American Fox in Shamrocks

New Year's Music 2012

2012-01-08T19:33:00.001Z

As per usual, I'm behind on my normal New Year's bits... I blame a lot of this on being on call from New Year's Eve until New Year's Day. The rest is pure laziness and switching jobs. So to kick it off, here's my New Year's Play list:

New Year's Music 2012:

Nothing Left to Lose - Mat Kearney
[Somehow, this is how I felt coming into 2011. It's bittersweet. I was done with Surgery, I was heading to Drogheda, and I was shaking off some old hang-ups... very very slowly]
Crash and Burn - Lifehouse
[Yes, I went to see Lifehouse at the Olympia. It was like a tour of old relationships. I hadn't realised how far back their music went in my life, and it brought up some feeling I hadn't felt in a long time. That being said, Feb was pretty damn dark in Ireland. Still pretty bittersweet. Still a little moody... hell, that's how I was.]
Skin and Bones - Foo Fighters
[Some retro Foo, in honour of their new and fantastic album. But let's be honest, in retrospect, intern year is about getting stripped down to nothing and rebuilding. It's brutal. It's depressing. It's humbling. And if you survive it, you're stronger for it. I think it was in January that I bottomed out at my lowest weight, and it was probably March that I was emotionally destroyed. Sometimes you need that.]
My City of Ruins - Eddie Vedder
[I avoided any Pearl Jam this year. Not that I wasn't enjoying their music. But Eddie makes an amazing cover of this song. Dedicated to Drogheda... a city of Ruins.]
Adolescents - Incubus
[Incubus released a new album that is far more chill than their older music. But they rocked the roof off the house in Cardiff. It was a strange trip at a strange time. But I can't avoid keeping them in the album for 2012. Plus, the verse is very appropriate for early 2011. I felt as though I was always racing against some unknown deadline.]
Notbroken - The Goo Goo Dolls
[This is in for a number of reasons, but if you haven't seen the video for this, it's totally worth the watch. Somewhere around April, I found a second wind that pulled me through the rest of my time in Drog. Maybe it was the people... ok, it totally was the people. But it's a good song.]
Rolling in the Deep - ADELE
[Anyone that's ever felt like someone missed the boat, this song is amazing. I mean, Adele is fantastic, but it just manifests those feelings that you don't always speak aloud. So close... And yet so far... How stupid.]
Knots - Lisa Hannigan
[This lady released another album in 2011. It's brilliant. But she sings in an effortless and haunting voice that I find intriguing. There's something to be said for emotional spring cleaning... It takes time to untangle things. Time and distance. So for those of you that were busy tying knots, I may have finally undone the mess you left.]
What You Think You Know - The Coronas
[Another band that's released another fun album in 2011. I didn't go see them in Dec this year... mostly because I was afraid of a repeat of last year's power failure and rescheduled concert when I was outta town. That being said, I still think these guys put out a fun tune. With distance comes a certain callousness. A certain attitude. And you know what, I too am tired of what you think you know. (you know who you are)]
Dark Horses - Switchfoot
[Still on my list of bands to go see, released another album in 2011... and again, not bringing their tour to Ireland. But Dark Horses is a throwback to the old rock that Switchfoot started with. And I'd say about May of intern year, this is the attitude we'd all developed. Somewhat angry, a bit jaded, and starting to become hopeful... Like, wow, there's a bit of light at the end of this tunnel.]
Monarchy of Roses - Red Hot Chili Peppers
[These guys have been around for ages, and put out an interesting album this year. They did come to Ireland, and they'll be back in 2012... I'm not sure I'm a big enough fan to dish out the cash they're demanding though. Still, a bit of respect for the new music. They, in my mind, sound a lot like Incubus and Foo in this album... which we all know is music that I dig.]
Heaven - O. A. R.
[It really took until May or June before I could adopt this mentality. Fuck this game. You know what, if you're going to keep changing these rules and running a shit game then I don't want to play. And guess what? Leaving crap games will make you feel better. Stop with the bullshit. Let it go. There are other people that will feel the same as you, and they're probably great people to be with. And if others have a problem, fuck them. No really... do it.]
Strip Me - Natasha Bedingfield
[This was on super heavy play in March, but I really didn't get to the same feeling as the song until June. But, as per #12, once you get through all the bullshit, you feel so much better. It's how you feel when you shake off layers of crap and come out clean on the other side.]
Velcro - Bell X1
[I can't remember when this was released, but I didn't stumble across it until 2011. Respect to Bell X1 for coming up with more random music styles that end up on my most played. Beyond that, there were people that kept me whole for the 6 months I was in Drogheda... And who tolerated me while I was there, and was less than myself, and kinda needy, and rather self pittying... These people know who they are. Thanks to my Velcro.]
Stay the Night - James Blunt
[Not my normal choice here, but I have a few reasons for it. First, it's SOOO catchy. There's something retro about it, and it's peppy, and happy, and kinda cheeky to be so casual about a possible one night stand (not judging, just saying). But that being said, here's to making decisions that you may not normally make. Because sometimes they're the best ones you could make.]
Little Boxes - Malvina Reynolds
[I have this in here for two reasons. 1) for the person who made me listen to it on a random day. 2) for the memory I have following it of him dancing in the kitchen while cooking. Makes me smile. Sometimes, it's good to be 'the man.']
Feeling Good - Muse
[Still my favourite cover of this song. I think it was running through my head, if not through my car stereo when I left Drog for the last time... (or the last time until next time). And feeling like you've opened a new chapter in your life is really really refreshing.]
Called Out in the Dart - Snow Patrol
[I'm also not a huge Snow Patrol fan, but this has the taste of Killers. I think it wasn't until Oct that I found a real groove in 2011. But this is how it feels to me to be in that space. It's kinda funky, and it makes random sense, and it's got a great rhythm, and it feels like celebrating. Welcome to the late fall of 2011.]
AKA... What a Life! - Noel Gallagher's High Flying Birds
[If there's someone in music that's an arrogant bastard, but has the balls to do stuff that maybe people shouldn't (but totally want to), Noel Gallagher is that man. Most of the time he's in the news I want to shake my head. But a strong nod to his new band and their album. I really dig it. I think it was more November before I was feeling this, but I had a great co-SHO (yeah, you're awesome... no lipid), I had a job that started to make sense, I had a great home life.]
Shake It Out - Florence + the Machine
[Have to give a nod to the other redhead rocking out in 2011. For some reason, this makes me think of Sinead. There is no reason for this (or none that I can recall). But hey, here's to wrapping up the end of one year and getting ready to start another. I promised to leave some crap behind in 2011... I'm doing that. Shake it out, friends. Cause it's hard to dance with the devil on your back.]
Good Life - OneRepublic
[Of all things, this makes me think of the Williams' reunion in June. But it was a great time. And I think this is the note I ended 2011 on. I am happy where I am. It doesn't have to be perfect, but it's gonna be a good life. :) Roll on 2012.]

It's beginning to look a lot like...

2011-12-04T11:58:00.001Z

At some point last week, the weather in Dublin turned. It has a certain bite to it. There's a frosty feeling (though, without the hazard/disaster snow of last year) and it has the smell of winter in it.

I'm over a short bout of gastro (I suspect it was thanks to back to back shifts in the A&E), and my man just got back from his trip home for Thanksgiving. You know what I did while he was gone? I cleaned and decorated. I've my Christmas decorations up in my flat, and now the baking is to begin. They'll be cookies and cake, and maybe a few extra specials on the side.

I have to start packing for home since I'm leaving on saturday, and I'm getting ready to do my Christmas cares as well. I love the holiday season. Now for some snow? If not in Dublin, I know there's some waiting for me at home in MN.

Must. Not. Bang. Head. Against. Wall.

2011-11-28T21:37:00.001Z

Those of you residing in Ireland with me may understand where this is coming from. Those of you working in health care most likely understand exactly where this is coming from. And anyone who has ever been annoyed by an illogical loop of policy and stupidity will definitely know where this is coming from.

I just took a day off of work. (yeah... I know... Liz took a day off of work... Do both of her legs work?!). I worked 7 days straight, including 2 weekend shifts in the A&E spent dodging vomits and getting coughed on. Summed up, it sounds like this: bark bark bark bark cough whinge whaaaaaaah! sniff sniff wheeze bark bark wheeze PUKE! (yeah, that's a croup joke). I rolled home just after 11pm, ate a light snack, set my alarm so I'd get to work at 8.15am, tried to fall asleep... And the vomiting started around 12.30. I'm not going to be exceptionally graphic here, but I was miserably awake until 4am. Clearly when my alarm went off, I had to ring my co-worker and tell her that I wouldn't be able to come into work... And I felt guilty. With next to zero sleep, having been up sick all night long, probably dehydrated, definitely hypoglycaemic, and barely able to move, I felt guilty for not going into work.

I should take a moment to clarify that at present, I'm actually working for a neonatal service. I work with small babies. Small babies that are unvaccinated, because they are too young to have them yet... Prem babies, little babies, very sick babies... And I felt guilty not going into work. Why? According to my contract, if I have to miss more than 2 days due to illness, I need a doctor's note (yeah, I know, soak up the irony)... And I felt guilty taking one day.

Before further exploring this emotion, I need to discuss the last week and an email I've received. This past week, I have been at odds with one of my superiors. At odds is a nice way of putting that I completely disagree with the way they function at work. I have been pushed further and further out of my comfort zone as a doctor. It's been progressively worsening for the past month, and I feel as though I'm not learning, I'm just trying to keep my head above water as more and more work is poured onto my shoulders. Work that I'm neither competent to complete nor qualified to complete (nor am I paid to do)... I had to force my superior to do something they'd asked of me for "Medical-Legal" reasons. I have reached a breaking point when I have to throw down law to keep from doing work. (I won't get into the shifts I work... EU law be damned).

I also received an email from my medical union requesting I fill out a survey. The survey was focused on the working conditions and how to improve to keep the Irish trained doctors from leaving the country. (Spoiler alert: We leave because working conditions are shite and we are over worked, underpaid, and asked to do things that we've never been taught how to do. We aren't taught because all the seniors are overworked and filling the gaps of people that have left or been fired or are on maternity leave and the HSE can't be arsed to pay for cover.) Most of us work the jobs of two or three people, and yet we're expected to somehow take our annual leave, take our study leave, pass our exams, research and publish, and improve the system. You know what, feck off. SHOs burn out for a great many reasons... I've mentioned a few of them. And no, the other systems out there aren't perfect either, but I do know that if I were at home, I'd not have to move cities every 6 months for my jobs.

Now... with all of that, how could I ever, possibly, even minimally feel guilty taking a day off when I'm projectile vomiting for a night? Because I know that without me there, my co-worker will have to do her work AND my work. That anything I didn't do on Friday night will not only be waiting for me, but probably doubled in volume because there are things that can't be handed over to other people. Because there are patients that I've been seeing every day for a week and no one else knows them as well as I do. And because I am me... I've always felt guilty when my body isn't strong enough to do what I want it to do. For that last reason, I worry that I won't be able to remain in Irish medical system.

I will go back to work tomorrow. Just over 24hrs from the last time I vomited, I will go back to work. I have a 24hr rule, some places have a 48hr rule. There's nothing in writing right now that says whether or not I need to go back tomorrow or if I should take another day... Welcome to survival by the goodwill of your workers. But with the best and brightest leaving the country or burning out over the ridiculousness of demands, this system is on a road towards crash and burn. Maybe when I'm sick, I'm more cynical... Maybe I need more sleep... Maybe I'm just being bitchy. Who knows. But I needed a rant, and there it is.

