was (were) born. Am I predisposing any children I might bear to inferiority?

Then, once the child is born, presuming it survives and thrives, what does a parent do? Continue to practice medicine full-time, letting hired help raise my child or children? Hope for a man who  is willing to be a house-husband and is capable of doing a decent job of it? Compromise, as in practice part time. Quit practicing medicine except for the required number of hours per year to maintain licensure, hoping that my little family can live off the spouse's salary plus what I have put away until the child or children is or are old enough for me to work part-time?

How do I even survive and keep my head above water, much less pursue excellence in any way, shape, or form? The big idea of having it all is a myth.Thanks, Mr. Guest. You may have thought you were doing us a favor in teaching that little blurb that hardly qualifies as a literary work, but you've opened a can of worms where I'm concerned. Now can you please tell me how to shove the worms back inside the can and slam the lid shut before I come up with any more bleak thoughts about my future?

P.S. I can already guess Judge Alex's response: read the Desiderata. (It, too, I have committed to memory. I cannot even remember if it was intentional.)

Sunday, October 23, 2016

Coffee and Obnoxious LVNs

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I really don't have an opinion about coffee drinkers as long as they don't try to force me to pay for their habit.

Some hospitals supply employees with coffee free of charge. It's just part of the hospital's budget. If it's a teaching hospital, and if they, the hospital
administrators, consider that they're expecting interns and even second-year residents to make intelligent life-or-death decisions while working an insane number of consecutive hours with very little sleep, paying for the coffee is probably the very least the hospital management can do. Some hospitals even make coffee available in certain waiting areas -- usually for the families of patients in intensive care units or in surgery.

Other hospitals are less generous. Both staff and visitors of patients are very lucky to get free toilet paper; assuming coffee will be provided is pushing expectations a bit far. Some have vending machines that provide -- for a fee -- what is reported to be among the worst coffee on the planet. At that point, were I a caffeine addict, I'd take a few steps further down the hall to the next vending machine and just get a Red Bull or its equivalent.

The hospitals at which I do the vast majority of my work are all part of the same system run by the same governing board and financed by the same operation. One would think their coffee policies would be the same, or at least similar, at the respective hospitals. One would think wrongly.

I should explain at some point that I am a non-coffee drinker. Many people say they don't drink coffee. By that, they mean they don't have it every morning, or maybe not even once a week, but if it's cold enough and they're sleepy enough yet expected to work, they'll down a cup. Or if they're with a group that decides to visit Starbuck's on the way to wherever they're going some morning, they'll order something coffee-related -- cappuccino, latte, espresso, whatever, or just plain coffee; I couldn't identify one from the other if someone held a gun to my head and demanded that I do so -- even if they might not otherwise do so.  

if I were with a group that insisted on making a Starbuck's pit stop, I'd order orange juice if anything, and I'd drink it with trepidation. I once, in perfect health,  drank just half of a Starbuck's small hot chocolate. Within fifteen minutes I had fainted, and I spent to remainder of the day either clutching my stomach or worshiping the porcelain goddess. And that was the hot chocolate. One time someone -- I cannot even remember who, which is probably a good thing -- insisted that I at least try coffee.  Someone prepared a cup of it for me with cream and sugar. I didn't particularly like the taste, but it wasn't so bad that I couldn't at least drink a couple of sips. I probably ended up finishing maybe half of one of those standard-sized styrofoam cups of the stuff. That is the point at which I began  barfing. It's unfortunate that I didn't barf sooner and more, because some of the coffee inevitably made its way to my colon, where it inflicted major damage. I'll leave out the gory details, but I ended up admitted to a hospital for what I will euphemistically refer to as a  procedure. That was the beginning and the end of my relationship with coffee.

So I was caught by surprise very early Saturday morning when an especially officious  LVN (The woman is twenty-five years old now and seems to feel that she accomplished a feat nothing short of amazing by having become a licensed vocational nurse [in some other states referred to as a "licensed practical nurse"] at the age of twenty-four. I'm not denigrating LVNs, as they're an essential part of the collective medical team. It's just that, for example,  my friend Caitlyn, now 23, who currently holds a bachelor's degree in nursing science and is pursuing a master's, graduated from high school as an LVN. There's nothing especially astounding about having achieved the rank as a twenty-four-year-old.) hollered out to me from down the corridor, "I don't know your name, but I need twenty-five dollars from you." I looked in the opposite direction, assuming the LVN must be extorting money from someone other than me.

When I saw that there was no one beyond me in the corridor, I turned and responded to the LVN, "I don't know your name, either, but perhaps you should find out what my name is before you demand money from me."  I then walked back to the main intake area of the E.R. and promptly forgot about the interaction. I took a few more patient histories and documentations of symptoms before receiving my injection and heading to my locker to retrieve my belongings and to leave. 

Officious LVN was waiting for me outside the med student locker area holding a a clipboard and pen. "I need twenty-five dollars from you," she demanded.

"I could probably use twenty-five dollars from you as well," I responded, "but I'm polite enough not to ask for it."

Officious LVN sighed. "The money isn't for me personally." she explained with mock patience. "It's for the coffee fund."

"I don't drink coffee . . . ever," I answered, trying hard to do so without even as much as a trace of attitude.

"Everyone says that, but everyone drinks it," she replied, not bothering with even a phony half-smile.

"No. I really don't drink coffee," I clarified. "A little over two years ago I tried it for the first time because a couple of my cohorts insisted. Half of  cup of the watered-down version landed me in that hospital [I pointed to the adjacent children's hospital]. My gastroenterologist told me never, ever, to drink as much as a sip of the stuff again, and I haven't. He's in the E.R. right now if you want to verify my story."

"No," she laughed. "It doesn't matter. Nurses, medical students, and interns pay for the coffee. It's the way it's done. Even the Mormons pay the fee." She paused. "Some of them drink it, too." She giggled.

"Does the coffee fee cover the cups or the costs of hot water?" I asked her. I do occasionally use the cups that are stacked next to the coffee for water when the cones provided for that purpose haven't been re-stocked, and I can see possibly bringing a package of instant hot chocolate (the very mild kind -- not like what Starbuck's serves) when I have to report for duty on an early winter morning, although I prefer bringing one of my own mugs to using styrofoam. 

"No," she replied curtly. "The hospital pays for the cups and the water.'

