Things Don't Always Go As Planned

We were having a great weekend. We got all our errands done yesterday, I did some shopping and finally got some new clothes. I made dinner and had plans for enjoying my Sunday. I was going to go to the farmer's market and see if they still had Heirloom tomatoes. I was going to get fruit. I was even going to take some pictures so I would have something to post on the blog (I know I've been neglecting to provide you all with pictures to enjoy, but not much worth photographing since returning from Peru!). I was even going to go to the gym. I have piles of cooking magazines to sort through, I need to save my basil from the little green worms that are eating it, and I was going to put together our guest book from the wedding now that I have all the pictures.

But alas, things did not go as I had hoped.

At some point last evening, I began to feel a little unwell. I ate dinner, but about an hour later began to regret having eaten dinner. I was afraid I had poisoned us but Adam felt well. I recounted our day and identified the likely culprit as the taco I had for lunch. Damn taco. Things just got worse from that point. I will spare you the gruesome details, but suffice it to say, I did not sleep last night. And I have not been terribly functional today. Adam decided to conduct a scientific experiment to determine the exact cause of my food poisoning. He ate the left over taco and confirmed that yes indeed it was the taco. While I do appreciate his committment to the scientific process, I hope it doesn't hit him as bad as it did me.

Hopefully I recover in time for work tomorrow morning!

Realities

We rotate at several different hospitals here. Besides the VA hospital, which is like every other VA hospital in the country, the university operates two hospitals, one downtown and the other in La Jolla. I've spent most of my time working at the downtown hospital, and I've come to realize that that experience has really influenced my view of health and illness. The downtown hospital is effectively the county hospital in San Diego. They tend to care for the uninsured population, those on Medicare and Medicaid, the undocumented population. There are a lot of people who haven't spent a great deal of time focusing on their own health. As a result, they tend to be chronically ill. I see these people, and can't help but think how far apart our life experiences have been. I can't possibly understand where they are coming from or how difficult their lives have been, but it's easy for me to distance myself from their problems because it is impossible for me to imagine being in their situations. Somehow, that makes me feel protected, that their problems will never be mine. I feel safe.

For the last month I have been working at the other hospital, and realize I am not safe. In the last month we have admitted three physicians to our service. Two have newly diagnosed metastatic cancer. Another seems to have found himself in situation he no longer has control over. We've admitted a former math professor, who we discharged to hospice. A chemistry professor, who is still holding out hope for a cure, but it's not likely to happen. We had a diplomat who died a quick and unexpected death. People who were active and presumably healthy 3 weeks ago, show up in the emergency department and their lives are changed forever. It's sobering. I've always felt safe from illness, as though there is something about my socioeconomic status, my education, the fact that I'm a doctor! Something about that that should protect me from illness, from cancer, from death. But as these patients prove, it doesn't (and given my reluctance to ever actually go to a doctor, I suppose that being a doctor doesn't really provide any protection at all).

I don't know that this last month has really changed my life in anyway. I'm still going to speed when I drive on the freeway. I'm still going to eat pie for breakfast on occasion. I will drink my glass of wine at night and I suppose if any bars allowed smoking anymore, I would still inhale second-hand smoke. It just makes me realize how tenuous life can really be, and that you need to make the most of it. Maybe it will make me procrastinate less? Maybe I will finally go to the doctor and get this lump on my leg looked at? Or maybe I will just keep doing what I'm doing, but with a little more compassion, as I realize I'm really not that far removed from the people I care for.

Getting Out

Not only did I get out and go running yesterday, but Adam got free tickets to the Padres game, and since we have yet to go to a game this year we headed out to the ballpark. The seats were great--first row, right along the third base line. I couldn't really enjoy the game though. Besides the fact that the Padres pretty much suck, I was terrified I was going to get hit by a rogue foul ball. I forgot to bring a camera, but I did take a horrible picture of the umpire's behind with my cell phone.

Today I'm at the hospital all day and all night, but I discovered the Physician Libarary. It's a beautiful room with windows and couches. And best of all... at TV! Unfortunately I cannot find the remote control for the TV, and the channel buttons are all broken. It is stuck on Fox Sports, which is currently showing sport fishing. I've opted for my iPod instead. Maybe after I finish my presentation for tomorrow I will scour the room for the remote, unless of course something comes up and I have to actually provide patient care.