Thanksgiving... Ex-pat styles

2011-11-25T20:43:00.001Z

As an American, there is no holiday more universal than Thanksgiving. It is celebrated nationwide. It's a family holiday. It's a sports holiday. It's a shopping holiday. It's a 4-day weekend holiday that's notorious for travel (and delays). And in spite of the universality, it's celebrated uniquely in every home.

Many will describe a similar scaffold for the holiday:

Wednesday: Travel, get stuck, dig out, get stuck again, travel more, arrive a little late...
Thursday: Cook cook cook bake cook FOOTBALL! At some point, sit around a table, at multiple tables, at the adult table, at the kid's table, on the floor... wherever is comfortable, and EAT...
Friday: SHOP! It's black friday, you have to get going on those Christmas presents. Plus, there's more football on TV. And LEFTOVERS!
Saturday: Uh... Football and Leftovers
Sunday: More leftovers... more football... And it's time to pack up for travel back. Why does that always go smoother on the return trip?

Everyone has their own traditions. Their own habits. Their own recipes that make the holiday what it is. And it's something you cannot duplicate. And it's something I miss.

The holidays always leave me a little homesick. I haven't decided if knowing my family is together makes it easier or harder to be apart. But in my time away from home, I've learned a few things. Most importantly, you cannot do the exact same thing without the people. I once tried to replicate what my family does at home; that was a mistake that only left me feeling more miserable and further from home. I once had a group of ex-pats make a Thanksgiving dinner and take a small holiday... That too was a bit of a let-down. Sometimes the traditions from different families don't blend together very well.

For nearly a decade, a very generous donor (and member of the board of trustees) has hosted a Thanksgiving dinner for the Domers in Dublin. It's not the traditional Thanksgiving at home, it's not family style serving, it's not sweatpants or looser belts, it's not a beer and the game on TV. But I have to say, I enjoy the ND-Dublin Thanksgiving for all of those reasons. Rather than being in jeans and a sweatshirt, it's semi-formal attire. Instead of a giant bowl of mashed potatoes in the middle of the table, it's five-star fully catered dining. And while football is the normal background entertainment, a small talent show greased by the wheels of a champagne reception is a suitable replacement. I love the ND Thanksgiving because it isn't home. It is different enough not to try to be home. And the food... it's delicious. It's not exactly right, it's not what I'd be having at home, but it's close enough. And for five of the past six years in Ireland, I've been lucky enough to attend this Mass and Meal in celebration of Thanksgiving. And for that, I owe Mr. Martin Naughton a very large and heartfelt thank you. I do have to dash home from work, change clothes (put on something fancy), re-do my makeup and hair, then dash out to Mass. It's all very rushed. And I don't have Friday off work, so I can't make it too late of a night. But Dublin is my home (not that Minnesota is not home), and Mr. Naughton has helped me find a lovely way to have a comfort of home in a grand Irish way.

No offense to the Irish, Thanksgiving is a holiday that's very foreign. And I miss home. It's one of the most difficult holidays for an Ex-Pat... But I have so much to be thankful for. So much here, and so much back home.

Happy Thanksgiving.

Home sweet pasty legged fools :)

2011-06-18T04:41:00.000+01:00

Just off the plane in Boston and I notice a few things in the first moments in the ol' US of A...

1) Americans = much more comfortable in shorts than the Irish. I was actually a tiny bit weirded out by the amount of leg I was seeing. Ps: Anyone not in shorts is in jeans. Maybe this is just Boston.

2) People I talk to when I travel often ask me if I'm heading home. I'm starting to find this a difficult question to answer. A few of my friends know that if I say "I'm going home." I mean my place in Dublin. But if I say "Home-home" I mean actually going to the States (which may not even be MN home, just State-side)... When did the definition of home become so complicated, and when does it start to make sense again?

3) American news stations... They have all lost the plot. I mean, really, all of them. Can someone please tell me what's going on in the world without completely covering with your taint (and yes, I mean that both ways). In addition, most of the politicians are also 8 shades of crazy.

4) If Amit thinks I'm loud and angry... He needs to visit the States more.

Effing Brilliant!

2011-06-05T18:28:00.000+01:00

That was some AMAZING tennis!...

I absolutely love watching Rafa play. And I know people were gunning for a Novak v. Nadal final. But there's something about Federer and Rafa duke it out. Crap time for the rain delay... I think that really got into Rafa's head. The tie-breaks were brilliant. Rafa needs to stop picking his butt between points. I want to learn Federer's drop shot and Rafa's forehand. I need some bright tennis clothes! In fairness to Federer, the match was a lot closer than the score showed. Brilliant tennis! Congrats to them both! Vamos Rafa!!

How to make a present

2011-06-05T12:17:00.000+01:00

So... I like a challenge. And sometimes, I look for a good reason for a challenge. And sometimes, I just make up a reason for a challenge. But every once in a while, things come together and I don't need to manipulate the situation.

Last Tuesday was Des' birthday (Happy Birthday!). Now, some of you may remember that I made some nifty cupcakes for Muireann's birthday. I wanted to do something different, but equally cool... Yeah, I'm a showoff. So here's my step-by-step guide to making a "present."

1. Make a plan. I know that's sideways, but that's what I up and did while sitting in Starbucks one day. I should have coloured my blueprints :)

2. Make sure you have all the necessary ingredients... There's nothing more annoying that getting started and finding out that you're actually missing something important. (and before you ask about the gloves... just wait...)

3. Wear an apron. Any apron will do, but if it's a fun one that you like (with a pocket for your mobile/timer) it makes everything just that much more fun!

4. Start the mixing!!! mmm... melted chocolate... There was actually a lot of mixing, because I made a lot of cake... And a lot of fondant wrap. All the fondant was white when I started, and I individually dyed the sections... Hence why I needed the gloves. I don't want to imagine the colour my hands would still be if I hadn't worn gloves!

5. Get to work... I tend to multi-task as I go. So as one was baking, I was washing dishes, or frosting, or cooling, or mixing more batter, or colouring the fondant... I couldn't tell you how long it took start to finish. I suspect about 4 hours. But that's only because I do multiple things at once. I'd dread doing something like this without that ability!

Top layer is made of chocolate cake with chocolate frosting and then lime green fondant wrapping. There were teal polka-dots added after I took this picture. The middle layer is made of red velvet cake with vanilla frosting and teal fondant wrapping, kept plain. The bottom layer is chocolate cake with chocolate frosting and then teal fondant wrapping with lime green stripes. As a final touch, I made navy ribbon...

6. Stack 'em up! Now, if you notice, the other presents are "similarly wrapped." There's a reason for the colour scheme... It's a long story, but it was on purpose. So it was all matchy-matchy :)

7. The last step is to put on candles and light them. I used "angel" candles that burn different colours, and I have a photo that somewhat shows the colours... But I think it makes it look a little like a Dr. Seuss cake? Don't get me wrong, I think it looks great!, but it does look a little Seussical, no?

You do of course need to throw in a birthday boy. Preferably a happy one. And enjoy the cake!!!

Ps: Yes, it did in fact taste really good too.

Lemony Fresh!

2011-05-30T12:40:00.000+01:00

Well... I'm on a week long holiday. It's just about noon. And I'm already kinda bored... What is wrong with me?!

Ok, let's be fair. I'm not bored. I'm actually working on recovering from 4 calls in 6 days... and this strange mini-plague I picked up my last night on call. I got home Saturday morning, had a fry-up with Amit, then passed out from noon until 5. I think I finally woke up for some food... Slept all night anyway. And I slept most of yesterday. Apparently I needed sleep.

Once sleep is done, cleaning, paperwork, and baking comes next! Also on the schedule, re-insuring my car, finishing my SHO paperwork, boozy lunch with Bren, numerous coffees with Sinead (plus seeing her in her GRAD ROBES!!! WOOT!), chilling with Greer, Cake with Des ('cause it's his birthday, and I plan on making him fat). By the end of this week, I plan on having a fresh polish on everything (my house, my car, myself!)... Spring-cleaned and lemony fresh!

I had a chance to catch up (briefly and loudly) with Lianne when she was in town, which was great! I wish we'd had more time, but she was minding her boy (who was borderline insane with stress) and I was on call. But it's great to catch up with everyone, even if it is rare and quick. We get to compare notes and see where the careers are heading... I still think we're all pretty cool. (Though Lianne is super cool... It's true, she just is).

Then just for smiles, I was briefly minding Luke yesterday. He's gotten SO big! But he is just about the most chilled out baby I've ever met. Totally calm for mass and a bbq with about a dozen loud people... and even without a nap, clearly tired as heck, he was an absolute trooper. And he really liked the aglets on Des' hoodie... A little bit of baby drool never hurt anyone, and it's in the wash now!

PS: Can't wait to get back to paeds...

Springtime...

2011-05-15T16:22:00.001+01:00

Everybody knows
It sucks to grow up
And everybody does
It's so weird to be back here.
Let me tell you what
The years go on and
We're still fighting it...

~ Ben Folds

I know we're now just mid-May, but I have the sneaking suspicion that the time between now and July is going to disappear faster than cocktail sausages at fat kid's picnic.

I have a pile of things to do on my desk, things that keep landing in via post. I have to re-register with the medical council, I have to fill out my employment papers for my next job, I have to sign a new lease agreement soon, I'm re-insuring my car, I've tried to re-NCT my car, my taxes are actually due back home.

It's almost harder to believe that intern year is nearly over. Well, it is and it isn't... The final meds have their results and a large portion of them are off in Portugal to celebrate (Have fun, Be safe, God speed!). Come July, more specifically, 57 days from now (yeah... that's the countdown working there) I'm no longer an intern; I'm an SHO... It's debatable how much that actually means when it comes to Paediatrics; it's not like I'll have an intern... Back to the bottom of the pile... But I know the expectations change. And I wonder if I'm ready for that. I know I've been whinging about the current situation I have at work (Liz, the first-year-qualified acting reg slash intern)... But at the end of the day, I am still an intern. I do still depend on the experience of those working above and around me. The only reason the current situation is working out is that me boss is very accessible and encouraging and the others on my team are extremely pleasant to work with.

From a long-term perspective, I see 2 more weeks being reg-less, one week of which is heavy with call... A week off... A bank holiday... A week on... A week with my baby bro in town :) ... A family reunion on the other side of the pond! ... A weekend on call... Two weeks... Then sayonara internship... Scary.

For those of you that don't know, I'll be kicking off the new job as a paeds SHO in the ED. 3 months of straight paeds emergency. I figure it'll be a great way to determine if it's where I want to end up eventually. Not gonna lie, I already have the books out. I do need to brush up on my paeds, and I want to hit the ground running. But I can't think of a better place to start. Colour me excited.

So for the next 57 days, I'm trying to balance my busyness with my exhaustion with my excitement. Some tennis to keep me sane, some running again to get the lads in shape, and yoga for myself. Time with friends, time to study, time to work, time for call, time with the family back home. Bit of cleaning, bit of purging, bit of re-arranging the flat. Welcome to the life of an intern.

Also, from facebook... I've discovered that my 6th graders are about to be high school seniors!!! Oh my word!!!

PS: Sinead, please come home... miss you! And Des, CAKE!

If Your Doctor Told the Truth at 3am...

2011-05-07T20:42:00.001+01:00

"In the end, when Mr Foster started coughing up blood the on-call surgeon was stuck in traffic, the nursing staff was busy losing the lottery, his original doctor was thanking a garbage man, and the covering physician was incapacitated. And what was Mr Forster doing? He was dying in the hands of the Interns! Does that about sum it up?" ~ Kelso, Scrubs

First off, uber mega congrats to the final meds who are done with their exams! I know the results aren't out until Friday, but have an awesome week! Unwind! Be nice to yourselves! You all deserve it!