"I'm not paying for coffee that I'm not going to drink. I'll even make a deal with you. If anyone catches me drinking your coffee -- and the person has to look inside the cup to ensure it's not water or hot chocolate -- I will pay ten times the annual coffee fee, payable within twenty-four hours of the time the person catches me drinking the coffee. You'll probably have to find me in the E.R. or on the gastro floor to collect, because that's how sick I'll be, but I will pay two-hundred-fifty bucks if anyone catches me drinking your coffee. i'll put it in writing if you want."

"You don't need to do that," she grumbled. "It's just the point of the thing. Everyone pays. I don't see why you need to be so difficult."

"I'll remind my brother to pay. He'll probably actually drink some of your coffee," I offered.

"What's his name?" she asked. I told her. "He's already paid," she conceded.

"Then I'll remind my dad to pay. He works here sometimes," I added.

"Oh, no!" she exclaimed. "He's a doctor!" Doctors don't pay for coffee here!"

By then i was curious. "Exactly who does pay for the coffee here?" I asked.

The list was apparently so exhaustive that she needed to count on her fingers to keep track. "The nurses. The nursing aids. The student nurses. The custodial staff. The medical students. [She added a hint of vocal disdain, apparently for my benefit.] And the interns!"  she concluded.

I thought for a moment, then commented. "The people who are paid the very least [meaning the custodial staff] pay for the coffee. The people who pay for the privilege of working here [the medical students and student nurses] pay for the coffee. The people who, when you factor in their hours of indentured servitude [the interns] earn practically less than minimum wage, pay for the coffee. but the doctors don't?'

"No," she replied. "And the nursing directors don't, either." She seemed almost proud of the concept.

"Is it because you don't have the guts to ask them to chip in?' I questioned in response as I walked away from her and out of the hospital.

I suppose I'll be on some sort of nurses' shit list from now on, but I don't care. Had the LVN asked me nicely in the first place, I would have just handed over the twenty-five dollars without comment, but she didn't, so I didn't.

It's not my issue, but if I ever find the time and energy, I'll print a flyer to be posted in residents' and attending physicians' of various departments' locker rooms asking if they would mind pitching in a small amount for the coffee so that the custodial staff isn't supplying coffee for people who earn five-hundred grand each year. Of course I won't word it that way, and I'll have people with far more authority than I have post the flyers. 

I don't care about coffee. I don't think who drinks it and who does not drink it is in any way a moral issue. It is my opinion, however, that people who drink coffee should pay for their own coffee. If my stating such causes a few people to dislike me who otherwise might not have had an opinion of me, so be it. I can live with the consequences.

For obvious security reasons I cannot post an actual picture of the officious LVN, but this is a close facsimile I happened to find.

Saturday, October 22, 2016

When Med School and Family Merge

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I believe that I've shared this story from my family's archives. Nonetheless, I'll share it now on the outside chance either that  I dreamed having shared it but didn't actually do so, or that I did share it and you happened to miss that particular blog.  If I did share it and you didn't miss it, either skip this blog or prepare to be bored. I apologize in advance.

My grandmother was in the hospital a couple of summers ago with pancreatitis. In her absence someone probably grocery shopped for my grandfather, in addition to preparing meals for him, because I cannot imaging that he possesses the mental faculties required to transport himself to and from a supermarket, much less to navigate his way through the various sections of a grocery store and to make purchases of food he could either eat without cooking or, God forbid, actually cook. (The Earth might cease to rotate if my grandfather were ever observed or even rumored to have done woman's work.) Someone usually goes inside his condo and disables the microwave if my grandmother is ill or otherwise away from home for a significant amount of time because he doesn't understand the concept of not putting metal inside a microwave and then operating it, and he has destroyed multiple microwave ovens and nearly started an equal number of house fires. Whoever came up with the idea  that a person would need to possess intelligence in order to help to direct the upper levels of a church has very little association with reality.

Anyway, when my grandmother is ill or otherwise indisposed, someone comes into the condo to bring food, clear away the old food, or what's left of it, anyway (my grandfather cannot be bothered even with carting his dishes to the sink; he's too holy and has to much of of the Lord's business on his mind to be bothered with such mundane chores), clean up the mess that my grandfather has made of the place while eating (once we brought our dog to my grandparents' condo while we were visiting; in a two-hour visit, the dog managed to gain nearly a pound just from lingering near my wherever my grandfather stationed himself, and it wasn't as though my grandfather was deliberately slipping treats to the dog, either, as my grandfather hates dogs every bit as much as he hates people; it's just that he's such a slob that an entire meal may be made  of the food that he drops while feeding himself; and yes, he is senile, but not THAT senile) and take care of other basic cleaning chores (I'd be really surprised to find out that my grandfather even flushes the toilet after himself; his excuse is probably that Jesus didn't flush toilets, so why should he?).  Come to think of it, except for cooking and cleaning up after meals. and most of their meals are restaurant meals, someone does almost everything for them even when my grandmother is at home and is well.

Anyway,  my grandparents receive all this pampering at the hands of a church membership that, in theory, cannot  afford even to pay for professional services to clean its local buildings and instead requires its local members to show up on designated Saturdays with their own cleaning products to scrub toilets and take care of other cleaning chores. My dad keeps eagerly anticipating the time when two different members unwittingly pour incompatible cleaning products into the same toilet and cause either an explosion or unintentional chemical warfare, killing god knows how many. It's not the incidental deaths that my dad eagerly anticipates (at least I hope it isn't, though he may be more morbid than I know) but, rather, the opportunity to highlight just how parsimonious this very wealthy church is in its ways of dealing with local members. The head honchos in Salt Lake City, however, are treated in anything but a penurious manner. (I would have loved to have used the word niggardly here, but the very last thing I need is for my  less-than erudite relatives to accuse me of overt racism in my blog.) They, the Salt Lake city elite, are not scrubbing their own toilets, much less those of the the churches they attend. 

I digress again. The hired help does a good job of taking care of my grandparents, and particularly of my grandfather during the times when my grandmother is not around to manage even the basics, but one thought never occurred to me pertaining to any of these domestic helpers: I really wonder if these workers are documented, i.e. possess green cards; it's neither here nor there, but my curiosity is piqued. One thought that never occurred to the domestic helpers, apparently,  was  to clean out the refrigerator when my grandmother is not around. In at least one instance, they clearly did not.

