Psychiatry has begun.

Booyah.

This is what I am talking about when I am talking about rotations. Lots more free time, no rounding on the weekends. It makes me long for second year. But, I have more rouding ahead of me, much more. I guess I will enjoy this as I can.

In other news, I am Team Cover today. TC is the resident who keeps watch over all of the residency patients for those residents not around to be there themselves. Maybe they are on vacation, maybe they are on an away rotation, maybe they are sick. It matters not, for TEAM COVER is there to save the day. Meh, thats far more glorious than it actually is. In reality is me sitting in a chair doing paper work and answering the odd phone call. On the typical day there are anywhere from 4-8 residents doing something that requires cover. During peak vacation times or the flu season, sometimes we have as many as 9-13 residents gone. But today? Block 7 when no one is allowed to be on vacation? Yeah, there is ONE person out doing a rural medicine block. And even this guy only needs his mail box checked, not even his hack box. So here sit, with no work and 2 hours to do it.

But hey, you won't hear me complain. It has afforded me the chance for an update.

And speaking of date, tonight is date night with the wife. W00t! And, thanks to the generosity of my mother and her $50 gift card to the Lob, we don't have to go to Sams and just eat samples. Not that there is anything wrong with that ;)

ICU almost done!

Merry Christmas everyone, not sure whether I will get another update in before the big holiday. And even if I do, two Merry Christmasses never killed anyone. At least not anyone I know of.

I get to write today because I have a rare quiet bit of time in the ICU. As my rotation draws to a close I am finding myself with little to do. Our census was thankfully small today, which means I had some extra time after rounding in which to sit down and enjoy myself online. Huzzah. and I am discovering that there is a really cool thing about working in medicine, and in the ICU in particular. I get to be really happy about business being slow without feeling guilty. If I worked in retail and business was bad I would feel bad about the fact that I was wishing the business ill. But here in the ICU when business is slow, it means that people are healthier, and thats a good thing, company be darned.

I can say that it has been a busy month, even though I have had some fun times as well. We had a pretty kicking party at the Sawlaw House. It was the 2009 Sawlympics. Wes brought a truck load of snow, and everyone else brought truckloads of booze. I bet you can imagine how that worked out. Having friends who drive Zam at the ice arena definitely has its advantages. I was lucky enough to have gotten the bulk of my Christmas shopping done before this rotation started, but I have still be pleasantly surprised that I have had as much time as I have had to get out and get whatever shopping I hadn't finished done and over with.

Its certainly going to be a fun Christmas this year. Mandi and I finally have paychecks, and a monthly budget that is soundly in the black, even with loan repayments. This has left us with the ability to be as generous as we have always wanted to be, to those who have always shone us such generosity. Christmas has always been about giving for me (even though the getting is fun too), and its nice to finally be able to have some real fun giving. I am especially excited that we have been able to buy gifts for the Siblings. All 15 million of them it seems at times, but all the same it was good stuff.

That said, my Attending Physician just alked in, it seems that its time to get rounding. Merry Christmas to everyone :)

Anniversary and the ICU

I am gearing up for my big push through 12 straight days of work, including 3 calls, one of which is whole house. So let me explain that. Normally there are three residents that cover the hospital. Typically its two first years and a second year. One of the first years and the second year cover the hospital. So any patients of our clinic, of other FMS clinics around the area, and any patients without doctors or who are from out of town are taken care of overnight by those two. The other first year (or sometimes a second year) covers the OB department by him/herself.

Now, I prefer FMS call. I am just not an Obstetrics kind of guy. Not my thing. And I think that FMS call is usually paced a little better. You get called more often, but its more consistent, and even though you have to run about through the hospital, you don't feel terribly hurried most of the time.

OB call however, there is oftentimes way more work to do than one person can do in a night, and its a common occurrence for certain things not to get done, in favor of C-Sections and Deliveries (you know, the important stuff).

Well, on a whole house call night, its just the two FMS covering residents, and there is no OB resident. Which means that two have to do the work of 3. As well, that extra one that we are covering is often too much work for one.

Basically, it sucks. And I have to do it on Thanksgiving. The nice part is we only have to do one of these an academic year, typically. Thanksgiving, Christmas, Easter, 4 retreats, and a few random days. At most we do three in our 2 years doing in house call.

