Wednesday, March 20, 2019

Zig for Great Justice*

This is not I, but it might just as well be.

I've worked all the hours I can work for a time, and am on vacation as a result. It seems to me that I would learn more if I worked more twelve-hour shifts and fewer twenty-eight hour ones, but scheduling is not my decision, and it's not just about me. Regardless, I end up with ample time off this way. By the time I return to The Great White North, spring may even have sprung or at least started to spring.  I am visiting California relatives briefly, after which I will visit my brother at his place of employment two-thirds of the way across the continent.

Work has been a mixed bag. You can't please everyone, and I haven't even come close to doing so. I have to be satisfied with the few crumbs that have been tossed in my direction. When I had to assist a pediatric surgeon in an abdominal surgery, he told me that I do very neat and precise work but that I suture about as efficiently as an eighty-nine-year-old woman at a quilting bee, and that my patients are all going to die on the table while waiting around for me to finish my beautiful handiwork. When I backed into one surgeon's car while driving a car belonging to another surgeon, damaging both cars in the process, the owner of the car I was driving told me I had more spine than he would have guessed I possessed because I didn't cry or pass out when the surgeon who owned the car into which I backed came looking for me, shouting obscenities all the way down the corridor. I also didn't cry five minutes later when an attending physician came to scold me over a medication order I had thoroughly screwed up, which fortunately was caught before the medication was administered to the patient, but unfortunately was caught by the only nurse to the best of my knowledge in the entire province who actively dislikes me, and who seemingly considered it her sworn duty to inform everyone within a thirty-kilometer radius of my incompetence and idiocy.

When the best I can do is work neatly and precisely but too slowly, remain conscious, and not cry, it would seem to be rather clear that I'm not exactly thriving. I was mildly concerned that I would not be invited to continue my employment here after this fiscal year, but an acquaintance who shall remain nameless and who has inside knowledge of such matters told me that I'm on neither the list of those whose fate has already been decided against them nor that of those who are still on the chopping block. This doesn't mean I couldn't possibly screw something up so congressionally as to be arsonized, but if I continue with my status quo quasi-mediocrity, my employers are too greatly in need of even minimally competent cheap labor to give me the grand DCM.  (I should clarify at this point that it's only my level of competence that is lukewarm.  I'm tired now, so I undoubtedly come across as apathetic at best, but I remain passionate as ever in regard to the prospect of saving every life and/or stitching up every boo boo that comes within my reach, if painstakingly and at a dead tortoise's pace.) All of this is contingent upon passage of Step 3 of the board exams, but that's the least of my worries. It's not that I'm not worried about it, but it's quite literally the least of my concerns at this point. I've been studying in what spare time I have, and I will commence with active worrying as exam time draws nearer.

I wish I could share some of my more interesting stories, but, alas, I have these rather pesky addictions to food and a roof over my head, the satiation of both of which necessitate my continued employment. I'm keeping the stories in a journal, and someday I will disguise the location and everyone's identity enough that I can share them in some form. For now, though, I shall be professional.

* zero wing dialect

Sunday, February 10, 2019

R.I.P. Valerie

The case of Valerie Reyes, the 24-year-old woman from New Rochelle, New York, whose body was recently discovered in Greenwich, Connecticut, bound at the hands and feet and stuffed inside a suitcase, has me more than a little creeped out.  Police haven't yet announced any suspects or leads in the case, but they often don't until they're either ready to make an arrest or need the public'shelp in locating  specific person of interest in a case.

Young women making their way in today's working world often live alone, and sometimes in not the most secure of living situations. I really don't know much about Valerie Reyes' basement apartment -- whether it was the type of place into which an enterprising intruder could gain entry with a sturdy nail file, or whether it was more like the above-garage apartment I call home, which requires multiple keys and codes for one to gain access.  From  accounts I have read, though, it doesn't seem likely that Valerie was abducted from her apartment.

Valerie's last known contact was a phone call with her mother on the evening of Monday, January 28. She didn't report for work the next day. She was seen at the train station in New Rochelle on that morning. A private detective later located her as having been at a Chase Bank ATM near Radio City Music Hall in Manhattan. It was the last known sighting of a living Valerie. 

Valerie was an artist who sang. She apparently battled anxiety and depression -- conditions not uncommon among the creative in our society -- though prior to her disappearance, she seemed, depressed and anxious or not,  to have made it to work on a fairly regular basis. In her final phone conversation with her mother, she shared fears that she would be murdered -- fears that she associated largely with her basement apartment. This may have prompted her to leave the relative safety of the apartment for a more perilous situation. What actually prompted her to leave, and what ultimately led to her being found lifeless in a suitcase in Greenwich, Connecticut, are still unknown to the general public at this point.

It's natural at this point to compare one's own situation with that of a prominent crime victim whose circumstances in any way resemble one's own circumstances. Valerie was twenty-four, as I am. She was unmarried and living independent of her family, as I do. She appeared to be petite, as I am.  On the other hand, I come from a more economically advantaged background than did Valerie.  While I have completed an undergraduate education as well as medical school, she hoped to eventually put her artistic talents to use as a tattoo artist.  Still, there's precious little in my life that offers any guarantee of not facing the same end as she did.