My Uncle Lee paused in the kitchen for long enough to notice that my grandfather had seated himself in the breakfast nook of the condo and was feeding himself one spoonful after another of mold-laden cottage cheese.  The idea of eating cottage cheese in its pristine state is more than enough to make me gag, but my grandfather was helping himself to a full carton of a mold-enhanced version of the vile concoction. "Trogolodyte!"  *** my Uncle Lee said to his father-in-law [my Uncle Lee obviously did not address my grandfather as Troglodyte, but since I cannot use his actual name here, Troglodyte seems as fitting as any other pseudonym], "You can't eat that! It's full of mold! Can't you see the mold there?"

"Mold, schmold!" Troglodyte answered him. 'What do you think they make penicillin from, anyway? Everyone knows penicillin is good for you, so mold is obviously good for you, too! Didn't your dang medical school teach you anything?"  Uncle Lee was and is a doctor, though not necessarily a very good one. Troglodyte continued spooning one bite after another of the puce-green-and-white mixture from the carton into his mouth. Meanwhile my Uncle Michael walked into the room.

"Trogolodyte is eating moldy cottage cheese," I told my uncle. My Uncle Michael took one look at the situation, grabbed the cottage cheese container from his father's hand, walked over to the sink, turned on the water, flushed the stuff into the garbage disposal, then flipped the garbage disposal's switch.

"Dagnabit!" Troglodyte yelled. "What in the Sam Hill do you think you're doing, throwing away perfectly good food?"  He stood and moved toward me, as though either to kick or slap me, considering that this incident was in some way my fault.

"Don't touch her," my Uncle Michael warned Troglodyte as he stepped between the beast and me. "She didn't do anything to you." "Ihere are enough bacteria and mycotoxins in that cottage cheese to kill you if you eat enough of it," my uncle said to the Troglodyte. Then he whispered under his breath where only I could hear it, "But he's probably been eating that garbage far so long that it probably wouldn't even have any effect on him. It's just that the rest of us don't need to get sick from watching him eat it."

I hadn't mentioned in an earlier blog that I learned very recently that my paternal grandmother has been giving extravagant birthday, Christmas, and other  gifts and checks to my brother but not to me. My parents kept this information form me for quite some time, but I eventually learned of it when Matthew left a sizable check lying from her around that was a gift for passing the USMLE. Matthew didn't leave the check where I would find it to be hurtful to me. He had no idea I didn't receive one as well.

I initially kept this information from my blog with the rationale that if my feelings were hurt, it would be a source of mirth to many of my less-than-kind relatives. instead, I decided to share the information. I'm probably not the only black sheep in this loosely-bound organization to which some would euphemistically refer as a family. We, my grandmother's progeny, deserve to know where we stand. My guess is that roughly 80% of us have been on the receiving end of generous gifts and checks from my grandmother.  I could have erred in either direction. Perhaps I really am the only one who is not a regular stipendiary of her fortune.  If such were the case, though, I'd be very surprised.

I wrote a sincere and heartfelt letter to my grandmother in which I expressed my hurt feelings at her preferential treatment in favor of Matthew. I sent it by certified mail. She received it. I have have no way of knowing for certain that she actually read or even opened it. In any event, I gave her ample time to respond. She chose not to do so.  Cousins, if you're among the recipients of our grandmother's generosity, you can either consider yourselves to be fortunate, or you can consider yourselves the beneficiaries of a cold-hearted woman who uses her considerable financial resource to the betterment of some while deliberately disregarding others, perhaps even for the sick pleasure of pitting the haves against the have-nots.

I hope that if I ever possess sufficient means to make a difference in any way, that I will use what I have to help rather than to hurt people.

*** Thanks to Judge Alex Ferrer for the inspiration for my grandfather's new name. Judge Ferrer observed that some people are not very evolved.  That description certainly fits my grandfather, who shall be known in this blog and in any future references in or out of this by me as Troglodyte.

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Couldn't enlarge it any further. Sorry!

Thursday, October 20, 2016

Get Thee to a Nunnery!

I was especially feeling the effects of the medication I'm currently taking earlier this evening and missed out on the presidential debate, which I had really wanted to catch. Now I'm limited to the reviews. Fox News says it was an overwhelming victory for Trump. MSNBC says it was an equally overwhelming victory for Clinton. The rest seem to think it fell somewhere between the two extremes.

It's a really good thing that I have done nothing that would have exposed me to the possibility of becoming pregnant because were such not the case, I would be almost 98% certain I was pregnant and suffering from hyperemesis gravidarium. There are few advantages to practically living the life of a nun, but I suppose I'm now reaping the benefits.

My job still consists for the next couple of weeks of non-physical contact with patients for liability purposes. I can take vital stats while wearing gloves, but that is the more or less the extent of physical  contact. I can't insert IVs, which is an area of strength for me, and makes it hard for me to watch when someone else is having trouble with a difficult vein, such as a child's or a vein belonging to a dehydrated adult. I'm confident in my skills, and I knew I could have nailed either the little girl's or the sick guy's IV in one attempt tonight , but I'm not permitted to do so right now.

I walked into a messy situation when I arrived a couple of hours earlier than usual tonight. A fatal auto accident had just happened. I didn't even see the drunk driver who didn't make it, but was left to deal with survivors. I held a five-year-old girl on my lap (with a blanket between us minimizing the contact) while her parents were both being treated for more serious trauma than she was.  I sat with her and attempted to keep her calm (with the help of drugs) through the radiology, neurological assessment,  and setting of a bone. Someone had to be with her until relatives from out of state arrived to assume custody of her, and that someone was I.  The family was visiting on a work-related trip from Nevada and had no local contacts. I read to the little girl for a bit, but mostly we just watched TV. She kept dozing off, but anytime I tried to move her to the bed, she woke up and cried to be held again. Her parents will recover from their injuries. Father had  three  broken vertebrae and a more significant head injury, but no resulting paralysis; mother had some internal injuries in addition to [or because of] broken ribs, but she, too will recover. They were hit head-on while driving on a state highway by someone who crossed the center line while driving under the influence. As I mentioned earlier, he didn't make it, so there will be no criminal trial. I was told he had insurance. The family  should be compensated for their medical bills and time off work. They have insurance as well, so they don't have to fight the battle themselves, though they were advised by one of my supervising physicians, once the father was coherent, to seek a competent attorney to insure that their financial needs were met. It turned out that the dad IS an attorney, so he's well aware of the idea of seeking legal representation.  