Excuses

Call months are rough because of the 30+ hours you have to spend in the hospital every fourth night. I think it is really the fact that I am awake from 5:30 am until 2 or3 am on those nights that make it hard. If I actually had the chance to get some sleep, I wouldn't mind having to sleep at the hospital (except for the fact that our call room is so damn cold). The flip side is that on the days that we aren't on call, we only have to stay at the hospital until our work is done. Most days, that usually ends up being 4 or 5 pm. We have conferences to go to during the day, clinic once a week, and my day off is always a weekday, but weekends... those are a different story. My intern is off on weekends, so it is just me, seeing the patients, putting in orders, making sure everyone is tucked in. I always get out early on weekend days, but today we only had 6 patients and they were are so completely stable that I was done by 10 am. It was almost like having a day off.

So I went running today, and realized that this was the first time I had been in the sun (not counting the walk from my car to the Target entrance) since we got back from Peru. I make a lot of excuses for not exercising. I get up really early. I have to make dinner when I get home from work. I need to sleep when I'm post-call. As I was running though I realized I'm always going to busy. If I use "being busy" as an excuse for not exercising, I'm never going to leave the house. I will become pasty white from lack of sun (more so than I already am), I will develop vitamin D deficiency and osteoporosis, and I will need to take the elevator up one floor because I will be too out of shape to take the stairs. I don't want to be that person. I need to stop making excuses and just leave the house. It really is nice being out in the sun. And if it keeps from breaking a hip in my old age, it is definitely a good thing.

Back to Knitting

I think I'm in a rut. It comes with the territory. The details of my job vary from day to day, but for the most part it is always the same. The part that is most frustrating is the lack of flexibility. There's nothing I can do to get out of work early. I can't take one day off in exchange for another day. Holidays have no meaning. And even when I have a day off, I can't think of anything creative to do with that day.

I start off each day with grand plans for accomplishing long lists of things. Today for instance, I have a stack of thank you notes to write for all our wedding gifts, I have that 20 page application for Kaiser to finish, I'm making dinner tonight, I have a presentation to give at work some morning next week, I have laundry, I need to go shopping. But it is almost 5 pm and I have accomplished none of those things. I did go to the yarn store. It's been quite some time since I embarked on a new knitting project, but I finally felt motivated to pick up some new yarn today. There's a whole lot of babies coming in the next few months, in addition to some teeny tiny twins who made an early appearance and need some teeny tiny hats. And of course Little Bear provides a constant opportunity for me to make larger and larger sweaters as he continues to grow (speaking of Little Bear--if his parents are reading this, I would like new pictures please). So while nothing from my "to do" list has yet been accomplished, I've throughly enjoyed my day off and will just pend my to do items until my next day off. In 8 days. I miss having weekends.

But I keep doing what I'm doing knowing that it will eventually get me where I want to be with my life. And I guess eventually I will figure out where I want to be. Until then, I knit. I cook. And eventually I will get around to writing those thank you notes!

Settling In

Two weeks in, andI'm actually handling this rotation better than I thought I would. It's busy, especially on call nights. I have yet to get to sleep before 3 am on the nights we admit. We have to admit patients until 2 am, or until we have admitted 10 patients, and the last two call nights we have hit our 10 patient cap well before 2 am. Yet I'm still up until 3 am, writing notes, making sure everyone is tucked in, and ensuring that my main goal of any call night is accomplished -- everyone lives through the night. That's really my main objective when we admit new patients, especially late at night. We work with a skeleton crew at night, and while if there is something that MUST happen, I can usually coerce the necessary people into the hospital, it is much easier and faster to get tests the next day. We also have our full team the next morning, too, which makes the process of diagnosis much more productive.

I do miss having weekends off, but I'm doing ok with my one day off a week. I'm still finding time to make dinner every night, which lends some element of normalcy to my life. The exercise is still lacking however. I may need to relenquish dinner duty to Adam a few nights a week so I can get some work outs in. Maybe. I do hate to give up control of things, but I suppose I should allow Adam a chance to work on his cooking skills. If I want to accomplish that goal of running a 5K sometime this year, I probably need to start by leaving the house a few days a week. You do have to start somewhere...