On top of this, I am on ICU. Which means before and after call I have to round on my patients. So I will be covering the whole hospital for 24 hours, likely without sleep, only to have to go and try and fix the sickest patients in the hospital. Don't tell me I'm not a badass ;)

And I am not necessarily complaining, just sharing. I knew I signed up for this. This isn't really a surprise. But its not fun either. I will be missing turkey and pumpkin pie this year :( But thats the way it goes sometime. Hopefully this is the last time.

On a much more fun note, Mandi and I are celebrating our 2nd anniversary tomorrow. I can't believe it has been 2 years already. Time sure does fly. She's the love of my life, she is God's joy for me incarnate. And she is my greatest earthly blessing. I love my wife. A lot.

So happy anniversary to us.

Been a while.

As usual, I have been slacking off on my blog posts. I have been doing better with the Awesome blog, but this one seems to always take last place on my list of things to do. Its now November, over halfway done with November, and I am just finishing up my Surgery rotation. Not going to lie, Surgery was pretty sweet. Hours were a lot more regular, and there was less call than when I am on service. One would think that I would have the chance to update my blog a little more. But nope, instead I filled my time with as much fun as possible.

Work is definitely going well, being off service does make it seem better, but even considering that I would say that it is going well. I am finding that despite call, and the paperwork, I am still getting to spend time with my wife, and my friends. Just this weekend I had Mark and Wes over for a night, and that was fun. Got to have some nerd fun, which was a welcome relapse into the times before the party-house era.

It is also ramping up to Christmas time, which is exciting for me. I have actually managed to get my Christmas shopping almost 100% done! I am pretty proud of myself, as this is about as early as I have ever gotten it done before the week of Christmas. Mandi and I have taken our new income status and gone a little crazy on our family. All of my siblings will be getting something this year, which is fun. All of Mandi's sibs as well, including Vanilla Bean and Kati. It is wonderful that God has afforded us the blessing of income, with which we can be generous to those that we love. Nothing is more fun than giving gifts.

Well... getting gifts is pretty fun too. And I'll be honest, I already ruined two of my gifts. My wife, in her amazingness, bought me a Bears polo, and after much convincing she gave it to me early, seeing as how the Bears are unlikely to make the playoffs it would be nice to have the polo before their season is over :). The other ruining was a little worse, because it involved me being a jerk and assuming that my wife would never actually get me the PS3 she had said forever I would never have. Well, I'll shorten the story and just say that I got the PS3, but there were hurt feelings involved, Mandi wasn't given the chance to be super generous like she wanted to be, and now I feel like a jerk. But we've mended, as we do everytime. And now we have both gotten our big gifts out of the way. Who am I kidding though, Christmas is going to be ridiculous as it always is. We are spoiled every year.

ICU rotation is coming up, it should be interesting. I have worked in the ICU a bit on call, and I have already had my medicine rotation so I am hoping for no huge surprises, but one never knows. I do know that its in-service, and that means I only get two weekends. It also means that I am going to have to work the weekend of Thanksgiving, which is a bummer. All day and night on Thanksgiving day... whole house call. Bummer. And then again on that Sunday, regular call. All the while in between I will be rounding. Its especially a bummer as I have sort of become the go-to guy to shop early on the day after thanksgiving.

Hopefully I get the chance to update before then though.

Birthday Weekend

So its my Birthday Weekend. And yeah, the birthday lasts the whole weekend in this family. Thats a tradition from Mandi's family that I have to admit is a lot of fun. Its also my weekend off from work, which is nice. MNPS is almost over now, I am done with call, and I am ready to rock and roll all weekend.

A bunch of my buddies have come down to celebrate, and two of them, Mark and Ethan bought me a really cool present: Descent. This is one of the headrunner games out of Fantasy Flight, a game making company known for their detailed, and visually rich games. And Descent is no exception. Its not dissimilar to a game from my childhood... okay, from about a year ago as well: Hero Quest. A lot of fun, and a good way to spend the day with friends.

Tim came over with Shaun, and they brought me a 40 oz of Cobra, that was totally awesome too.

All the while, my wonderful wife has been busy whipping up some delicious meals for my friends and I. She has been more wonderful than I could ever ask her to be. It was Cinnamon Struessel Muffins with a side of pineapple this morning. Pulled pork tonight. Talk about a good time.

So far its been a wonderful birthday weekend, and I am looking forward to more.

On call.

So its 05:55 and I am sitting at the desk in Labor & Delivery. One of those rarer calm moments, waiting on results and physicians to call back. More of the same really. This is also hour #22 of this particular call. I don't know whether it is depressing or exciting that I only have a full, regular-person's work day between me and blessed sleep. Probably a little bit of both.