I was relieved to hand the child off to her grandmother, who flew in from Nebraska as quickly as she could get here. The child was initially reluctant to be handed off, as she hadn't seen grandma in over a year,  but grandma knew how to handle it, and the child was soon comfortable. We put together a gift basket with a stuffed animal, soft quilt, a few small toys, juice boxes, snack foods, books, and little games and activities. We offered the grandmother the option of admitting the child and putting a recliner for grandma in the child's room, or discharging the child and helping them to find a hotel room. The grandma thought they'd both be more comfortable in a hotel, and grandma seemed competent to manage the child's medications. Other relatives are to arrive later today. The parents will probably remain in the hospital into early- or mid-week of next week.

The grandmother assumed I was a nurse, and then was most apologetic when she learned that I was a medical school student. The lady had no idea how flattered I was that she had thought I was an actual medical professional of any kind and not some variation of a candy striper.

I'll be most relieved when this phase of my training is complete. It is incredibly difficult to stand by and watch something be done less well than I am capable of doing it.  This probably sounds a bit overly self-assured perhaps to the point of conceitedness.  I have weaknesses, both related to my future profession and otherwise. Likewise,  have strengths related to the profession (and otherwise), and I'm aware of what they are. I know when to step up, and when to back off and allow someone else to handle something if someone else more qualified is available.  Unfortunately, even when I'm more qualified than is the next person now, I'm forced to step back. I am becoming quite the baby- and child-calmer, the interviewer of teens extraordinaire, the one who is called on to attempt to have rational conversations with individuals under the influence of God knows what, and the long-suffering person to listen to senior citizens when there's little else we can do for them.  Perhaps all of these things are very necessary skills, and maybe I would never have perfected them to the degree that I now might without my current "situation."  That's the positive spin I'm trying to put on my present limitations.

It appears that my barfless night is not to be, tonight anyway. The good news is that the dentist who was handling my orthodontic adjustments here, who lives maybe ninety minutes away, heard of my plight, and he used my most recent molds to make two sets of protective teeth-guards for me to wear while throwing up in order to minimized the erosion of enamel from my teeth. Sometimes all one can do is to count one's blessings, however small they may seem. Right now a teeth guard seems like as much of an inconvenience as a blessing, but the time will come when I am grateful for the preserved enamel on my teeth.

So it's off to lose the contents of my stomach, and then back to work. Such is the life of a third-year medical student.

Thursday, October 13, 2016

A Half-Mormon Catholic Mennonite?

Dwight Schrute has to be a Mennonite, or at least a lapsed one.

Just to spare you for a moment from my health-related complaints,  I shall share with you that I'm thinking about becoming a Mennonite. I won't be an old-order Mennonite who dresses in prairie clothing and covers her head at all times (probably even when she's sleeping and shampooing her hair), but one from one of the more normal conferences of the faith. I even ordered one of their hymnals. I've been watching some of Katherinethe19th's videos on her youtube channel, and I've become quite taken with the culture. The problem is that if I look up "Mennonite"  in the book section of Amazon, most of what is offered is literature related to the Amish.  

I've been to Amish country, and my curiosity of the Amish has been thoroughly satiated. My family spent a night in a town called Intercourse, Pennsylvania. Matthew and I were just old enough (nine, I think) to know the meaning of the word, or the most popular meaning of it, anyway. Matthew loved telling everyone for months afterward about our night in Intercourse. I think he described it as "our night OF Intercourse," which probably made it all the more scandalous to the Mormon relatives he regaled as we made our way westward to Utah.

The night in Intercourse was especially miserable for my dad. It's a dry county, and while I exaggerate my dad's alcoholic tendencies, I will admit that he does not drink every single night of his life. The past two nights he hasn't had a drop of anything stronger than Grape Crush as he monitored the status of my state of hydration. When he was stuck in a car all day with two bored and slightly contentious nine-year-olds, at the end of that day he didn't merely want but genuinely needed alcohol. I had tried to warn my dad that he should pick up something he might want to drink before we reached Amish country, as anything truly potent might be difficult to come by once we got there. It was just one of those odd facts I knew at a young age for no particular reason, but my dad thought I was merely trying to come up with an excuse to stop at any store that might sell candy. (My usual method of operation in those days was to score candy in any way I possibly could.) He had to learn the hard way that on that particular occasion  I was not merely looking to feed my own sugar addiction. To top things off for him, because of a motorcycle convention for which people were traveling from all four corners of the nation to get to Sturgess, South Dakota, we were unable to get a suite or adjoining rooms in the little motel. We were lucky to get the single motel room with two double beds that we got.  The point is, not only was my dad sans alcohol  on that night in Intercourse, Pennsylvania,  he was also, ironically enough,  sans intercourse.

Because she's a prolific producer of kidney stones which can strike with no warning, my mom never travels without Vicodin. My dad doesn't like narcotics even when he legitimately should take them, much less as a recreational outlet, but that night he pulled a "House, M.D." maneuver and self-medicated with Vitamin V from my mom's stash.  

Hydrocodone does not have a soporific effect on my dad (a trait the two of us share), but he was a happy insomniac that night. My mom drove most of the rest of the next day.  Before departing Intercourse, my mom insisted we have a proper breakfast at the restaurant adjoining the motel where "we" had eaten dinner the night before. I had refused to eat anything from the restaurant because pig stomach was a featured entree on the menu. My parents explained to me that just because an item was on a restaurant's menu -- that they had no intention whatsoever of eating pig stomach, either -- didn't mean that the cooks slipped a bit of pig stomach in as a secret ingredient in every other entree or side dish they prepared, but I was taking no chances. My mom picked up a few piece of fruit and a loaf of some sort of German bread at a grocery store across the street so I wouldn't starve. Curiously, I recall a sign posted directly outside the entrance of the store. The sign read, "Please do not photograph or videotape the Amish inside this establishment." Even at the age of nine, I recall wondering what sort of a person would  snap pictures or videos of people going about their business just because they happened to dress differently than most of the rest of the U.S. Obviously someone must have done such things, or the sign would not have been needed.

