Monday, November 28, 2011
Sorry I didn't write anything about vacation after the first day.  There was much pie eating and shopping and no time for computers.  I thought I'd pop in with a little house updating since I haven't done that in a long time.  Here are some shots of how my dining room has changed over the last 5 months...

This is what it looked like on move-in day.  Very yellow.

I painted three walls chocolate brown with the front wall a light grey/beige color (that runs into the living room also).  The big picture window in the front lets in enough natural light that it doesn't make the room to dark or feel small.  After painting, the dining room became a great staging area for many many tools... and it looked like this.

That's a lot of stuff.  The plan is to put up some shelves, pictures, frames, etc to break up the dark chocolate.  I also want to add some color but not sure what or how yet.  I did template out and put up some floating white shelves.  Very precise measuring going on here...

Take notice of the wonky lopsided light fixture seen above.  That was one of the things I really wanted my dad to help me replace while he was here.  I thought about refinishing it, but just couldn't get it to hang right and get the shades to sit level.  So I ditched that idea in exchange for a nifty modern drum light. 

Ooooo.  So this is what I have now, after putting up the shelves and adding a bit of different decor to the table...

Things I still want to do include:
Add a runner to the table
Paint the table a chairs an antiqued white
Add more things to the wall
Get a hutch/buffet/small server sort of thing
Maybe add a rug...

It still looks kind of naked, but it's getting there!

Sunday, November 20, 2011
Yesterday started off with a trip to Lowes.  I imagine a lot of the coming days will start with a trip to Lowes...  Anyway, after getting a couple small projects done, we headed towards the Notre Dame stadium with plans to find some tickets to the game vs. Boston College.  We were kind of anticipating a blowout by ND, but it's still fun to go!

We walked up to some shoppes south of campus, and while my dad was in the bookstore, I scouted out the scalpers.  They were buying tickets from people who had extras for like $5, and then trying to sell them for face value (at least $80)...  Not happening. 

Instead we walked through the tailgates, and there was a kid selling extra tickets their family wasn't going to use.  So we got the pair for less 50% of face value.  Yay us.

And then we went to the stadium, got some food, and found our seats.  I got a hamburger with mashed potatoes on it.  It's called a Legends burger, and it was practically invented for me.

The game was much closer than expected.  And there were a couple surprises.  At some point, Jon Bon Jovi came out and was "directing the band" in the stands.  I don't think there was much directing happening, but he was definitely there!

At halftime, the band did normally does a halftime show, but this week they decided it would be cooler to make up a whole new show to songs made famous by Chicago... and they thought it would also be cool to have Chicago there to sing along...

Rockin' Around The Christmas Tree (side note: what movie do you think of??)

25 or 6 to 4 (the formation is starting to change to its hard to read)

I think that's pretty clear...
 I think the most impressive part was that the band learned a whole new show just for this day. 

And then, during the second half, my dad bought me $5 hot chocolate.  He must love me, because that's a lot for hot chocolate... but it was cold and I didn't bring gloves.  It made me warm.

Day 1 of vacation ended with us walking home, meeting up with someone he knows from work at Corby's (a bar) for a bit, then getting pizza at 11 at night.

Day 1: Success.
Friday, November 18, 2011
Today is the last day of OB.  Tomorrow is the first day of vacation.  10 glorious days of vacaton.  I'm excited. 

Various family members are coming to my house over the next couple days.  And I plan on putting them all to work.  Don't worry, they kind of volunteered.  Knd of...

You see, they have skillz.  Skillz far beyond mine.  My dad has building skillz and wiring skillz and plumbing skillz.  My mom has decorating skillz and ironing skillz, and being creative skillz.  And I happen to have lots of thing on my to do list that I am not equiped to do.  I sent my dad a list of LOTS of possible projects so he could bring proper tools. 

I have big plans.

Be on the lookout for pictures of cool stuff.
Sunday, November 13, 2011
Have I mentioned before I have a jacket problem?  I think I have... but it never hurts to repeat important things.

I have a jacket problem. 

As in, I have too many of them, but just can't stop.  Seriously, I am one person, and my coat closet it totally crammed.  But they are all so important.  And none is more important than my Mountain Hardwear Monkey Woman Jacket...

Okay, fine.  I have two.  You didn't have to be so mean about it.