I've been keeping a bit of a countdown going (as some of you know) until this intern year ends... It's my own form of therapy. It's to keep my eye on the prize. But I think I'm just now realising that as soon as that timer ends, all those final meds just slip into the vacant intern posts. I'm not sure I even remember how that was. There's a small part of me that knows I've learned a helluva lot since I started, but that part of me still tends to be drown out by the sheer volume of the gaps in my knowledge.

I have often wished that I cared a little less, expected less of myself, had lower standards, could just "turn off" the worry and concern. I can't. And that's one of the reasons I have been chaffing under the yolk of the job I'm in. I know how dangerous things can get on call. I know how close to disaster I've been. I know how thin the cover is. And I know it's only a matter of time before I run out of fingers to keep plugging the holes. So... as a bit more therapy for myself, I'm going to try to be funny (and bitingly real) about a night on call, and how that sometimes goes... For those of you that don't work in medicine, keep in mind, sometimes, you work a full day shift before this. Sometimes, you have to work the next day... Sometimes, it's just the "12 hour" overnight shift.

7:55pm:
* Drop bag in res
* Get arrest bleep from intern going off-call
* Ask if there's anything important I should know about...

8pm:
* Paged to chart warfarin - don't know the patient, don't know why they're on warfarin, don't know what their INR is today... they had 4mg yesterday... so... yeah, let's go with that.
* Paged to chart IVF - normal, healthy, young patient, fasting from midnight for a scope tomorrow... fair enough. Just some saline... What do you mean they don't have a cannula? Fine. Insert green line.
* Paged to r/v CXR for NG siting - Can't even see the tip of the NG because the x-ray is off centre. But sure, it's clearly below the diaphragm, so that's fine. Pull the wire, start the feeds.
* Paged to r/v desaturation - Patient ++BMI (like maybe 39), known COPD, known OSA, on home O2... For some reason doesn't have oxygen mask on now... Put on mask, sir. Sats back to 94%. No, that's normal for him. No I'm not doing an ABG, you took off his O2, that's why it was low. What do you mean he needs a cannula? You paged the team ALL day? Who did you page? Yeah, that intern was post-call, they weren't here. Did you page the SHO at all? No? Seriously? ... Insert gray line, just because I can, and because anything shorter wouldn't make it through the fat.
* Paged for warfarin x3 - yeah... ok... done, done and... Wait no... Why is this one on hold? Is it still on hold? The patient is actively bleeding from an ulcer?! No, I'm not charting that tonight... No, I'm sure. No, I won't ring the reg! If they're bleeding, we're not giving warfarin.

9pm:
* Paged to re-chart paracetamol - ran outta room in the PRN section, fine, rewrite and leave.
* Paged to r/v patient with chest pain - patient has pain... in the ribs... pleuritic... and oh... in the hospital for rib fractures. Why aren't you giving her the oxynorm? ... Because of the pain?... Oxynorm is FOR the pain (PALM-FOREHEAD)... No, I'm not doing an ECG. No I'm not doing a TNI. Give her the pain meds! That's what they're for!
* Paged to r/v patient with low BP - BP 105/60, patient sleeping... uh, let her sleep.
* Paged to r/v patient post-fall - patient is confused normally, shockingly confused now. No obvious head trauma, seems to have slipped onto the floor and landed on their bum. No bruises. Oriented in person... and that's about it... well... keep an eye on her. What do I mean? I mean neuro obs... About every 2 hours... Yes all fucking night. No, I will not order a CT Brain right now.
* Paged for IVC - Patient on 3 abx for VRE... yeah, I'll put one in. Patient has zero veins. So... you're telling me that the intern on the team, the SHO on the team, and the reg on the team couldn't get this cannula in and you expect me to get it now? Why didn't they get anesthetics? Fine... I'll try. (15 minutes later) Yes... there is now a cannula in their GSV, right leg. What do you mean you wanted it in their arm? No, I don't care. They have one in now, deal with it.
* Paged to chart night sedation - Patient 3/7 post respiratory arrest, normal sats at 92%, COPD... brittle... hm... No. No night sedation.

10pm:
* Paged for tachycardia - Patient "tachy" at 90. Usual HR is 85, BP was up, now low, mild pyrexia ... just vomited? Oh... Do they have an antiemetic charted? Ok, well why don't you give them that. No, the tachy is probably from the vomiting.
* Paged to r/v low urine output - post-op, no urine in the bottle... Ok, BP normal, IVF show roughly 1L in... Sir, have you peed? Oh, you walked to the toilet and peed? Ok... awesome.
* Paged to r/v need for IVF - IVF charted in kardex by team... What do you want from me? If the team charted it, give it. You seriously expect me to take what the team wrote down at 5pm and change it? No.
* Paged to remove abdominal drain - uh... ok? I've never seen one of these before. I've not only never seen one before, I haven't seen one being put in or taken out. Ring reg. How do these work? "You just take it out." Ah, ok, thanks for clarifying... I'll take care of that now. Look at drain closely. Pull on sterile gloves, pull off adhesives, study base of drain for sutures, cut those off, study drain again... Pull out... Dodge the shot of ascitic fluid that shoots out too... ew. Apply pressure. Apply more pressure.... Pager goes off, pager goes off, keep applying pressure. Pager goes off, what the hell, that's this ward! Apply dressing. Throw away all the dirty bits. Wash hands.
* Return pages - run around like a scut monkey for an hour...

11pm:
* Paged to r/v patient that is deteriorating - deteriorating how? They're NFR... ok... But how are they deteriorating? They're dying... right... I'd assume if they're palliative. But what exactly is wrong? They're chesty and it's upsetting the relatives... Ah... That I can do something about. Review chart to make sure I know the allowed intervention for patient. Chart comfort measures. Discuss with night staff. Pop head into room and have brief but compassionate conversation with family. We will keep him as comfortable as possible. Leave note in chart.
* ... Regretting the crap I ate for dinner...
* Paged to r/v patient that is "off" - Patient is definitely off... in fact, kinda turning blue, diaphoretic, complaining of pain... Shit shit shit. Throw on oxygen, sit him upright, demand to know why he's in hospital. Give neb, ABG, fbc, ue, coag + ddimers (I hate ddimers), two IVCs, ecg, and cxr... Ring the reg... Spew rough background and the results I now have... I think it's a PE... Well, should I start therapeutic innohep? ... Any suggestions? ... Right, ok. I'll do what think is best and since YOU would have to get the radiologist in, I'm just gonna order the CTPA for tomorrow then, yeah? Thanks.

12am:
* Now to catch up on the 14 pages that came in while dealing with that other gentleman...
* Rewrite kardex - meh, rewrite 2 items into new kardex and label it II of II. They should have done that themselves today
* IVC for 2am ABX - yeah, I'm getting the tired blurry vision, throw in a pink line because I can't deal with a green right now.
* Run a BNP from CCU - fetch the HF clinic key from the A&E office, plate the sample, start it running, leave the office unlocked, return the key, return to the office, wait another 10 minutes, take the print out back to CCU... this in no way changes the management...
* First dose ABX x2 - patients sent up to ward from A&E without first dose given... nice...
* Patient with SBG of 24 - give stat dose of actrapid... as per the sliding scale... thanks for letting me know...

1am:
* Paged for IVC - Wait, that's my patient. He's not on IV anything. Go to ward, flip through kardex, yeah, that paracetamol is iv OR po... give it orally!
* ... Really should have peed earlier...
* Paged to admit patient - Uh... it's 1am, what the hell? No you haven't paged me about this! What do you mean they came up from A&E without an admission or kardex?! I'll tell you what, have another look, because if I get there and the patient has been admitted and has a kardex, I am not answering another page from you again. Swing through the A&E on the way to the ward, grab the "non-existant" kardex from the trolley, go up to the ward... Here's the kardex, there's the admission note. Thanks for calling.
* Paged to r/v irregular heart beat - well, they're in afib. It's slow. It's been previously diagnosed. They're on all the proper meds for it. No I don't want to do an ecg or TNI. No I'm not giving meds. Do you even know what afib means?!

2am:
* Paged to chart night sedation - uh... that patient is asleep.
* Paged to r/v agitation - Patient in alcohol withdrawal... Can you draw up a dose of ativan? I'll be there in a minute to give it. Oh you can't? Why the hell not? Ok... fine, I'll be there shortly. Get to ward, drug press locked. Would you open this? You don't have keys? Where are the keys? Right... sit at table and twiddle thumbs for 5 minutes. Ok, press open, draw up the ativan, No, I don't need you to check it, where the fuck is the patient? Meet patient, have a quick chat, patient lying in bed seemingly calm. So... Why did you think he was agit- FUCK! (narrowly avoid getting punched in face) Patient starts thrashing and spitting... Riiight... Ok, 3 nurses help hold him down and I give a stat dose of ativan in his left arse cheek. Chart it in the kardex, chart PRN options, chart librium, write note in chart suggesting pabrinex tomorrow.
* Paged to r/v abnormal potassium - K+ = 3.4 (normal for lab 3.5)... resist urge to strangle someone... "But, doctor, don't you want to fix it?" Yeah, give the guy a banana for breakfast... walk back to res.
* Hi bed... take of sneakers, take off steth, pull pen out of hair, sit on bed, pager goes off... damn.

3am:
* Paged to pronounce - Palliative patient has passed away. Get out of bed, put on crocs, go to ward and priest is in room with family. Will come back in a few minutes.
* Paged to CCU - chart Mg for patient with tachy runs, chart pain meds for NSTEMI that has no analgesia charted, give first dose taz to intubated patient with temp spikes.
* Return to ward, pronounce patient, write note in chart, sign mortuary tf form, explain the next few hours to the family. Don't know the answer to most of their questions as patient isn't actually mine, tell them to discuss with the nursing staff, and offer my condolences.
* "Doctor, since you're up..." - yawn, rub eyes, probably should have washed my hands. Wash hands, wipe down steth, sign for bloods tomorrow, chart stat dose actrapid from before, sign off on 2x MSU and 6x swabs, rewrite one page of kardex, insert IVC for patient fasting and on IVF (went with a blue line because I was lazy), change another patient from IV lasix to PO (mostly because it has the same bioavailability, but also because I don't want to put in another cannula).
* Paged to r/v increased drowsiness - ... Wait a sec... This is the patient I just sedated... They're supposed to be drowsy! Unless you'd prefer he be bitey and punchy?! I'll come by and reverse his sedation. No? Awesome. Bye.
* Paged to chart glycerin suppositories - No bowel motion for 2/7, not eating, poor PO intake, team did not start laxatives during the day... Uh... No? Then no.
* Walk back to res... hello again bed.

4am:
* Paged to r/v abnormal LFTs - JESUS! his AST/ALT are >1000... Oh wait, he's in for hepatorenal failure. And you're telling me that the team is aware of these? And they're actually getting better? What the fuck is wrong with you? It's 4am!
* Paged b/c patient on telemetry was bradycardic for 10 seconds - well... how brady? 46? uh... what's his regular? 60? And he's sleeping, is he? Uh... ok...? What do you want me to do? You just have to tell me? Great. You've told me.
* Paged to rewrite kardex - Uh... no. The team can do that in the morning. PS: It's 4am, what the hell.
* Paged to chart glycerin suppositories - Patient is in "agony."... pager goes off again...
* Paged for transfer letter - patient for coronary angiogram tomorrow. What time? 1pm? Fuck off.
* Ring back ward re: glycerin suppositories - speak to different nurse. No, patient is asleep. Was already given the suppositories, they just need to be charted... Oh they do? Well, I didn't authorise their use, so I'm not charting them.
... Quarter to 5... Try to go back to sleep.