We couldn't cross the county line soon enough for my father's liking that morning. He never drinks in the morning or even really in the mid-day, but that day at about 10:00 .m., he had some concoction he called a Bloody Mary, mixed with tomato juice, some form of booze (probably more booze than anything else; the tomato juice probably existed primarily to lend the appropriate coloring to the cocktail), tabasco sauce, olives, and a bit more booze. He dozed comfortably in the passenger seat that day as we made our way across the Pennsylvania countryside. I do recall him dragging himself out of the car so that he and Matthew could sneak onto the main field at Williamsport, where the Little League World series is annually played. Rain was coming down in a drizzly fashion as I recall, and nothing seemed to be happening there that day, so my brother and my dad  were able to make it onto the field without detection. My dad and Matthew took turns pitching to one another as my mom and I chased down the balls that they hit. My dad can and pitch hit even when he's over the legal limit for driving.

That was a most labyrinthine way of explaining that I've seen all I ever need to see of the Amish or of the Mennonites who look and dress so much like the Amish that they may as well be Amish. My interest lies in the mainstream branches of the fold. Mennonites of North America, who, curiously enough, live primarily in the prairie and plains provinces of Canada, in Pennsylvania, Kansas, Nebraska, and in, of all places Fresno, California and communities immediately south of Fresno. (some also live, oddly enough, in New Mexico, and in a region of Paraguay and Bolivia known as el chaco, or simply the chaco -- those are the ones in whom I have an interest.

Mennonites needed to leave regions of the Netherlands and Germany because of their leader Menno Simons' insistence upon "believer's baptism," which contrasted sharply with the popular Catholic and Lutheran perception of the day that infants or children who died without having undergone the sacrament of baptism were lost.  This disagreement became so contentious that followers of Menno were literally on a regular basis losing their heads over their refusal to denounce their new-found beliefs.  Many escaped into less-populated parts of Prussia and to Russia. Russia welcomed them with open arms because they were skilled farmers and industrious workers.  For generations Catherine II's successors continued to welcome Menno's followers to their nation and to grant them waivers for military service because of their pacifist beliefs. Sometimes alternate service, such as forest service, was substituted.

It should be noted that by this time, as is typical of religious groups, while still in Prussia and Russia,  Menno's followers had broken into numerous groups, from the Amish, to the Older Order Mennonites, to what became the Mennonite Conference USA, to the Mennonite Brethren. Canada has roughly equivalent denominations. There are probably more Mennonites in Canada than in the U.S. The fractures were less contentious than religious splits typically are. (Mennonite Brethren and Mennonite Conference USA have a tendency to accuse the other of being more legalistic, but it's still largely an amicable relationship. Menno's followers are a peace-loving people.) When worshiping together as a group became difficult because of differences in interpretations of doctrine, one group would quietly move from another group and begin worshiping separately. This was usually done without either group condemning the other to hell. From what I've been told by my former violin professor, if  Mennonite USA family moves to a location in which only a Mennonite Brethren congregation is located nearby, the family would typically  attend the Mennonite Brethren Church, or vice versa. Contrast this with the Mormons, who either broke off with or were broken off with (who did the breaking depends upon whose version one chooses to believe) the Reorganized Church of Jesus Christ of Latter-Day  Saints.  If a family belonging to one branch of Joseph Smith's movement moved to a location in which their own branch was unavailable but the other branch was, the family would either hold a religious service by themselves in their own living room, drive three-hundred miles every Sunday to attend the '"right" church, or give up on religion altogether. The Mennonites believe that the differences that separate their respective denominations are possibly trivial, but their desire for peace and harmony outweighs practically everything else. They have their lists of items that are considered tests of faith, but belief in the Bible, belief in baptism only of individuals old enough to make a faith commitment, and refusal to go to war are central among them.

At some point after the onset of the 1905 revolution, the military waiver for Mennonites was eliminated in Russia. Mennonites of all factions needed to leave Russia in order to avoid going to war. Because of their skill as farmers, Canada welcomed to them, as were states in the U.S. plains in need of farmers to farm the land and build up homesteads. Pennsylvania's offer of  religious freedom was something many of the branches found especially attractive. Eventually Menno's people ended up all over North America, though larger concentrations are still found in the Canadian plains and now even in Ontario, in Pennsylvania, in the U.S. plains and prairie states, and in the greater Fresno area.

At some point in my life  when the time I'm at home is not limited to times when I am either sick or asleep, I shall check out a couple of Mennonite churches. I'm not sure of what is available in my area, but their greater denomination is worldwide enough that I'm reasonably certain of finding some aspect of their denomination. I'm just very curious.  I'll probably never formally join any branch of their faith, as I don't think I can ever be a total pacifist. The issue of me personally going to war is probably a non-issue. Any branch of the military that cannot get by without me in its ranks  is an army that is doomed for defeat. And if the military branch isn't smart enough to figure that out on its own, I have health conditions that would stand in the way of my military service, not the least of which is my weight. Military uniforms are not made in my size.

Beyond my own personal means of escaping service, and perhaps this is hypocritical of me because I'm not in any big hurry to sign up if the draft is reinstated and women, too, are required to register, I believe that a cause for war can be just.  I wouldn't say that of every war that's ever been fought, but someone probably needed to stand up to Hitler. World War I was probably similarly needed. I can't ever seriously place my faith in a religion that cannot accept that a despot sometimes must be stopped.  I'm not sure exactly what is their justification for maintaining peace at all costs, especially when it's not true peace when a despot is ruining the lives of those living under his reign. Perhaps the Mennonites have a perfectly clear explanation for how this should be handled, but I've yet to hear it. Peace should always be the ideal, but we all know the ideal cannot always be achieved.

Still, I'm highly intrigued by the faith, and particularly by what must be a genetically influenced  ability to sing in four-part harmony from a very young age. 

Should I ever have a son, I'm considering naming him Menno.  What do you think? Would a little Menno be bullied because of his name, or would he be cool? Regardless, I'd rather have a little Menno than a little Liam any day. Today's Liams are becoming  the Jasons of 1.5 generations ago. Thirty years ago it was easier to find D,B. Cooper's discarded cash than it was to find a well-behaved child named Jason.  The same can be said of little guys with the name of Liam in today's world.