It was an interesting night, but nothing that I can talk about of course. Overall I can't complain, hard to do that when I know what I have waiting for me at home, a beautiful wife, beautiful house, with some Filippo's pizza and my new TV. Should be a good time.

I can tell you right now that I am definitely "done" with MNPS (OB). Just not my cup of tea. I understand the noble nature of the field, and I will be the firs tto admit that OB/GYN's do a lot of good work, and do tons of good for their patients. But the lifestyle... I don't care if it brands me as selfish, but I can't imagine ever having this kind of lifestyle. Nothing is worth this too me. Even the noble pursuits of medicine.

And I wonder if that isn't part of the problem. Through this false image of the "altruistic" doctor who puts their perception of the patients' well being above all else, along with this misguided ego-driven idea that only "I" am the one who can properly care for "my" patients... we have created this bizarre social dynamic in which we elevate ourselves as martyr's while being highly paid and increasingly resented by the patients who's best interests we believe we should be, and are working in.

I think it would be far better if we admitted that we are just people. And that sometimes breaking continuity of care is okay. Because if it came down to me having "my" doctor after 22 hours on call, or someone else's doctor who is working a regular, reasonable 12 hour day... I would pick the "other" doc everytime.

Of course, these patients, they are getting some "other" doc who has been on for 22 hours. Where is the benefit there?

Again, this isn't a personal complaint. I will do the work. Its hard, and long, but its doable. And the light is there, ever present at the end of the tunnel. I have no doubts that I am one who can go that distance. Heck, I'm cocky enough to believe that I can even do it with relative ease. My comments are more along the line of pondering what is best for everyone, patients and doctors. And not even everyone, but myself, in the future, when I can chose when and where I work. And while I might not be able to say definitively what will be best, MNPS has certainly shown me what is not.

Maybe thats the point? I hope not, because I got that point a long time ago.

Delivering Babies

Had OB call last night. So I was the guy for delivering those babies. Arrived on the L&D floor and saw that there were 5 laboring patients. For the record, thats not a small load. Not super busy, not crazy, but certainly enough to convince me that I was going to be up all night. Because if you have five, you can probably count on getting one or two more that come in during the night. And the five patients were a mix of primes and multis, meaning that some were having their first, some their second or third time around. This also means that some are going to go faster than others... so I am expecting a night of steady deliveries. Between that, outpatients, and progress notes I was ready to rock and roll.

Well, as per the theme of L&D this is exactly how it didn't go. Three of the mothers progressed pretty rapidly, and the three of them gave birth to three perfect kiddos in a matter of 18 minutes. Now I am pretty good, but I am not good enough to be in three places at once. So I miss out on two of them.

After that the night was actually pretty slow. The other two mothers took their time, and there wasn't a single outpatient until 6 AM. I got plenty of sleep, and even got to deliver a few babys. Always a good time. I will be honest though, I don't think I am ever going to get to a point where deliveries don't make me nervous. Its just not a smooth process. There is pushing, fluids, and then screaming, contractions... you get the idea.

AND, bonus, because I am doing ER this month, and you aren't allowed to see new patients after a 24 hour call, I got to head home "early"... that being 16 hours later than any reasonable person, and 12 hours later than every other high liability performance intense job does (pilot, trucker, heavy machinery, captain...). But I digress, the point is that I had this whole day post call, AND I had plenty of sleep. Its like a bonus day. So I am pumped. Now if only the weather was nice I could mow the lawn :)

A Different Day.

Now, I recognize that I might not be far enough into my residency to make calls about what is different and what is routine, but today was pretty different. I worked the ER this morning, its a fun time. But its ordinary. I am used to it. I see patients with problems that I have seen before. Its challenging, but its routine.

But this afternoon was something different altogether. UICOMP holds an annual Faculty golf outing. And since all the residents are faculty (Thats right, I am actually considered faculty at a university now... *checks self* whew... still conservative. That was close) we get to go. In fact, we HAD to go. They made us do it.

Except it wasn't a golf outing. Or at least it didn't have to be. There were three choices for the day. You could either go to the golf outing, the RiverPlex, and/or go out to Dinner. Well, I didn't want dinner, because I want to be home with my wife. And I don't golf, so I figured that was out too. And for those of you who don't know me, I am rarely one to turn down a hot tub. So I had an afternoon of playing in the pool, hot tubbing, eating free lunch, and weight lifting. And I was paid for it. Very cool. But very different.