6am:
* Paged to chart glycerin suppositories - Please, doctor, before the day staff comes on. No. *click*
* Paged for early morning ABG due as per the request of the consultant. Uh, define early morning? "Don't know. I guess before nine?" Right... I'll be up before 9.
* Paged for repeat TNI in A&E for an admitted patient - *sigh* go down to A&E. Where are the TNI forms? You don't have any? Ok... spend 30 minutes finding a new TNI form. Fill it out. Find the patient. Hi sir, I'm just going to take a wee blood sample if that's ok. "NO! It's not ok! Fuck off!" *sigh* return to nurses station. That patient is very agitated and is refusing bloods. "Yes, we tried and he said no, that's why we paged you." Ugh... Well he's refusing me too, so the team can do it in a few hours.
* Paged by A&E... wait, I'm effing in the A&E! What?! "We think this patient was supposed to be on ABX, but they were never charted." ... (blink, blink) I don't understand. "Well, the consultant said they might need ABX, but like... they aren't in the kardex." ... (blink, blink)... Uh... What exactly do you want me to do about that? ... "Well, can you check?" ... (blink, blink) ... Uh... Check what? Check the chart? Because, I would hope that you can read too... "No, check with the consultant." ... (blink, blink)... (blink, blink)... What? Wait, you're serious? It's 6am. The consultant will be in soon. I am not ringing him on his mobile to ask that!
* Paged to r/v urinary retention - "Patient hasn't peed in like 4 hours." ... I'm guessing they're sleeping? Four Hours?! Oh my God! I haven't peed in 10 hours! Fuck! Tell you what, I'll come put a catheter in him if you put a catheter in me... hello? I think they hung up on me.

7am:
* Go to ward and do the "early morning" ABG. Manage to hit the artery on second try. Take sample to CCU... machine broken. Uh, fine, go to resus in A&E... machine broken. *Sigh* Go down to the lab... swipe in... machine broken. Wtf... shit... There's another machine somewhere... where was it... Oh yeah, in the SCBU... Run the sample. Return the print out to the chart. Get asked to put in 2 more IVCs on that ward... I consider it... One of them is my patients. Put in that IVC. The other one... I just put that in last night. Oh they pulled it out? Forget it.
* Paged to chart IVF - No. Leave that for the team.
* Paged to admit a patient to dayward - It's like... 7:55. No. By the time I hang up this phone, it'll be 8. There's a different intern on call. And the team can be called.

8am:
* Page incoming intern - no response.
* Consider turning off my bleep, but generally leave it on until I hand of the arrest bleep so people can find me if they don't have their mobiles.

8:15am:
* Ring fellow intern - where are you? You're supposed to be carrying the arrest bleep... I'm tired.
* Paged by team back in hospital - "Why did you give those suppositories?" Actually, I didn't. Because I didn't think the patient needed them, I didn't authorise them. I didn't ask them to be given. Talk to the nurses.
* Paged to r/v patient for CXR - "Doctor, patient is for repeat CXR today. Will you come order?" Uh... who's patient is it? PS: NO! The X-ray dept won't be open until half-eight. I'm not on call anymore. The team can do it when they're here in 45 minutes. Calm down.
* Ring other intern - Just a heads up, one of your patients passed away last night. Their family is still here. Let your boss know?
* Paged to rewrite kardex - would you please fuck off.

8:30am:
* Ring fellow intern - seriously dude... it's been a long night. I have an hour long drive in front of me and about half a day of errands to do before I can sleep... Where the fuck are you?

8:32am:
* CARDIAC ARREST BLEEP - CARDIAC ARREST A&E! CARDIAC ARREST A&E! - fml... Run to A&E. Reg looks at me funny, why are you still here? Well... someone has to carry this thing. Nurse looks at me, "Are you the anesthetist?" (insert crazy laugh) HAHA... No... ED SHO rocks in, looks at me, "Hey, are you the reg?" (look at reg with super confused look on my face) Uh... no... He is. (look around... something like 13 people in the room now), Hey reg, can I go... Too many cooks and all? I get the nod, I leave.

8:33am:
* Drink bad instant coffee in the canteen.
* Look up and see fellow intern walk past with his team... wtf... Hey assclown, please accept this arrest bleep and slap upside the head as my parting gift. Hand over the arrest bleep and officially go off-call.
* Finish drinking bad coffee.

8:40am:
* Collect bag from res and head toward exit

8:42am:
* Run into team... Hand over anything and everything from last night that had to do with our patients. Remind them of 5 super important jobs that need to be done today. No... I'm not here today... I'm going to go sleep... Uh... No, they're not paying us post-call, so I'm going home. In fact, I just attended an arrest that I won't be paid for. I'll see you tomorrow.

9am:
* Dump bag into boot of car, climb into the driver's seat, start car, stare blankly at the low petrol light... damn. Swipe card won't open the gate... honk... Wait for security to let me out. Bye hospital...

9:15am:
* Fill car with petrol. Purchase another bad cup of coffee.
* Sit in rushhour traffic for next hour and a half...

10:35am:
* Park outside my flat
* Stumble down stairs and into room
* Strip... these dirty scrubs aren't touching anything in my room.
* Put on clean shirt
* Pass out, face down in my bed.

2pm:
* Wake up... wonder how many of the patients I saw last night are well... wonder if I made a mistake... worry that I missed something important... What if that guy was actually in urinary retention? What if me ringing the consultant and starting antibiotics would have made a difference for the patient? What if those LFTs had been really off, and I should have seen them, I should have reviewed that patient... What if I'd been wrong about that ABG and it wasn't improved? What if it was getting worse? Or if that guy that needed the TNI was actually having a NSTEMI and I didn't take the bloods because he'd refused? Well, taking them when he'd refused would be assault, but like, it might have saved his life?...
* Get up, shower, put on civies, run errands, try to be a normal person for a few hours...

"It's never easy when someone accuses you of screwing up, especially when you know it's true. When that happens you can't shrug it off, because in a hospital the best way to learn from your mistakes is to carry them with you." ~ JD, Scrubs

So... to my fellow interns, let's be sure we're learning from our mistakes. To the incoming interns, be ready to make a few... and learn from the experience.

Counting... down...

2011-04-24T21:13:00.000+01:00

We've discussed what happens when I'm bored... But I think this just needed to be done:

The Countdown.

On grief... and giving it

2011-04-18T21:34:00.000+01:00

I am not the first, nor will I be the last intern to express their dislike for the weekend-day call at my current place of employment. But let me again say that trying to be a full time phlebotomist while covering all acute medical beds, plus admitted patients still in the A&E and the patients in ICU/CCU/HDU is virtually impossible. That isn't why this weekend was particularly brutal.

I don't particularly like losing patients. No one does. (not even palliative... that's an old joke). But I do understand when people are actively dying and beyond the reach of western medicine to save. It's a knack; some people can't tell, some people can. And when a patient is dying, it's important to make them as comfortable as possible. I do that. Whether by charting comfort measures myself, contacting a senior to do so, or ringing the palliative team for advice. But as an intern, if the reg or palliative consultant says the patient needs further active management, my job is to do as I'm told...

Also, death in an acute medical hospital is not, I repeat NOT, the same as dying in a hospice. The intern on call is not a palliative care nurse. They do not have just the one patient, in fact, they do not have just the one ward to cover, they have the entire fucking hospital. And it's almost a given that there is more than one acutely ill patient, if not more than one that is actively dying.

Now, let's combine the situation of weekend-day call with three patients actively dying with no palliative input, no comfort measures previously charted, and a reg that is difficult to get on the phone (let alone get up to the ward to see a patient). Disaster. But for the first time since I started practicing medicine, I had a family accuse me of being a bad human being. They tried to "soften the blow" by assuring me that I was probably a good doctor otherwise, but I completely lacked all compassion and empathy. It would have been easier to stomach if it'd been the other way around. I spent 20 minutes listening to them dress me down, accuse me of not caring, accuse me of not knowing what loss is. Then I apologised and had to move on.

Now with some distance, I can brush off the whole thing. Partly because they said some ridiculous things, including, "The most important thing for a doctor is to be with a family and patient at the time of death. Medical emergencies can wait." Maybe in a hospice, but not when you're the only doctor for roughly 130 patients. But that doesn't mean I didn't leave that awful day in tears. And you know what I learned... To stay further away from patients and families at the time of death. Because I can't afford to sit in the res and cry for 20 minutes when there are so many patients that are unwell. And I can't afford to spend 30 minutes with a family when they express displeasure. And I can't afford to lose any more of my self confidence dealing with things that are so far above my pay-grade and experience.

Deep breaths

2011-04-14T16:05:00.000+01:00

Finally a bit of good news...

Ok, it's not a bit, it's a huge chunk, a meteor of good news. I have my jobs for the next 2 years. I accepted the offer nearly straight out. It's a training scheme job (so it's protected), I'll be in Dublin for 75% of the time (and commutable for the other 25% if I'd like), the order of my rotations is practically perfect (I couldn't have designed it better myself), I'll stay in my current flat for another year (so no moving at the moment, woo hoo), and I can get by without really needing my car for the first year (sorry, Timmy, you're going to be upgraded eventually).

This is such an immense relief for me. Sinead said she could see me visibly decompressing... I feel better. It doesn't change what's happened in the past few weeks, and it can't make everything better. But from the job front, that concern is gone now. I can plan for things again. I can keep nesting my flat. I stay in Dublin. Whew...

Can't this time thing go a little faster?!

2011-04-11T22:13:00.000+01:00

I'm back to holding my breath. I'm holding my breath for Wednesday night when I get the final word on jobs... Oh wait... I'm on call... screw that. Let's hold out for Thursday. I'm holding my breath, waiting to see where I'm going to live. I'm holding my breath waiting for words from home. I'm holding my breath in hopes that I've been horribly horribly mistaken. And I'm holding my breath for the next break I get.

I want to again express my utmost condolences to the Cutlers. I want to thank my brother for letting me know. I want my dad to know I love him, and want to give him a hug. A friend like Robbie is an absolute blessing.

I want to thank my brothers for handling Zadie. She was the sweetest kitty. I'm sorry I wasn't there.

I've had friends come and go in my life before. I'm sure there will be more that leave. But this time, it feels so much more painful than ever before. Maybe it's the timing... It's been a difficult few weeks for me. Maybe it's the sudden disappearance with no word... Maybe it's because I feel like a total fool in this, believing that people are actually good. So much for restoring my faith in humanity. My faith in myself. Time heals all wounds... But scars can last a lifetime.

I'd appreciate if my friends would stop giving themselves head injuries that land them in hospital, and avoid car accidents that wreck their cars. You two are lucky that I didn't kill you myself... And Aido, you're lucky I wasn't on call.

I really want to clean my apartment. My fingers are itching to scrub everything from floor to ceiling. I've been in a purging mood. I've rid my room of a few bags of baggage that needed to go. But I can't really settle down to clean properly unless I know whether I'm staying or going... Ugh Wednesday... I'm trying to distract myself. I'm trying to find things to occupy my brain. There's not much I can find.

I did make myself some cake... In a mug... it was worth it. I should probably thank the lads for providing some boozy distraction. And Shinners for the everything.

Legend...

2011-04-09T14:52:00.000+01:00

Robert J. Cutler Obituary: View Robert Cutler's Obituary by The Boston Globe

I've known Robbie most of my life (or rather, I should say that he has known me). Robbie and my father were friends since they were terrorizing the Boston neighbourhoods as kids. They survived college, they survived the Navy, they survived business, they survived marriage, they survived moves around the country. When my uncle passed away, Robbie flew last minute to Florida (I won't say how) to keep my father company. He made numerous trips to Ireland for the craic. He loved golf. He loved the Red Sox (and pretty much all things Boston). He loved life. He was wild in a great way. Absolutely full of life to the end in spite of everything. Robbie, you will be missed.