Vampires, Jehovah's Witnesses, The Probability of My Survival, and Kinks Even Weirder than Adult Babies

I'm still sick from powerful medication and am still looking very much like the twelve-to-sixteen-year-old-girl who was taunted as  "Anorexis," but I'm beginning to figure this thing out slowly. I take the medication at 6:00 a.m. It gradually works its way into my system until by 10:00 a.m., when I am worthless to the human race unless someone is conducting some sort of research for which they actually need, for research purposes,  vomitus, or even perhaps something that is expelled from another orifice.  My brother (How does he know some of such things while others elude him seemingly forever? Some sitcom -- "Scrubs," I think,  had a presumably intentional error of displaying a chest X-ray backward on an illuminator. Matthew used to watch the show each morning while he ate breakfast our first year of med school, and he never commented on it. Curiosity got the better of me, and near the end of the school year, I asked him what looked funny about that X-ray. He had no idea and presumably had not yet, after nearly a year of anatomy lab, learned the differences between the right lung and the left) tells me that there are people who will actually pay for such by-products to fulfill their kinks, but I want no part of such sick-in-the-head-ness. And to think I thought adult babies were weird. I understand why someone might want to illegally purchase one of my kidneys or maybe even my old kidney stone, but barf? Holy Mother of God! To what depths is the world sinking? P.S. If you want to know anything like how best to sell the scrapings from under your fingernails or your used contact lenses, ask me and I'll check it out with Matthew for you. He's sure to have plenty of insight.

Then I'm out of commission for the rest of the day. I sleep or don't sleep,but even if I'm lucky enough to sleep, I feel as though I am dying. The time does pass more quickly if I sleep, though. If I have the TV on or have any music playing when I sleep, it all gets incorporated into a sort of Bohemian-Rhapsody-level-of-weirdness dream from which I try to emerge but can't, where it feels like I'm smothering in my sheets or my arms are tangled under me and I cannot free them to move. It could be a song as tame as a Mozart flute andante and it would still turn into a nightmare about vampires or Jehovah's Witnesses chasing me.

Somewhere around almost 2:00 a.m.I  wake up and start to feel almost human again. I try to get fluids down, because if i cannot, I have to have another iV. By 4:00 a.m., I'm ready to eat, as in ginger ale and soda crackers.  I won't absorb all the nutrients, but as bad as barfing is, it's worse to go through the motions when there's absolutely nothing to come out. Dry heaves are almost as bad as it gets. Two things are worse. One I will share with you, which is when the barf comes out of your mouth and nose simultaneously. The other one is too gross to share. If you pondered for long enough, you would come close to guessing correctly, so I'll leave it to you to decide just how intensely you want to ponder.

The epidemiologist I'm seeing told me that what I'm experiencing resembles the reaction to certain forms of  chemotherapy except that I'm not going to lose much hair, though if I stayed on this drug for long enough, she said, I probably would. It differs also in that, barring a positive test, I'll be done with it for good in something like 22 days. (I'm beginning to lose track.) She said it's also a lot like a major bout with hyperemesis  gravidarium -- the pregnancy-accompanying morning sickness that some women are unfortunate enough to experience that doesn't stop once high noon hits and often lands women in the hospital. Duchess Katherine, the mother of those adorable toddlers Prince George and Princess Charlotte (Jaci doesn't like them, but I find them perfectly charming) had a particularly nasty bout of hyperemesis gravidarium and spent time in the hospital with, I believe, both pregnancies. My mom never had the grave form of morning sickness, which was a good thing, as she barely birthed healthy twins once out of two tries even as it was. Had she been nutrition-compromised, I'm not sure what might have happened to me, as roly-poly 6 lb, 9 oz. Matthew was clearly the placenta hog of the two of us, with me weighing in at 2 lbs, 2 oz., or 2 lbs 4 oz., depending upon which birth certificate and hospital record one chooses to believe; as far as other matters are concerned, Mathew's level of acumen could only have gone in one direction as a result of maternal prenatal hyperemesis gravidarium,  and we all know he has few IQ points to spare as it stands..

I'm becoming one much like of those old ladies who talks about nothing but what ails her. I promise soon -- not immediately, but very, very soon, to change the topics of my discourse. 

Wednesday, October 12, 2016

Life Is Like a Box of Chocolates: Ex Lax, To Be Specific

It's two steps forward and one step back, but that's still progress, albeit slow and impeded. I made it both up and down the stairs on my own today, and I was able to coax my aunt's moronic dog back inside with the help of the Fedex deliveryman when she decided she would rather go with him than stay inside my condo with a person who loves her so dearly [sarcasm font]. I spoke with one of my favorite friends on the phone today. He was very busy and didn't have to take the time to call me, yet he did. My mother is back, which is simultaneously good and bad.  My sweet aunt convinced her, after a lengthy shopping trip, that this is the place she needs to be right now. My aunt even came with her.  To be perfectly honest, it probably would have been even better if just my aunt had shown up here while sending my mother on her merry way elsewhere, but life doesn't always work out perfectly.

Speaking of life not always working out perfectly, such is the state of my medication. I've been so stoned and/or sick that I'm not even sure what I've shared. I'm taking post-operative prophylaxis fr occupational exposure to body fluids of someone who very likely  does not have the human immunodeficiency virus. I'm not at liberty to share the circumstances surrounding my exposure. The hospital system with which my medical school is affiliated is concerned that the media would love the story and would be all over it, which would, in turn, bring on ambulance-chasing attorneys, in part because one person involved -- I shall not even state his or her position -- acted rashly and not in the best interest of a patient. Because of all of these political ramifications, I'm not at liberty to talk about something that very much involves me. I feel this is wrong, but what can I do about it?  I want to finish medical school, and someone connected with the school may be aware of my blog.

It is not totally my choice to undergo the prophylaxis routine. If I wish to continue with clerkship rotations at least once my 4-week tests come back clear, and possibly until my 3- and 6-month checks come back clear, I am at the mercy of the school and must take the drugs. If a particular pharmaceutical cocktail is making me especially ill, which was what happened, I have some say in changing the particular drugs. Still, I'm relegated to a three-drug treatment, which is most effective if the virus is actually present. The part of my brain that thinks logically (though some would say that no part of my brain actually thinks logically) says if I'm going to do this at all, do it the right way; take the three-drug treatment. The half-@$$ed two-drug treatment is merely hedging bets, and it will still make me sick, though not quite so sick. There is wisdom in doing it right or not doing the treatment at all.

What bothers me most about this situation, in addition to the forced confidentiality (I'm probably going further than my superiors would prefer simply with the authorship of this blog) is that I am forced either to undergo this treatment or to place my participation in my medical school program on hold at least until my three-month-check. Doing such would not allow me to graduate with my cohort, and would also likely prevent me from obtaining a match and beginning my internship/residency in the summer of 2018. 