Tomorrow its back to the "routine", including call. OB call too. Wish me luck. If I get it, I might be able to post another entry from the call room on some down time.

Tiger

Residency in Full Swing.

So I have been cheating on this blog with my other blog: How To Be Totally Awesome. And because of that this blog has taken a huge back seat. Which is somewhat unfortunate because this is the blog that I intended to use to chronicle my journey through residency, as well as to put some of my views out there for ideas and comments.

But that aside, I am back. I will try to work with both blogs, this one will always play second fiddle I think, only because my other one has advertisements, and there in needs to be updated more frequently to stay entertaining. That said, this one probably has more meaning, and hopefully a lot more depth.

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A lot has happened between my last post and this one. For one, we closed on our house. Which was a great thing. An expensive thing, but a great thing. We are so happy with our home. Check out Mandi's Blog for details on that. She covers things a lot better than I do.

We have done some renovation, mostly painting with a few other things. Again, Mandi's blog has details on that.

Probably a greater change for me was the beginning of my Family Medicine Residency here in Peoria. Its been a huge adjustment. Going from a lifetime of learning, to a lifetime of clincal decision making. I know this is an abstract way to think of it, but having information poured into your brain for year after year after year, and then to have to turn around and spit it out in a way that helps people, and that works... its an interesting change.

I think I am doing a fair job, I try to ask the other doctors around me to critique me, and to offer me feedback and so far its all good. I feel confident in my knowledge, and in my ability to make the proper calls on the floors.

And speaking of the floors, call has been a real adjustment. There is nothing positive to say about staying up all night, being sleep deprived, hungry, and annoyed for more time than I care to think about at a time. Our call on weekdays lasts from 5:00pm to 7:30am the next morning. Keeping in mind I have to work the day before, and until 1:30 the day after too. Thats 30 hours at a time. Sometimes without sleep! Its nuts, not fun, and probably not safe. I am hopeful that the policies that are being considered will change that. For my sake, but moreso for patient's sake.

And weekend call isn't much better. Its only 24 hours at a time or less, but then its on the weekend. And it kills any hope of having the kind of good time I would like to have.

Now don't get me wrong, I am not trying to complain. I can handle the work. I have worked over 80 hrs a week before, so this is no biggie. And its FUN work, its challenging work, and its what I have been training to do for years! I can honestly say that I love it. And I am blessed to be able to do it. That said, it IS an adjustment, and one that I am finding harder to make than I thought it would be.

I also got a vacation. Thanks to a scheduling flub up I got vacation THIS August, when I thought I was going to get vacation NEXT August. I took full advantage, and went to WI to see my grandparents. It was a blast, great weather, and Bond Lake was great! Overall though, the best part is seeing my Grandparents. Time with them is priceless.

All in all there has been too much to cover in one post. Hopefully I am somewhat caught up with my blogging here, so that I can go ahead and stay current from here on out. More to come!


Tiger Striped Doc

Mowing

Isn't much fun. But I won't lie, I find a strange satisfaction in it. I think if my 14 year old self were standing here he would probably punch me for saying that. And a good portion of him inside me is saying how wrong it is to take any enjoyment from the activity that trapped him on so many summer mornings.

But alas, we all grow up. Or at least we all get older and most of us grow up. Then again, I am a Toys'R'Us kid so who knows.

Either way, I have a house, and now a lawn. So it has to get mowed.

Lets come to an understanding.

I am not much for blogs. I don't read many, nor do I presume that mine will be read by many. Lets face it, very few of you reading this actually care about my days, about my chronicle, or whatever. And if you do care, you're probably related to me or have been close friends with me for a very long time; in which case you have likely already heard anything that I write about.

That said, Hello! I'm the Tiger Striped Doc. Otherwise known as Joshua from "Mandi's Musings". I am also known as Yosh from the blogs of the Vanilla Bean Counter.

I will do what I can to write about interesting things. Probably not the most interesting things I see or do, because the hungry hungry HIPAA would come after me. And that would be bad.

So why Tiger Striped Doc you ask? Well it used to be Tiger Striped Dog, but then I graduated from Medical School. And it was Tiger Striped Dog because of my love of Cowboy Bebop. More specifically from this scene. Except I hate cats, so I changed it to Tiger Striped Dog, instead of Cat. I also have a hot temper, and have been known to get pretty pissed from time to time. In my vanity I think of it as the tiger in me, and so in anger the stripes start to show.


Thats it for now. More later?