Stay of execution or more anticipation... either way, it's killing me

2011-03-27T19:09:00.006+01:00

So, as some of you know, I was on a week long holiday this past week. It was very very much needed. I was exhausted, overworked, and stressed out. I didn't do anything in particular with this week off. I cleaned a bit (not enough), I baked a bit (not too much), I had a few tennis matches (getting back into the swing... ha), I slept a lot... I remained slightly stressed out. But I certainly don't really feel like going back to work tomorrow.

As slightly more of you know, last Wednesday RCPI announced their 1st round offers for SHO. The emails came out in the early evening, well after the close of normal business hours. I was expecting that. But it didn't make the wait any easier. I have 3 very brief things to say about the results. 1) I did get a job offer, and I've accepted provisionally depending on the 2nd round. 2) While it took a few hours (and maybe a few drinks) to get my head around it, no matter what happens in the 2nd round, I'm happy with the job I have (or with whatever I may get). 3) The number of people that did not get an offer in the 1st round was shocking. I have a few friends that didn't get any offers, which is insane. They are ridiculously qualified individuals. And I have more friends that didn't get anything near their higher picks, some of whom truly deserve it.

So now we wait again... I feel like the next two weeks will pass a bit faster than the past few, and some of that is anticipating the job change in April. I need a change of scenery (and my apologies to John, I wish you had the same impending relief). The heart-wrenching thing is that with everything that's been going on in the past three weeks, there's one person that I keep wanting to tell, wanting to talk to... And I can't. It's not even that I'm angry, I'm just disappointed... It makes me sad... It makes my heart hurt.

So I've been distracting myself as best I can. I'm starting to study again (so much for the one year of no study), I've been playing more tennis than usual with 3 matches or drill per week. We had team tennis finals just this Thursday (go The Who!... yeah, we won), and I made little tennis ball cupcakes for the after party (bit messier than my normal work, but people loved them anyway). And in my head, I'm preparing myself for a massive change in July... Massive. But I'm not sure it's coming. I will wait on April 13th before committing to it fully. But change is on the way...

Like a top

2011-03-21T22:13:00.006Z

Day 1 into my week off... I've half cleaned my kitchen, done 2 loads of laundry, gotten a much needed haircut, had a fight with my scanner, coffee with Sinead, and baked my first trial of cinnamon rolls (not exactly cinnabon, but damn close). It was a labour of love, and the recipe had to be modified, because I don't really know what they meant by "bread flour" (... not to be confused with plain flour which was also called for), and they don't really "do" margarine here in Ireland. Also, I don't have a kitchen-aid mixer yet. YET. And they suggested that it was necessary for the frosting. As per the above picture, I strongly disagree. My frosting tastes fantastic, and it was hand mixed (as is everything else I make at the moment). All these recipes that require dough to rise for an hour, then to be rolled/cut and prove again... It's a trial for me. I don't like waiting. INSTANT GRATIFICATION!

Now comes the important question... I've only filled the first 24 hours of what will probably be a 36 hour wait. What the hell am I going to do tomorrow?! My flat is going to be glistening clean. I'm going to sort a bunch of bank stuff. I'm going to "sleep in" as much as that's possible for me. But then what do I do after 11am tomorrow?! Waiting kills me. I feel like I'm getting wound tighter and tighter. It's giving me ulcers. This needs to be over. ... So here's another shot of yummy warm cinnamon rolls. Distraction.

Special booby prize

2011-03-18T11:06:00.002Z

The longer I've been in Ireland, the less I've celebrated Paddy's day. I don't know if that's a product of me needing to be more responsible, of the time of year it falls, or of me just being old.

Two years ago, I was in Cavan on Paeds and spent the day studying... Mary and I did catch the tail end of the town parade and grabbed a few pints before cashing in.

Last year, the impending doom of exams had me staying in... And watching the entire boxed set of Father Ted while studying.

This year, I was balled up on the couch, dreading the fact that I was on call last night and suffering from a bout of food-poisoning, or noro, or repulsion.

I can't decide if what I had was food-poisoning or a 24hr bug. I did eat lunch in the canteen in Drog on Wed and exactly 8 hours later I was returning said food to the toilet. One point in favour of food-poisoning. But then again, I've been exceptionally stressed out the past two weeks. It's possible my weakened little immune system... wait, no, my hardened, over worked, super exposed immune system just kinda gave up. The good news is that I survived call in spite of vomiting up to about 4 hours before going on call, I did manage a small bowl of cereal before leaving for work, and I rehydrated without needing an IV bolus (though, Ben, I really was seriously considering it).

And now, post-call, post-ickiness, post "grown-up" Paddy's day, I get to start my week off... The only advantage of being on call yesterday night, I have Friday day off. Let the recovery begin.

Now accepting suggestions for de-stressing activities next week...

And in parting, here's a picture of the random ferris wheel outside my house. Oh the stuff that happens on Paddy's day.

Unacceptable vs. Unforgivable

2011-03-12T22:47:00.003Z

I had planned to put up a post last weekend. But then I'd gone and left it for Sunday, and I was on call all day. And for anyone who hasn't experienced being on call at the end of the weekend... it sucks. So when I managed to drag myself home late Sunday night, I was in no mood to put up a post. To be honest, I'm not sure I am now. This week was horrendous. I would easily say this was the worst week I've had since I started in July and Tuesday is the worst day I've had... possibly in my life.

I'm not one prone to massive exaggeration, so bear with me here. I'm going to try to give it some context. I work on a rather large, combined team, medical service that provides, in addition to general medical hospital take, cardiology admissions, in hospital day case admissions, and overnight interventional transfer service. At full service ("full" in these recessional times), we have 2 consultants, 4 SPRs, 3 SHOs, and 2 interns (plus currently one very involved sub-intern who has been slaving to keep me from losing the plot... she is a star). That leaves a consultant, 1 or 2 SPRs, 2 or 3 SHOs, and both interns on the wards for the in-patient service. This past week, at best, we've been ranging at 1 consultant, 1 SPR, 1 SHO, 1 intern. I spent two days on my own on the wards from about 9-4... No Reg, no SHO... Needless to say, I've been in a few hairy situations that I'd rather not revisit. I've been working overtime that I'm never going to get paid. And I've been unduly criticized for holes in the work. I hated this week.

Things that are "Unacceptable":

Leaving an intern alone to run an in-patient service.
Belittling an intern for not doing a job that they've not been asked to do and is not in their job description (And thus are completely unaware of).
Allowing an intern to lose confidence in their ability to practice medicine when they cannot fill-in for multiple missing people at once.
Yelling at an intern in front of patients/staff/colleagues.

Things that are "Unforgivable":

Doing all of the above at the same time.

... Dearest of dear consultants, this type of behaviour is the reason half of the intern class is planning on leaving. You will be short NCHDs for years to come. You will be sadly disappointed if you continue to expect interns to make up for missing SHOs (PS: especially if the hospitals continue to refuse to pay us).

This was the first time since I moved here that I thought, seriously and 100% thought about moving home... I thought about calling in sick because I was dreading the idea of being in work. I thought about quitting. I thought about yelling at my boss. I thought about refusing to do work while in work. And I imbibed more alcohol in the past week than I have in about a year... My current post is dangerously close to giving me an ulcer, or a drinking problem, or both.

On Tuesday, arguably one of the worst days of my life, I had 2 other separate blows. First, it was the day I needed to submit my preference form for SHO. I got home, 100% crushed, balled my eyes out, drank, tried to eat without throwing up, and then tried to figure out where I wanted to be for the next 2 years of my life, all the while battling the voice in my head that was screaming to just go home. I have not experienced such an evening in the better part of a decade, and the last time I had one of those, was in fact the worst day of my life. Thank you job... Second, I was seriously let down by a friend; nearly as soul crushing as the day...

Needless to say, I'm happy to see this week gone. Fuck you second week of March. Please accept my foot up your arse as a parting gift.

My holidays cannot come soon enough.

On Call...

2011-02-27T11:44:00.004Z

"This is the reason why your headache didn't go away: That's actually pronounced an-algesic, not anal-gesic. Sir, the pills go in your mouth"
~ Turk, Scrubs

I'm fresh out of another night on call, one in which I managed almost 5 straight hours of sleep. It's pretty much unheard of. In fact, I woke up at 4:30am and checked my bleep just to be sure it was still on. Now, that doesn't mean that it was a nice call. It was just a call that involved "sleep." I may have mentioned this before, but I never actually sleep while I'm on call. I'm a light sleeper and the res is never silent. Plus, I hear ever other bleep go off, and the sound of an ambulance backing up sounds shockingly similar to my bleep. As painful as it is to not actually sleep, I'd rather that be my problem than being too sound a sleeper and not hearing the pages (esp with the arrest bleep, or "bomb" as Ben likes to call it, sitting next to my normal pager).

Maybe I was due a gentler call after the last night I had... I don't know. But I've decided that as I'm well past the halfway mark of intern year, I'm going to try to take a learning point or two away from each call I do. Lesson from Friday night: Lots of people want to be leaders, few people actually are.

The arrest bleep went off and I ran to casualty. Some people say that the interns aren't required at the A&E resus, but when that pager goes off, I'd rather be an extra hand than leave them short-handed. We have 3 designated resus beds, and there's no saying that there isn't another in process at the time. On this occasion, there was an ambulance 5 minutes out with ongoing CPR/arrest. One would think the extra time to plan would help... It didn't. I then participated in a 20-minute resuscitation attempt on a person who was, and I know this sounds cold but it's 100% honest, DOA. Why?

Why did we spend 20 minutes (and I'm not going to consider the cost of equipment and drugs) of time on this? That's the lesson. 3 people sort-of, kind-of, maybe tried to run the resus. The person most qualified had stepped back with the feeling of too many cooks in the kitchen. The next most qualified didn't take command of the situation, allowing a lesser qualified person to change the plan from something that was pragmatic and, well, sound to straight algorithm. And the 3rd person that sort-of tried to steer the ship had no clue what the defib was saying, authoritative without the knowledge. I was twice mistaken for someone I wasn't. I had to tell people that 1) No, I am not the anesthetist and 2) No, I am not the medical reg. Now, I do have to say that no one panicked, no one did anything stupid or harmful. We just spent too much time on a no-win situation.

I want to reassure people of a few things. First, under different circumstances (ie: the patient were younger, fitter, hadn't collapsed at home, hadn't been under 10min CPR by the family, hadn't had 40min CPR by the paramedics... It's a distance from A&E problem) it would have been an efficient and probably successful resus. Second, I (as well as most of the interns I work with) am ACLS certified. I wouldn't necessarily be comfortable leading an arrest at the moment, but I could if necessary, and I would if I had to. Overall, mark it down under things I'll try to do better/not do at all.

I did have another great learning moment on call. By pure coincidence, I was in CCU to put an IVC into a patient that had (just moments before my arrival) been due for central line placement. I bumped into the anesthetist who let me stick around and see the central line go in. Now, I've ordered them before, I've dealt with them on a day to day basis, but I'd never seen a central line get sited. And now I have... cool.

A lovely day break.

2011-02-21T15:44:00.009Z

So... What do you do on a Sunday night in Dublin?