Let me explain.  I have had my eye on this jacket since I worked at EMS.  It was love at first wear.  But, being that I am relatively cheap (ie, like to get things at a bargain), and it retails for $150, I didn't own one.  I only oogled.  That is, until one fateful day in Portland, OR.  I was on a bit of a Columbia outlet store shopping spree, when I came across this particular jacket on sale for 50% off!  Woo!  But I was Christmas shopping for OTHER people, not me.  So I was going to let it pass on by.  Until I saw a sign indicating that it was marked down even more, to a mere $40.  I'm only human, people.  And that deal is beyond my ability to pass up.  So I snagged it (only it was blue, not purple like the one above), and promptly wore it around Portland, and on the airplane home (and I may or may not have let my apartment temp run a little cool so I had an excuse to wear it while sitting on the couch......).

The other day, while on a bit of a TJ Maxx shopping spree (I don't do that as often as it sounds), I found the purple version you see above, stuffed between some other inferior jackets and hiding from the masses, waiting for me.  And, of course, it was at a great TJ Maxx price.  What's a girl to do??

Yes, I already said I have a problem.

Anyway, I am not opposed to owning two of these jackets because, quite simply, they are wonderful, and double the wonderful never hurt anyone...

Why, you may ask, is the Mountain Hardwear Monkey Woman jacket so great?  Well, first of all, the product description on MH's website says it's constructed of Monkey Phur.  How can it not be great?  Aside from that, I love this jacket because it's incredibly soft and warm while being light weight and nifty looking.  The fleece tapers at the cuff so the Monkey Phur doesn't get all up in whatever you're doing with your hands.  It has a convenient zip breast pocket (always a plus in my mind... the best place to put a few dollars and some chap stick while frolicking in any winter wonderland), a feminine cut, and did I mention it's warm?  The fleece also holds up extremely well to abuse without pulling out or pilling. 

It's like getting a giant warm hug from an extremely friendly brightly colored polar bear.

The downside to this jacket, like most fleece jackets, is that it doesn't do so hot in the wind protection department.  It'll keep you warm if it's cold and breezy, but if you're in blustery conditions, you're better off to throw a shell on top to keep all the toasty inside. 

I definitely would recommend this jacket to anyone looking for a cozy addition to their winter outerwear collection.  And don't fret, gentlemen.  The version for guys is called the Monkey Man.  It's still made of Phur though...

Adventure on,
Friday, November 11, 2011
Some may find the hype surrounding today's date, 11/11/11, a bit ridiculous. It's just one day, right? Wrooooooooooong! For one little soul, 11/11/11 will forever be an awesome day. Because it's the day she was born. Yes, lots of babies were born today...

But how many were born at 11:11 on 11/11/11??????? Not many. Maybe none.

But we did it. We delivered a little Chica at 11:11, no embellishment involved.

And it was awesome.
Thursday, November 10, 2011
Disclaimer:  This post will contain language routinely used in OB world.  If you are unfamiliar with or offended by the proper terms for female child-birthing parts, this post might not be for you, and you should stop reading.

It was a dark and (not so) stormy night.  I, having delivered all the babies on the board, was sleeping soundly in my call room.  Then, my pager went off.  In my hazy just awoken from a (not so) deep sleep, I looked at the number and thought, "huh, that's not the triage number...".  So I called it back and heard, "Dr. Sears, you're needed in birthing suite 2".  Birthing suite 2?  There's no one in birthing suite 2....

So I crawled out of bed, wiped the goop out of my eyes, and wandered over to BS2.  The nurse said that lady had come in saying she woke up and felt "something between her legs".  I lifted the sheets with plans to check her cervix, and was greeted with this:

(You thought I was going to show you a cervix, didn't you?)
I was greeted with a teeny little premature newborn foot.  Only it wasn't in someones hand, and seen above.  It was sticking out of the momma's vagina. 

For those of you not familiar with the normal delivery process of a baby, let me explain what usually happens.  First the head comes out.  Then the body.  Then the feet.

The feet are not supposed to come out first.

Needless to say, I felt a little outside my pay grade.  So I called for backup, in the form of a scalpel wielding obstetrician.  We whisked her to the back for a c-section of not only the little girl who tried to kick her way out of the uterus, but also her twin sister, who was pretty much sitting on top of her to put a little weight behind the kicks. 

Momma and both babies are doing fine.
Saturday, November 5, 2011
Ahhh, falling back.  The one night of the year where you can snag an extra hour sleep or stay up an extra hour late knowing that after 1:59am, the clocks will magically forget to go to 2:00am, and instead flip back an hour to 1:00.  Splendid, that is, unless you happen to be on nights.