What makes this all the harder to swallow is just how low is the risk of exposure from the patient from whom I was exposed.  No one is zero risk, but let's just say for the sake of argument that  Big Brother went crazy in the form of Obama Care going on steroids, metaphorically speaking. The government decided, in my analogy, that in order for our collective medical expenses to keep us from going under financially, that everyone in the U.S. had to have a needle partner, and an unrelated one at that, with whom he or she must share hypodermic needles. (The unrelated part would be because some people have no relatives, and we have to make it fair.) I know this sounds crazy, and it is, because I am on drugs right now, but please humor me and hang with me  for just a moment. 

So each of us has to find a person unrelated to us, and possibly even outside our social circles, with whom to share syringes, hypodermic needles, IVs, scalpels, and the works.  The person whose body fluids were exposed to me is quite possibly the person I would choose. She's clean. The least  safe thing about her is that she is an elementary school teacher. A kid may potentially spit at her or bite her someday. Otherwise, her health habits are beyond reproach. She has more to fear from me than I have from her.  

So with such a low-risk subject, why am I being forced to undergo this treatment regimen? I can understand exercising extra caution with regard to what procedures I'm allowed to perform until my testing comes back clear. Frankly, prior to my HIV exposure, I had already performed multiple procedures that third-year residents are not supposed to undertake. I'm way ahead of the game at the moment. I can afford to step back and watch for a month or two or three as others take the lead in procedures.

The bottom line here is that I'm ordinarily a cautious person -- not so cautious that I would not have done what I did in the first place that caused the exposure --  as I reacted on impulse. Those of us who enter the profession I am entering should be doing so with the intent of saving and/or improving the quality of others' lives. If I had the opportunity for a do-over, I wouldn't change a thing. I did what I thought was right, and I still think it was the right thing to do. If another person whose identifying information shall be withheld had done the right thing as well, I might never have been in the position to have done what it was that I did, but that's really neither here nor there.  My point, after all has been said and done, is that I think, even given all the information I have regarding the clean lifestyle maintained by my source of exposure, I still would have elected to undergo the post-exposure prophylaxis.  My quarrel with the process is that it should have been my decision without the heavy threats having been hung over me.

Regarding the title of this post, I thought of it myself, though I was far from the first person to coin a similar expression.  Its pertinence is to the effects of one of the new drugs I'm taking. I now not only have to worry about vomiting, fainting, dehydration, and low blood pressure: I now have the ghost of Montezuma haunting me.

Why is it that, in going through this treatment regime, I always feel best between 3:00 and 5:00 a.m? It's a time when it's probably least productive to feel at one's best.  I suppose I should consider myself fortunate that there is any time at all in a given twenty-four-hour block that I don't feel like euthanizing myself. Count your blessings. Name them one by one. (It's a Mormon hymn, though fundie Protestants may use it as well.)

Tuesday, October 11, 2016

Highway to Hell

My mom is tired of my negative attitude and is leaving to stay with her sister an hour-and-a-half  or so from here to spare herself the agony of listening to me barf and complain that I'm feeling ill during the time that I'm not barfing. I acknowledge that I'm not seven years old any longer and that I am capable of throwing up without someone else giving me directions. Still, I thought mothers were supposed to be more sympathetic than that. 

If she just needed to get out for awhile and planned to come back, I would certainly understand that. If she called my dad and asked him to come home or at least come check on me, that, too, I would understand. I don't believe either of such things is the case, though.

I am at home and not in the hospital because someone is supposedly here with me. I am capable of managing my own IVs, although if I had to take out the one that is currently in and couldn't find a good vein in my right hand (my veins have all more or less been used up) I would probably be stuck, as I'm not quite good enough to insert IVs using my non-dominant hand. 

A situation happened at the hospital last week that exposed me ever-so-slightly to HIV. The potential exposure is real enough that I have to go through post-exposure prophylaxis, mainly because of the nature of my work with patients; if I were a regular person working in a regular job, it would likely be determined that the risk of becoming seriously ill from the treatment was greater than the risk of contracting HIV; at the very least, it would be my prerogative to opt out. Because  I  work in the health care field, however, my choices are to continue the treatment, which will last for another 23 days, or to opt out of my program for two months, then return in seven months and one day, presuming the test came back negative. At that point I will be almost a full rotation behind my classmates. i wouldn't be allowed to graduate with my cohort, and would have to finish my final clerkship rotation after everyone else had graduated. I would probably still be allowed to apply for a match for my residency, but it wouldn't be guaranteed, and I would have about 12 hours between the time I finished my final rotation and when I was to report for my residency. The worst part would be not being allowed to graduate with the rest of my cohort.

The situation is highly confidential. a few people in my real-world life know that I'm receiving post-exposure prophylaxis.  An even smaller number know why. I'm not allowed to talk about the situation because the hospital administration wants it kept very quiet i talked to four people online that I trust not to say anything to anyone that would get me into trouble. I shouldn't have done that, but I trust them not to post anything or to try to find my medical school and to call someone there and say, 'Do you know what Alexis just told me?" I trust them all to have more important things going on in their lives.  I I don't even know if it's OK to talk to a shrink about it. It's obvious that they're getting tired of hearing about it. I need to leave them alone. 

My dad probably knows something because he was in the ER when I was taken there this morning after a hypotensive crisis due primarily to dehydration. I don't know what he knows, though. If I said something confidential and then he in turn said something to the wrong person, I would be in trouble. Consequently I cannot say much to him. I don't even know if he's coming back here anyway. Perhaps he's going with my mom to stay at my aunt's house. My mom packed downstairs, and I'm stuck upstairs. I don't know what she packed.

If there were a fire (which isn't going to happen; I'm paranoid but not THAT paranoid), I could get myself downstairs and out of the condo. I couldn't make it back upstairs, though, so getting  7-up or ginger ale or crackers isn't a good idea because no sofa is close enough to the bathroom, and I'd be stuck barfing in the same trash  receptacle all day. Even making it downstairs and to the kitchen is almost unmanageable for me anyway.  So I'm essentially limited to tap water.

I have four bottles of Ringer's solution. If no one comes back within twelve hours, I'm out of the stuff.  I do have syringes filled with the post-exposure prophylaxis.  I can inject myself in the thighs with the stuff, but that's the only intra-muscular site I can reach myself that I'm supposed to use. I'm not supposed to use my arm, but I could reach my right arm with the left. I'm not supposed to repeat a site for at least five days, but it may become necessary.