I have a few suggestions:

Spring Cleaning. Maybe it was the sunlight and mild weather on Saturday, but I did a massive cleaning of the flat. And since the place looks and smells clean, I bought flowers. The place has a fresh look and feel... Which makes it much nicer to come home to.
Bake cupcakes. Much to the chagrin of my roommate, I'm working on certain baking skills, including what I'm going to call "Gourmet Cupcakes." I bake because it's cathartic, and relaxing, and you have a sharable happiness that comes out of it (as long as you don't burn it). Now, this time around I was making cupcakes for a friend's birthday... And I was putting a little extra on it. It was an experiment. I've never tried anything like it before. But I have to say, they turned out quite nicely, no? I think I'm going to be attempting a few more creative designs in the near future... In all this spare time that I don't actually have... Whatever. Watch this space. But I owe my roomie an apology for torturing her all day with the constant, "Hey, look at them now!" and then telling her we couldn't eat them yet... Sorry.
Catch a show. Saw a fantastic concert last night at the Olympia. First of all, they didn't lose power (sorry Coronas... I know it wasn't your fault, but that did make it a rough evening), though there was a moment with a bunk guitar... Fixed and show barely paused. The openers were a group called The Shoos - a Dublin based band, eclectic group of lads, but a great sound. I'm hoping to see them again in the future (and given that they're opening for a few more bands in the Dublin area, I'm sure I will). Good luck to them with the EP coming out in April! The Shoos were opening for Lifehouse... a band that I've been listening to for more than a decade, but have been around longer than that. Most people know them for their softer, ballad songs, but I will say this: Lifehouse ROCKED. Good job guys! Returning to Dublin for the first time in 9 years, they went through their whole catalog of music, which was brilliant... and a little bittersweet. It was almost like taking a tour through my past dating life... I've had a few of their songs intimately tied to a significant other, including songs being dedicated to me, sung to me, or being 'our song'. It would have been awkward had the songs still made me cry... seeing as the company I was in... But I do have to reiterate, Lifehouse was brilliant! They need to come back to Dublin more often. I'd see them again in a heartbeat.
Remember the closing time of the public ramp you park your car in... Yeah, that one is a little self-explanatory. Sorry for being a brat about the bill. Sorry for delaying that last 10 minutes. I'm glad we rescued your car!! It would have been fine if we couldn't, but I'm glad we did...

All these things served 2 main purposes... 1. Happy Birthday Muireann! (I hope you had fun!) 2. I'm avoiding thinking about how stressed I am for the impending SHO interview on Thursday...

New Year - New Job

2011-02-13T13:30:00.003Z

Welcome to Drog, Welcome to Medicine, and Welcome to... well... I don't even know what to say about this.

The mental shift from surgery to medicine is taking me a bit of time. After 6 months of being decisive, cutting, stitching, and sending home, I've found myself with patients that on average are in hospital for months. The mean age has increased, the average amount of time with us has increased, but I have the distinct feeling that what I'm actually doing for the patients is bottoming out at less. The pace is slower, the ward rounds are longer, and the "let's see if this works" takes longer to see than in surgery.

While this is all going on, I've a few things on the front burner - like SHO applications. The most recent landmark of which was a 24hr delay in finding out about interviews. And in my mad panic, Bren reminded me that after 5 years here, I should be darn used to it... And I've come to expect it... But I'm a worrier. And not hearing anything had me sweating. Interviews are coming up soon... Ugh, I need a new suit.

On a similar vein, how the hell has it become February?! There's a part of me that can hardly believe that I'm a month into my new rotation, a month into medicine, and over halfway through my intern year... It's flying. I think in a good way, but in the back of my mind, I'm realising that I'm going to be an SHO soon. That's scary... That's really really scary.

The French are in town this weekend for the Six Nations Rugby... This does not please me. First of all, Rugby weekends make it nearly impossible to do the things you do every weekend just to keep the house running and yourself fed. Second, the French tend to make more of a mess of city centre (not rubbish mess, just walking/pedestrian rushhour mess) than the other blokes that come around. Third, some jerk knocked me clean off my feet yesterday. I've a bruise that covers the bulk of my left side (thigh to mid back) and my neck is killing me... Merde.

Monday is bringing my least favourite holiday, what I tend to call "Singles Awareness Day" or SAD for short. It's one of the worst days to be single... Having everyone remind you that you're single... At least there's a lot of good chocolate around. Mmn Chocolate!

And I think I'm going to leave it at that... Chocolate. Yum... Happy thought of the day.

About that letter...

2011-01-03T16:28:00.003Z

"You see, I can't survive on my own. Even now, when I finally get to go home, in the back of my head, I'll know the hospital's still here, wide awake. But what the hell. The most important thing is that I got through my first three days without looking like a complete idiot... I'm the man."
~ J.D.
(and anyone intensely familiar with Scrubs knows that he promptly walks into a door)

Hi there 2011.

That's right, I do have a letter to myself. I did read it on NYE. And I did write a new one on Jan 1, 2011...

For those of you who don't know what I'm talking about, allow me to explain. A few years ago, I stopped making a list of resolutions and adopted a new plan. I write a letter to myself. I carry the letter around for a year (it's normally tucked away in a small pocket of my bag). Then I read it on NYE (or NYD). Last year, being a fresh decade, I wrote two letters to myself, but then I only get to read one this year.

I'm not comfortable publishing the entire letter online. It's too personal. But there are a few main points I made to myself last year; those I will share.

Be Loveable - in the sense of embracing myself and loving me.
Plans are... like peeing in the ocean - No, Joe, I didn't write that for you specifically, but think about it. You know I'm right.
Life isn't fair, get on with it - don't take the important people for granted.
Lose the baggage - it's not just that I'm a pack rat... I carry everything with me.
Polish your halo - be good.

I asked for 3 main things for myself... I managed 2. And as Meatloaf says, two outta three ain't bad. Recurring phrase: Happy Bunny! (for those of you in the States, this is NOT the same as chubby bunny).

2010 was a good year. It was intense, it was full of change, it was scary, and it's over. To my friends: thank you, you are amazing.

To 2011... Bring it!

Welcoming 2011 with More Music

2010-12-31T21:16:00.004Z

So, as my tradition stands, I've put together a playlist for the new year.

2011 is a prime year... I've been to a few concerts this year, so there's dedications for those. Most of these are things on heavy rotation, new and fantastic, or things that I have a special tie to. So without further ado, here's Music for the New Year (2011 edition):

Trust Me I'm a Doctor - The Blizzards
[Dedicated to the RCSI class of 2010 - welcome to being real doctors... Scary.]
Wish List - Neon Trees
[This is the 2nd song from Neon Trees that I'd heard. It's now on my Christmas playlists. I like these guys, they've got some spunk, and it's a different sound than what I've heard recently. Plus... I have a bit of a wish list like them.]
Firework - Katy Perry
[Ok, Katy's songs get overplayed every time... I think the second I put this on the list, I'm going to be sick of hearing it. But I like it. I admit it. I like it. At the moment, it's being used to promote Love & Other Drugs. Heart.]
Future Kings - Miracle Bell
[Heard these guys as they opened for the Coronas. They're fun! Their 2nd on vocals/misc percussion/guitar looks like "Tighten" from Megamind or Jonah Hill... Hilarious. But they've got a great sound. I hope they go far.]
Little Lion Man - Mumford & Sons
[I can't believe I've only had this album since Feb. I love it. Mumford has a great crescendo in just about every song. But this one is my favourite... And it's #1 on my top played list for iTunes right now.]
Radioactive - Kings of Leon
[I have to give a nod to Kings for their new album. But... There's nothing like hearing a clip of a song, live, when you're in another country, feeling miserable, and stuck in a city that you don't belong in. This song will always make me smile now.]
Sweet Disposition - The Temper Trap
[After first hearing this in 500 Days of Summer... It is EVERYWHERE. Thank you O2 for overplaying something in every commercial you've ever made... But I still like the song.]
Christmas Lights - Coldplay
[New this holiday season... And chill... And a bit sad... And brilliant piano music. On heavy rotation for the Season, and probably will keep on into the new year.]
Stuff We Did - Michael Giacchinos
[If you don't know this song, it's considered the "theme" from the movie Up. It makes me tear up. It's so gentle, and the way it was used in the movie was brilliant. It's also one of my new piano songs.]
All We Are - Matt Nathanson
[Peaceful with where things are in life... I think this guy is going to be big. He's a bit in the mold of Mayer and Morrison, but he has much more content lyrics. I really like this one. Chills me out.]
For the First Time - The Script
[Love the new album... I'm considering getting tickets to see them in the Aviva this spring... I'm just not sure I can tolerate the teenagers I'd have to fight off. But I dig this song. Positive in the economic time.]
Curl Up and Die - Relient K
[Ok, it's been a while since I've given Relient K a listen. This came up on my genius a month ago, and I really like it. It has a different guitar feeling than most of their stuff (and I bit less Jesus than some of their songs). But it's a b-side, so that's probably why. It's not as depressing as it would sound from the title.]
Black Hole Sun (live acoustic) - Chris Cornell
[I remember first hearing this in Humarock when I was in middle school... Crazy music video. But this is a nod to Chris, and the fact that they're getting back together and making some new music.]
Yellow Ledbetter - Pearl Jam
[Saw them in concert! Great concert! (totally suited for the O2) Now, this was not played, but it needs to be out there. Plus, I got this on cd for Christmas. <3]
Second Chance - Shinedown
[I don't know of another song by this group, and I don't know who to compare them to, but I like this. Heard it once, and was sold. Just a bit of growing-pains, bit of positive spin on accomplishments.]
You've Got the Love - Florence and the Machine
[This has been a great year for this band. I think this is my favourite of their songs, ignoring that it was used a bit too often in Grey's Anatomy commercials.]
All the Right Moves - One Republic
[There is something great about this song. I don't know if some of it isn't that I found out how they got the fantastic drum sounds in it... it involved an old house, a spiral staircase, multiple floors of percussion, and a moving mic... Cool.]
Come On Get Higher - Matt Nathanson
[And here he is again. This is such a great song. Light and happy, hopeful, chill... Something I'd love to have a boyfriend sing to me one day.]
Halfway Gone - Lifehouse
[They're coming to Dublin! I'm super excited for this concert. I've never seen them live, and I've been listening to them since Hanging By a Moment came out my freshman year of college. The new album is great. A bit more rock than they have been recently. Good job!]
Far from Here - The Coronas
[One of the few songs that went off before the power failure at the concert in Dec. Go Coronas! I dig the new album, and they're very fun in concert, even when things aren't going to plan.]
Raise Your Glass - Pink
[A nod to all my nitty, gritty, dirty, little freaks. You know who you are. It's a fun song and a great wrap for a cd.]

... Roll on 2011. I'm looking forward to more great music!

On All Things Christmas

2010-12-25T15:20:00.011Z

HAPPY CHRISTMAS!!!

Happy happy Christmas to everyone! How is everyone spending this day? I have to admit, I was dreading today. The idea of being away from home on Christmas was bad enough, but the idea of being alone on Christmas had me fairly worked up. You know what? Today is great.

First of all, my family celebrated Christmas last week. We were all together, we had a full Christmas day, dinner, presents, party, games... Yes, mom, we played a ton of games just like you wanted. For some reason, the day didn't seem as hectic as it usually does. It was relaxed, peaceful, it was really nice. And when we needed something from the store, we could actually go get it (since it was the 18th, not the 25th). And let's be honest, there was a butt-load of snow on the ground when I got home. I had wanted to make a snowman, but there was no space! We had roughly 5 1/2 ft, and I couldn't use the very little cleared sidewalk to build one. I did find time to play with the cat... and annoy her by taking a picture :) We did manage a full family picture.

Before I left home, I had the chance to meet a few friends for food or coffee or a chat or really just about anything. I also got to see my brother's new house (his stocking is pictured at the right)... and their cat, who is now bigger than Zade... crazy! I think the static electricity from the carpets is making Stella grow fast.