Which I am.

Which means that instead of getting an extra hour of sleep, I get an extra hour of work!  Yessssss!  But not only do I get to work an extra hour, I get to do it without our electronic medical record.  You heard me right.  We are falling back in time AND technology.  Yeah, yeah, I know that doctors used to practice medicine with paper, signed orders in blood, and walked to the hospital in snow uphill both ways.  But since those days, all the records have been put onto the computer.  So while we can write orders and document without the EMR, we can't look up old records.  Which is a problem.

AND the fetal monitoring will have to be done with paper.  If something goofy happens on the strip and no one is in the room to watch it, it won't get noticed until someone looks back through the strip.

I'm thinking that if we tell every woman that her labor will be an extra hour longer because of the time change, she'll come back in the morning..........
Friday, November 4, 2011
I have a theory... about shoes.  Specifically sneakers (or tennis shoes, running shoes, athletic shoes, whatever it is you want to call them).  My theory goes a little like this:

When I look at my shoes (while I wear them), I only see the toe.  And the laces. 

Therefore, the toe should be interesting.  And worth looking at.

It's a pretty simple theory.  And I keep this in mind when I go shoe shopping.  Sure, a shoe may look snazzy and fun from the size, but it the toe is white and boring, the snazzy side does me no good.  The other day I was out shopping for some new shoes to wear with scrubs.  The ones I have now are a retired pair of running shoes, and they stink.  And after this OB rotation (where they may or may not have gotten doused with various substances in one or more delivery), they will the throw away before leaving the hospital. 

I was looking for something very specific: an inexpensive running shoe (I've found they're the most comfortable for me to wear all day) that was a bright and fun color, with an interesting toe.  If I'm wearing them with scrubs, that means almost certainly on call.  And what better to make call more fun that to wear ridiculously bright shoes? 

So this is what I came home with:

They are super fun to look at.  And comfy. 

And definitely follow the toe rule.
Tuesday, November 1, 2011
99% of what happens on the Child Birth Unit (CBU) is happy and exciting.  Sometimes where are bumps along the way, but generally babies are born healthy and families are happy.  But 99% still leaves room for tragedy, and those stick with you.

While medicine continues to improve, and we are able to do increasingly more remarkable things, there are still limits on who we can save.  Never was that more evident than today.  I wasn't directly involved with this case, but not much happens on the CBU that everyone doesn't hear about. 

There are a woman who came in overnight (before my shift) who was 21 weeks pregnant and started having contractions.  This is not completely unheard of, and there are a few common things that can cause preterm contractions that are generally pretty easy to deal with (infection being the most common).  This woman was treated with fluids and terbutaline, but her contractions persisted.  Ultrasound revealed a grossly normal baby without obvious deformities.  Lab tests did not show any source of infection that could be treated.  As her contractions continued, her cervix started to dilate.  After much debate, she was started on Magnesium as a last ditch effort to stop her contractions.  It failed.  Preterm labor in itself is not uncommon, but she was only 21 weeks pregnant.  The general limit of viability for a fetus is 24 weeks.  Sometimes they will resuscitate babies born at 23 weeks. 

Nothing before 23 weeks is considered viable.

She was in rip roaring labor, and there was nothing to do to stop it.  She was delivering her baby, which was still alive, and they had to tell her that there was absolutely nothing anyone could do to save it.  The NICU doctors came to talk to her and reiterate that they could not offer her anything.  The OB docs talked to her and told her they'd done everything they could to stop it, but her body was going to have this baby.

She asked why, if her baby was perfectly healthy (from what we could tell), and was going to be born alive, we couldn't help it. 

She asked why we couldn't keep it in for just 2 more weeks until it was viable.

She asked what was causing her preterm labor.

She asked why no one was helping her.

She held her baby after it was born, as it was dying, and just asked "why?"

And there's only one answer, although not a good or satisfying one...

Because there are limits.

About Me

I am a Family Medicine intern at a community hospital in Indiana, navigating the new world of being a physician. I am privileged to work in a field I love, where every day is a new and unpredictable challenge.
I am not only a doctor, but also a cyclist, runner, DIYer in the making, lover of the outdoors, traveler, and human.
Human, MD is a glimpse into the world of a young doctor who is just trying to stay true to herself through the grueling whirlwind of residency.


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