Does a person go to hell for saying that her mother is a b!tch? if so, that's probably where I'm going.

When the (Student) Doctor Becomes the Patient

This picture has no real relevance to anything in this blog or elsewhere. I just saw it and liked it.

My schedule has been changed once again. I'm sure that whoever is in charge of making schedules is starting to hate me, but none of this is happening at my request. Beyond that,  all the people on the payroll --  not including my peers or me, as we're not getting a red cent other that the free meal (and I'm using the term meal  loosely, as what comes out of our cafeteria posing as cuisine is probably closer to soylent green than to actual food, but that's another. topic for another day -- that is provided if we're stuck on the premises for more than eighteen consecutive hours -- are lucky to have jobs in this economy. So he or she should suck it up and not complain about having to revise my schedule roughly three times each week, right?  

In any event, it was determined that it would be imprudent to put a clerkship student  as weak as I am into the psych ward. At my strongest, I could barely hold my own against someone who went bonkers and decided to go into attack mode. Right now, I would be unconscious before I even realized there was a problem. I may be stronger next week, but it's not realistic to expect my improvement to be substantial. I'll still be having the drugs injected into my body on a daily basis. I now have twenty-three more treatment administrations to go. A week or so after that, I should be within  reasonable distance of where I was before this fiasco began.

Hence,  on Monday of next week I shall begin an eight-week rotation in Internal Medicine. It's not the most exciting rotation on the planet, but neither is it the least exciting, and it's the basis of what all of us will someday do, no matter what our eventual specialty.  It's a requirement for anyone completing his or her first twelve months of clerkships. I was originally scheduled for it in the spring of 2017, but it's been bounced up a bit for me. The timing is actually good in that I will miss out on less by only talking to patients and observing for a couple of weeks until I get my medical clearance. There'll be plenty of time for greater involvement later.

I'm sad about not getting to OBGYN until later now. My psych rotation would only have been for three weeks. Now OBGYN in delayed until January. I'm more excited about the OB part of OBGYN.  Who wouldn't be, other than maybe Donald Trump?  All the content must be covered, though. 

I didn't pass my physical for pediatric oncology today.  They looked in throats , checked temperatures, and looked for obvious signs of contagious illnesses.  In checking temps, they were looking for fevers, but my temp was 95.6. A slightly subnormal temperature is normal early in the morning (several of my peers were running in the 97-degree range), but it shouldn't be three degrees below normal.  When someone checked my pressure and found it almost impossibly low, the lead doctor asked, "Does she even have a pulse?" He told Professor Larry Bakman that he wasn't sure whether to send me home, to the E.R, or to the morgue. He was aware of the status of my medication regimen but didn't expect the situation to be quite so grim.

I told them that my dad was finishing up a shift in the E.R., as he does ten times per year to ensure that he has sufficient patient contact hours for licensure. Someone  called for a wheelchair, and Larry [not his real name; I would never be so disrespectful as to refer to a professor by his actual first name] rolled me into the elevator, out of the building, and into the E.R. at the adjacent hospital. The problem was primarily dehydration.  Much to my chagrin, I had to be hooked up to in IV again. Th one good thing is that since I'm hooked up to an IV anyway, I didn't need and injection yesterday and won't need one today, either. I'll probably be off the IV at some point today, but at least two painful injections have been avoided.

Larry and my dad decided I will not accomplish anything by trying to work in pediatric oncology this week. If I don't make it to the staff restroom before hurling with each episode, I risk exposing them to body fluids. I would make it to a trash can, but there's still potential splashing. In a best-case scenario, I'll spend one-third of my time throwing up and recovering before getting back to the children. The director of third-year clerkships was consulted. It was determined that next year I'll need to complete a clerkship in oncology, but it's assumed that I'll pass the pediatrics exam next week at the conclusion of the rotation. If I don't and if the sections I fail are related to pediatric oncology, I'll need to spend four Saturdays or Sundays working on the pediatric oncology floor, then  re-take the exam. I don't anticipate the exam being a problem as exams are my forte, but if it is, i'll gladly give up the four weekend days. 

I'm now confined to my house util Monday. I'm not being expected to make up the lost time because it happened as an occupational hazard.  If I were an intern or resident in the same situation, I would continue to receive pay.  If I didn't have medical personnel here, I would possibly have to stay in the hospital, but my parents are here until Monday, at which time they leave for a Pacific Northwest cruise. Matthew, when he's here, can deal with IV s as well, and so can I. I can both change bags and reinsert my own IVs if necessary. I've done it before.

I slept so much yesterday that I'm awake now, but I can barely make it from my bed to my recliner or to the bathroom. My dad piggy-backed me up the stairs tonight while my mom held the IV pole. Pretty much everything I need is within my reach. 

At some point I'll probably grow bored, but right now I feel too yucky to even contemplate boredom. I'm just grateful I don't have to figure out how I'm going to get myself to work tomorrow.

The effects of this drug regime have been described as being a great deal like chemotherapy except that a patient doesn't lose his or her hair.  If a person continued with the drugs for long enough, supposedly he or she would lose hair.
It's a real quandary. If I were a private citizen, I could make the choice as to whether or not to go through the treatment. Because I work with patients, however, the choice is not my own. I could drop out of the program for two months, then be tested and re-join, but I wouldn't graduate with my class. The source of my contact has tested negative and presumably will continue to do so. She's an extremely low risk for HIV. Still, she's a teacher. Teachers CAN be exposed to body fluids, and they may not even remember it having happened. My mom says she's been bled, drooled (the drooled on was by a special-needs kid), and barfed on by students, and she only taught for two years before moving up the food chain to psychologist and administrator. If a kid needs help and a teacher is in a place where rubber gloves are not readily accessible, a teacher usually goes to the kid's aid anyway. While my source is of low risk, she's not of zero risk. It's probably smartest to go through this treatment regimen. Now that I'm spending a third of my time either throwing up or recovering from the immediate after-effects, it doesn't feel very smart.

My dad brought home four different anti-emetic (anti-barf) drugs to try.  If one seems to work, great. If it doesn't, I need to wait four to six hours before trying another one. I can at least take Benadryl, which helps to some degree and doesn't interact negatively with anything else I'm taking. There are also a couple of benzodiazepenes I can take. They don't really reduce the level of my nausea. They just cause me to care less.

In the event that you did not know this, it is only fair that I warn you: learning to be a doctor can be hazardous to your health.