I had a rough trip back to Ireland. Where the weather was the issue leaving, getting back was a bout of food poisoning (I think) that had the long flight from Atlanta to Dublin seeming much much longer... and with bouts of vomiting. To add to the misery, every 5th seat or so was a child under the age of 2... crying. But I was back to work on Tuesday, on call Wednesday, and while the week leading up to Christmas is normally mad busy, hectic, this week was calm. I took Thursday night to visit one of my best friends (out in the TUNDRA that is the midlands at the moment... Yes, the midlands are freezing. Pretty, but freezing) and had a wonderful night in. And a great long sleep into Christmas Eve.

So what am I doing today? On my own in Dublin? Actually, I'm not on my own. My neighbour wound up stranded, so we're having a lovely day in. Slept in late, went to mass, had brunch, am trying to stay warm (yay for the penguin slippers!), and am watching a bunch of silly movies. Number one on the list was... Home Alone! That's right, John Hughes defined my childhood, and I decided that it was an appropriate Christmas day movie. There are a few things I've to do tomorrow, but there's no rush.

I hope everyone has a very Merry Christmas. I'll be back before the new year.

Not all who wander...

2010-12-13T15:00:00.010Z

All that is gold does not glitter,
Not all those who wander are lost;
The old that is strong does not wither,
Deep roots are not reached by the frost.
From the ashes a fire shall be woken,
A light from the shadows shall spring;
Renewed shall be the blade that was broken,
The crownless again shall be king.
~ J. R. R. Tolkien

I have to say that I didn't start off Friday morning with the greatest of moods. But having to go to work early for a meeting will rarely put you in a happy frame of mind. But after the meeting, the MDM, chats with my besties, 3-monthly intern assessment meeting, and dispersion of cookies, I was heading outta hospital for a week of holidays. Ah freedom! Freedom, by the way, tastes shockingly like more Christmas cookies. I really ought to apologise to my roomie (and her waistline) for the continuous onslaught of holiday foods... But they taste SO good!

I spent the better part of the afternoon baking, cleaning, doing laundry, packing... Maybe now is a good time to shamefully admit that I forgot to pack any socks; Target here I come. Then I sat with my finger poised over the start button of the microwave as my concert-companion was stuck in the horrendous Dublin traffic. But he got in with plenty of time to spare, and plenty of time to eat (I really need to keep on experimenting with my cooking, it's working out pretty well, I think).

Now, if it's possible for all my bad luck for the year to be compressed into 48 hours, I think it was. In a day or two, I'll be laughing about it, but I'm not quite there yet. So we headed out for the Coronas concert at the Olympia. I have to say, the two openers were really good. If you like the slightly off beat bands, check out Miracle Bell (they've a free single at the moment). I was pleased enough with the two openers that I didn't freak out completely at what followed... The Coronas came out and started their set. Perhaps 5 songs in, the power failed. The whole theater lost power. Not just the Olympia, but the 2 block radius surrounding on Dame Street was without power. They gave it about 10 minutes... no power. So the lads came out with acoustic guitars, a tambourine, 3 violins, and a cello and performed another 3 songs by flashlight. It must have been hell on their voices to be heard without so much as an amp.

With still now power, management kindly told us that they would be rescheduling the concert or we could return our tickets to point of sale for a refund. Bummer. Concert was promptly rescheduled for Tuesday night, when I'd be out of the country... More Bummer. And let's be honest, what are the chances that I could make it to a TicketMaster box office before the concert to try to get my money back? (Please let us remember that I had an early flight the next morning). Mega Bummer. I think I would have been really ticked off had my partner in crime not spent the majority of the walk home singing :) Totally kept a smile on my face. It was actually a ridiculous night. But a good one. And one I won't soon forget. Plus, now Sinead can go see the Coronas play too!

Back to the flat, tidied up, went to bed for an early trans-atlantic flight... Woke up, went to shower, and subjected myself to about 30 seconds of ice-cold water before giving up on there being any hot water. PUBLIC SERVICE ANNOUNCEMENT: Dear people of Dublin - 1) running your taps is not going to keep the water mains from freezing. 2) running your taps involves letting the faucet drip about once every minute, you only need one tap in the whole house to do this... would you please, for the love, stop running your faucets like river?! We are back in drought conditions... And I get up for work around 5am. This whole no-hot-water before 7am is not going to fly.

This is about where things turned... the cold non-shower. Foreshadowing the cold to follow. Flew from Dublin to Atlanta, which is an extremely long flight for those of you who've never taken it. Landed in Atlanta, checked the screens, ATL-MSP on time. Sweet. Walked over to my gate. Screen says "Dear Liz, sorry, but you're screwed." In other words, no delay, just straight up canceled. Boo. I ring Delta. Never fear, you've been re-booked for tomorrow from ATL to Dayton to MSP. o_O Dayton? Really? Isn't there a massive storm passing through the midwest? And wouldn't it be prudent not to be STUCK IN DAYTON TOMORROW?! Ah, yes, good point, we've re-booked you on a flight to Memphis that leaves in an hour, and then you go from Memphis to MSP tonight at 7pm.

Small flight to Memphis later and the MSP airport is closed. First time in 19 years... 17 inches fell with 30+ mph winds, and they could only maintain one runway. Disaster. Also, please feel free to check out the video of the Metrodome caving in!

Insane! So Delta will get me a bit of a discount at a dodgy Memphis motel just around the corner from the airport. Great. That's what I've always wanted to do. Sandwiched between a vacant lot, a semi-tractor-trailer loading warehouse, a flight path overhead, and with a liquor store across the street, I felt warm and fuzzy all over. On the bright side, I can now cross "Stay in a shady Graceland motel" off the bucket list. Ok, it's not on my bucket list, but I may just add it in so I get the satisfaction of crossing it off. Boom.

Jet-lag had me awake around 2am, so I made my way back to the airport at 5. I was hoping to make it on the 6am straight to MSP, but no such luck. Instead, at 9:35am I took a school bus with wings to Tulsa, OK. Then 20 minutes later was headed Tulsa to MN.

I think we landed in another zipcode, because it was a 15 minute taxi followed by a 15 minute wait for the jetbridge before we could get off the plane. And just a small heads up to those of you without the diesel blood of those raised in a town that has proper cold winters: gate checking a bag means you wait IN THE JET BRIDGE for the bag to come up. If you've packed your coat, it's going to be cold. Suck it up or huddle together for warmth, but if you think the jet bridge is cold, wait till you get outside!

Nearly home, I was less than surprised to find that my bag had not made the various transfers with me. Great. Even though I'd forgotten my socks, now I had no clothes. *sigh* Thankfully, I keep a stash of emergency clothes at home. They don't really fit me any more, but in a bind, they'll do! So my mom and I went off to see the new Narnia movie in 3D before dinner.

Now I'm home. There's about 5 ft of snow on the ground. It's -10* (-25 with windchill)... and that's in Fahrenheit. Brr! And I'm happy. There will be celebration of my dad's birthday (he's an old dude now!), there will be a ton of baking, there will be family, and friends, and an early Christmas... and there will be a lot of sleeping and sitting by the fire doing very little. I'm excited. I'm really really excited.

So I'm done wandering for the moment. Now I'm going to hunker down and enjoy the weather. And I'm going to cross my fingers that there's not enough snow in Dublin to delay my return. Because, and I mean this with the utmost respect. I HATE the Atlanta airport.

More pictures to follow!

Doctor, heal thyself...

2010-12-06T12:05:00.003Z

"Few doctors will admit this, certainly not young ones, but subconsciously, in entering the profession, we must believe that ministering to others will heal our woundedness. And it can. But it can also deepen the wound."
~ Cutting for Stone

I want to talk about this quote... And I will. But first I need to talk about where I've been for the past few weeks. Dublin is under a gloomy cloud right now. The bitterness of the weather is adding salt to the wounds left by the current economic climate (and an attempt to add salt to the streets, which is something they haven't quite figured out yet). We are in for a long, cold, dark, bleak winter here. And only time will tell how damaged Ireland will be in the long run. In the short-term, the people in charge have been making extremely short-sighted decisions that are going to prolong the pain. For example, the pay cuts to junior doctors, the current work environment of the hospitals are leading to (what at the moment sounds like half, but will most likely end up being) one third of my intern class leaving Ireland for greener pastures. Some will go to the UK, some to Oz and New Zealand, the North Americans are heading home... The best and brightest doctors, educated in Ireland, started training in Ireland, are going to leave. The fall out in the future health care received by ALL of this country will last years if not decades.

On the tail end of Thanksgiving, a bittersweet holiday for an ex-pat, the cold and snow only reminds me of a weak approximation of home. And the inability of people to cope with the snow and ice (the inability of the government to prepare for it again) has brought on American temper-tantrums as I've been rear-ended, knocked down on the sidewalks, hit with ice-balls, and invariably delayed at everything I've tried to do. I miss my snowboots. I miss my SUV. I miss shovels that work, ice scrapers for cars, rock salt at the grocery stores, snow plows that work, central heating, Caribou coffee... I've compensated for this feeling by cleaning and baking on alternate days. My fridge is full of food to re-heat, and my cupboards are full of cookies. And none of this can soothe the impending loneliness of being alone for Christmas. Not just away from home, but alone...

So where have I been? Have a cookie.

Now, in the middle of all of this disaster, I encountered an extremely painful moment at the hospital. Scrubbed in theatre, my hands in a patient's abdomen, their heart beating just under my fingertips as I retract, I hear the phrase, "They're dead."

Clinically speaking, logically speaking, that patient was going to die. There was nothing within our power to fix the damage we were looking at. But this terrified and aggressively angry voice inside of me wanted to scream. "THEY'RE NOT DEAD! THE HEART BEATING IN MY HAND!!" And in fairness to that voice, we closed up and the patient survived another 18 hours before passing away. With the exception of that phrase, the situation was treated with the utmost respect.

I still haven't sorted my feelings about that day. It's painful and I'm angry about it. I think I'm most upset at the callousness of that moment. There are decent ways to express and rude ways state the condition of a patient. Maybe it was rude. Maybe it was cold. It was certainly blunt and upsetting. And at the end of the day, there are a good number of my colleagues that communicate in a similar fashion. It's something I've been exposed to over and over again. And you know what... I don't think I ever want to be ok with it. It's the ongoing divide between growing a tough skin, because medicine is brutal, and maintaining humanity and dignity in spite of the things you see. So... Am I healing? Or am I tearing open old scars?

Mass of Remembrance Reflection - ACE Fellowship Dublin

2010-11-07T17:07:00.003Z

So, as some of you know, this month was my turn to give the reflection at our Dublin ACE Fellowship mass. It was a mass for remembrance... This is what I came up with:

Elizabeth Langdon was not a traditional woman. Don’t get me wrong, she was born into loving and supportive family, named after her mother and grandmother. She worked her way through her education, found gainful employment, was married, and started a family of her own. But when she was widowed with three young children, she opted to continue her job, becoming a single working mother in 1955. And when her children were grown, starting families of their own, she became Grammy, and she became a pillar in the lives of her grandchildren.

She taught me to play tic-tac-toe, and more specifically, she taught me how to beat my older brother at tic-tac-toe. She taught me how to knit and sew. She taught me to appreciate reading and literature. She taught me to be curious. She taught me how to play cards. And I guarantee that every time I play poker, I think of her. She worked until she was nearly 70 and continued part-time beyond that, living independently in the community she’d settled in years before. And when she passed away, it was as she had lived her whole life, on her own terms.

Grammy was my idle, my mentor, and I was her namesake. I felt an obligation to uphold the service she’d done by carrying the name with pride, with dignity, with unerring confidence and strength. Her passing was one of the first losses I experienced. I handled it much as I assume other soon-to-be high school seniors do: with all the dignity and bravado of someone who knew absolutely everything about life… Which, retrospectively, was actually rather little.