There are no guarantees, anyway. I have lucked into a living situation that is optimal for a person of my age, gender,  size, and level of un-bravery.  I was a scaredy cat who heard noises outside and feared the boogeyman long before I suffered an unfortunate attack in  high school. Since then, I've had trouble functioning at night by myself. Fortunately, I rarely have to function by myself at night in my present living situation. I lease a studio apartment above a garage, but the apartment is attached to a home owned by a widowed physician with three children close to my age who looks after me as though I were his own child. (If I were to scream loudly, someone would likely hear me and would respond.) I have full access to the home attached to the garage which sits under my apartment.  One of the bedrooms in the main part of the house is designated as mine; I slept there last weekend when I was sick, on the insistence of my landlord.  If I'm too bothered by noises in the night or by anything else, I'm more than welcome to sleep in that bedroom. I'm getting creeped out just enough that I'm probably going to relocate there for the night as soon as I finish typing. 

A certain vague situation in my life has caused my parents and my employers to be mildly concerned for my safety.  I don't see the situation as quite so real  a threat as my parents, my bosses, or Doug, my landlord, see it, but I exercise caution nonetheless. I live in a secure dwelling. I don't enter or leave my place of work alone. For that matter, nor does any other female. Even the nurses here use the free valet parking service. My apartment is alarmed, as is the main house attached to the apartment in which I live. The alarms are activated now, as they always are at night, and are at anytime that I'm here alone even in broad daylight. 

It's colder than @&*% here right now. The last time I checked, it was nineteen degrees below zero Fahrenheit, and the wind-chill factor is at almost forty below. It may be even colder tomorrow. I'm staying inside. 

Rest in peace, Valerie. I'm saddened and angered by whatever led to your demise. It's a crime against humanity that you were robbed of life and that the world has been deprived of your gifts. 

Sunday, February 3, 2019

Back to the World of the Living for Now

I love this picture so much that I use it at any time that it is even marginally applicable.

Readers shall be spared all the gruesome details, but I've been quite ill for the past few days.  I'm returning to the world of the living, though I can only work a light schedule this week.  Not being able to work at all would be a problem for me, but working a light schedule is akin to having the best of both worlds. 

This week I am beginning a pediatric rotation. i've enjoyed pediatric work in the past, and I expect the same will be true this time. i will be mostly hospital-based for this rotation, though I will spend some time in a clinical setting under the supervision of an attendting pediatrician, and this time without a supervising resident.  While I harbor no particular ill will toward residents,  I've thoroughly enjoyed and have found most productive the times in which I've worked directly under attending physicians without the interference of  residents.  The duties delegated to me in such situations are typically the most interesting and the best learing experiences. If a resident is involved, he or she often takes the more interesting cases himself or herself, leaving the more menial or unpleasant tasks for underlings.

I don't mean to complain about inheriting menial and/or less pleasant  tasks. I try hard to cheerfully complete whatever assignments I'm given. Not long ago a resident assigned to me a manual extraction of fecal impaction.  Fecal impaction is akin to constipation on steriods. It most frequently occurs when a patient  unaccustomed to the constipating effect of opioids has been injured or has undergone surgery, and fails to take due heed to instructions regarding prevention of constipation. The patient is usually getting very little exercise at the time, further compounding the problem. There's a false perception that constipation will always right itself eventually. Such is obviously not always the case.

Fecal de-impaction or extraction is arguably one of the more dreaded tasks in medicine, but when it has to be done, it simply has to be done. A medical practitioner would do well to remember how much worse it is in every respect for the patient than it is for the medical personnel, with regard to the gross-out factor, the embarrassment, and the almost incomparable discomfort. It's rare that a physician has such an overt mode of offering a patient instant relief. If a practitioner is compassionate and humane throughout the patient's ordeal, most patients respond with extreme gratitude. It's really not all that difficult to to be compassionate and humane. A physician or other practitioner needs merely to put himself or herself in the situation of the patient, and to apply The Golden Rule.

In any event, the patient with fecal impaction was, unbeknownst to me at the time,  the husband of someone prominent in our community.   If a physician is the sort of person who is professional in every situation and treats all patients with respect, often it's better not to know that a patient has particular wealth or influence. I might have been nervous had I been aware of his standing. As it was, I didn't know, yet treated his wife and him  with the empathy I would have appreciated under similar circumstances.  After the fact, the patient's wife wrote a letter commending the nursing staff and me.  The resident who assigned the task to me was slightly chagrined with the way things worked out. Had she known the patient had connections, she probably would have taken the case herself. The problem with being a resident or intern is that we work so many hours that we spend little to no time in the community outside of the hospital. We have no clue as to whom the connected and socially prominent members of the community might be.

Yesterday my dad called when I was sick. He grabbed his guitar and played/sang a few of the songs I used to ask him to sing when I was very young. One song he sang was a song I hadn't head or even thought about in years --  "I'm Easy" by Keith Carradine. I've mentioned before that either my mom or dad sang to us every night when Matthew and I were little. We could each choose one song for whomever was singing to us that night. "I'm Easy" was one I requested several times. i think I liked the chord structure and Travis picking more than the actual song itself, but I remember my dad complaining to my mom that it was a rather strange song for a four-year-old to like. My mom responded to my dad that I was a rather strange child, and that I had inherited my strangeness from him.

"I'm Easy," written and performed by Carradine, was from the movie Nashville. At the time I would not even have known of the exstence of the movie Nashville, but I've since seen it.  I'm not sure what its rating is on Rotten Tomatoes or any similar site, but I'd have to say that it might be among the worst movies ever made. Still, the scene with "I'm Easy" was rather cleverly directed. The character portrayed by Carradine was something of a player, and he performed the song, announcing that the person to whom it was dedicated might be in the audience. It was amusing to watch the expressions of all the women who thought the song had been written for them.  Even occurring in such an abysmal movie, it was ingenious direction on the part of Robert Altman.

 I do not own this video. I express my appreciation to the rightful owner for allowing me to use the video on my blog  for however long the video is allowed to remain here.