I struggled with the loss. It hurt in the summer when we would normally visit her. It hurt at Christmas, on her birthday, on my birthday, and at Thanksgiving. And for the longest time, I could not move beyond the empty feeling, the void left when she was physically no longer there. I coveted the small trinkets she’d given me, more because I knew she’d never give me any more than because they held specific meaning. I was sad. And I mourned. And I feared that if I let go of the sadness that she would be gone. And that I would forget her. That she would be somehow lost.

And then I was visiting my cousin. And we played tic-tac-toe… That was the first time I recognised how much she had given me. How much of what she had done was enduring. How much of her was in me. And slowly, I found a way to celebrate who she was that didn’t make me sad. That wasn’t a sense of loss but a sense of peace.

My views on life and death are constantly in flux. At work, I’m surrounded by people struggling to live and struggling to die. I pronounce death about once a week. I’ve watched people struggle to cope with end-stage disease and terminal diagnoses, and I’ve told people that they are dying. And there is no such thing as death becoming easy. The dead move on, and it feels that we are often left to pick up the pieces when they’ve gone. To quote tv’s bleeding heart doctor, “dying is easy, living is hard.”

We mourn all the time. We mourn loss of time. We mourn changes in relationships. We mourn changes in the places we live, in the people we know, in the seasons, and in the world around us. It. Is. Difficult. To celebrate someone’s life rather than mourn their death. It is a process. It grows from within those who have lost, when we feel compelled to share the gift that this person has brought us through their life. It grows from joy. Sadness and happiness are fleeting emotions. Joy is a way of living. Joy is sharing what is good in our lives with those around us. Joy is what draws us together in community, and that shared joy is what we miss when someone has passed on. They bring light to our lives and they help us shine in ways we could not on our own.

I initially planned to talk about autumn and leaves changing being a beautiful process when it’s really the death of the tree for the winter with re-birth in the spring… But that’s been done. And frankly with the weather we’ve been having and the potential dampness looming this weekend, I’m not sure leaves falling are what’s most concerning. Life and death surround us, they shape us, they carve away our weakness and leave us with what makes us strong. And our relatives, our friends, our family, our neighbours, our teachers, our community that have passed before us have stoked the fires of our inner strength. And that light is something we have to share.

“People are like stained-glass windows. They sparkle and shine when the sun is out, but when the darkness sets in, their true beauty is revealed only if there is light from within.” Grammy was a rock. She helped me shine. And I wanted to share some of that with all of you. And as we say this mass, in remembrance of all those who have passed before us, I would like to know some of the people that have touched your lives, that have illuminated you from within. So maybe, at dinner, we can share a little piece of our rocks with each other. And if anyone wants to play some tic-tac-toe… I’m game.

Back from Travels

2010-10-31T16:25:00.011Z

I'd put it off before, so just a few comments about my little trip State-side.
I landed in Logan on Saturday (the same day my mom got in) and we drove down to Humarock. I hadn't been to Humarock in about 9 years, but this is the place I'd been every summer growing up. And it seemed unchanged.
I was there with my parents until Thursday. The daily schedule was pretty much locked in. Up around 6am (thank you jet lag) for coffee, reading the newspaper, and watching the sunrise over the atlantic with my dad. We had fantastic weather the whole time, and I didn't miss a single sunrise due to weather.

My mom would get up around 8, and there'd be more of a proper breakfast, then general nonsense until lunch. We'd either make lunch, or go out for lunch, or eat left-overs for lunch. In the afternoon, my mom and took walks up and down the beach. Or we would visit friends, or go to a movie, or meet the MacArthur's new twin grandkids (sooo cute), or get ready to have friends over for dinner/go out to dinner. And the sunsets out the back of the cottage and over the river were also wonderful to watch. It was a great time. Very very relaxing, and necessary. I needed a proper break. There were a few necessities to accomplish while there as well. I got the bridesmaid dress taken in, I got my hair cut, I slept a lot, I rented a car...

On Thursday, I headed into Boston. The 'rents had an early flight back to MN and I had to make tracks up to Hanover for a wedding. I met up with my friend Thom Thursday night for a catch up and cup of coffee. He's absolutely flying, landed a bit of a dream job, Boston suits him, and he's apparently turned into something of a ladies' man (sorry Aido). My parents left for a 6am flight on Friday morning, so I had a fantastic lie-in, picked up the rental, and drove up into the mountains. The weather turned a bit nasty half-way up, but nothing too disastrous.
Friday evening was the rehearsal and grooms dinner. Saturday the wedding. Now, I had pictures of the girls getting ready, and some of the leaves changing... but I stupidly broke the SD card out of my phone, so I've only one picture from the wedding (I backed everything up just before driving out of Boston...). And that picture is now my profile here. I will say that the wedding was lovely, the bride was beautiful, the reception was a blast. And I'm waiting for my friends to email me their photos :)
Sunday night, hopped a red-eye out of Logan, landed 5:30am in Dublin, went straight to the mont, showered, and started work just before 7am... It has been a bit of a blur since. I've been working solo for 2 weeks, this second week without an SHO on top of the co-intern being away. I'm a bit tired now...

Next round of traveling: December for home!

And that was a long lived thought...

2010-10-25T12:52:00.002+01:00

First of all, many thanks to Em, who got back to her blog, which made me think, darn... I need to do that too. So now I'm back. Brief update, 3months on Neurosurgery did not kill me outright. I'm now on GenSurg with Prof. This is looking far more reasonable so keep your fingers crossed.

I'm in the middle of writing the reflection for ACE Fellowship November. If you remember, I did the Dec/Christmas reflection last year. I feel like I have a lot to live up to, but I'm glad I don't have Dec again... That'd be even more difficult. So before I buckle down and really hash this out, does anyone have any pressing thoughts? We're looking at Nov as All Saints/All Souls day, the beginning of Autumn changing to Winter. Remembering those that have died... Let me know what you think. When all is said and done, I'll post it here too.

As promised, I'm updating the 25 Random things... So, about 2 years later:

25 random things:

1. I'm much more tell than show, much more truth than dare. But I do walk the walk. I'd guess that as long as I'm working on surgery, I'm going to be much more show than tell. It's a trick of the job. Always more truth than dare, and I walk that walk at a breakneck pace.

2. I'm a rebel... I break rules left and right. Actually no, I don't. I'm a by the book kind of girl, most of the time. But I know how to bend the rules and when to break them outright. I do play by the rules. It annoys me when others don't and they get away with it. But I've learned when to ask permission and when to just do the right thing and ask forgiveness later.

3. I'm trying to travel around Europe as much as possible before I have to really buckle down and work. To some, this will be when I graduate med school. To others, this is when GP ends and I'm into the Paeds-Obgyn back to back slap followed by exams. It's debatable. But I just got back from Prague and have a flight booked for Berlin. Prague, Berlin, London, Paris, Rome... I've hit up a few places, and I'm certainly not done. I'm a bit of a home body, so I've been traveling around Ireland a lot. Plus, the back and forth between the States and Ireland eats up a good chunk of my vacation time. Not arguing though. I'm traveling about once a month.

4. I think I've become both more laid back in life and more uptight since high school... Which is weird. I'm more laid back in life for sure, I'm a little stressed from time to time, but I think it's warranted given my line of work. I'm learning to let things go... very slowly, little by little, I'm learning.

5. Teachers are amazing. I was one, I may go back to that eventually. But I decided that becoming a doctor was easier than being an educator. That's crazy. Teachers are amazing. They come in all shapes and sizes. I owe a giant thank you to each one I've had. I'm debating that last statement about which is easier... I don't think it's a fair comparison. Teachers get far less respect than doctors, but their job is SO important.

6. Speaking of crazy, I am. Admittedly. Which I'm totally ok with. I like being a little out there. I'm not bat shit crazy, but I have my moments of insanity and I think they're unique and special. 10 pounds of crazy in a 5 pound bag. I appreciate each of my friends that somehow love me for my crazy, and know how to bring me back to sane when it's necessary.

7. I keep a blog. Ostensibly, this is to make it easier to keep my friends around the world up-to-date on my random life happenings. Really, it's because I'm so used to keeping a journal and I like to think I'm important enough to read about. Yeah... It's just so all my stalkers can keep track of me. That and I can't stand twitter.

8. I used to think dancing in the rain and jumping in puddles were great ideas. Then I moved to Ireland. I will still play in summer storms back in MN, but the rain here is cold and infinite and the puddles are not good for my work clothes. I think I'm a grown up. When did that happen? Somewhere between being handed a diploma for med school and having to pronounce a patient, I became an adult. That doesn't mean I have to act like one all the time... And my non-med friends bear the brunt of that. Sorry guys, but if I'm dealing with life and death at work, I need to go see Easy A on the weekends.

9. Thanks to technology, I watch a ridiculous amount of American TV here in Ireland. I'm up to date on House, Chuck, Dexter, HIMYM, Bones, DSM, Burn Notice, and NCIS (a guilty pleasure). I don't even need to sling it anymore, they've all come to Ireland on sky. Can't say I'm 100% up to date, but I do watch. Plus... ANTM, my new guilty pleasure. It's kinda fun to come home after a long and challenging day to see 20 year old girls cry when they can't memorize a line... Keeps things in perspective.

10. I love to read. In spite of the "in your leisure time" reading I have to do to stay on top of my studies, I still love a good book... or a cheap quick fun POS airport novel. Recently, I've read "25 in Mississippi" by (my friend) William Priestley, "Bonk: The Curious Coupling of Science and Sex" and "Twilight" (sadly, yes... I read Twilight) I wish I had more time to read, but I find myself quite tired... I've added "Eat, Pray, Love" to the list (read that one WAY ahead of the whole movie thing), "Eats, Shoots and Leaves," and "Sway: The irresistible pull of irrational thinking." I'm working on 2 books at once right now "Cutting for Stone" and "Guns, Germs, and Steel." Both are brilliant.

11. I've finished 2 marathons and have the sick desire to run another one... or try my hand at triathlons. Well... no dice here. Ran the Flora 10k after the Dublin marathon and that was just about the end of running all together for me. My right knee just about threw in the towel and after 8 weeks of physio, I decided to switch gears. I transitioned into yoga (thank you CPY - you are an amazing group of people/studios) and after a not so subtle challenge from a friend (*cough* Des *cough*) I've picked up my tennis racket again... 10 years out of the sport and it really is like riding a bike. So between running around the hospital all day, and twice weekly tennis matches, I feel that I'm keeping fit enough.

12. People absolutely fascinate me. And sometimes I confuse fascination with attraction. I'm working on that one. Still working on it. Maybe it's because I'm so complicated (half truth) that I like to think everyone else is. Maybe it's because I spent my first undergrad as a psych major. People are amazing, and interesting, and yes, fascinating.

13. I have a framed comic on my wall that looks like a poster to promote reading, but if you look closely, the person is reading porn... I think it's hilarious. I know it's hilarious.

14. I've tried my hand at a lot of things, drawing and painting, writing, teaching, dancing, psychology, philosophy, theology, video editing. And there's proof of all of these endeavors. I'm good at a lot of things. I haven't decided what I'm great at yet. Still pending... But I think I'm doing pretty good at doctoring right now.

15. I am a bleeding heart. This makes me want to take in strays, heal the wounded, and date the wrong people. It's led to me to trust the wrong people, do the wrong thing when I'm trying to do right, and more than once, I've been badly hurt. So... My heart is a little battered and bruised, and yes, still bleeding. But it's still in one piece. I'm not sure I'm still bleeding, but I carry my scars on the inside rather than the outside. I'm not as tough as I seem... It's mostly bravado. But what isn't bravado is survival.

16. Becoming a doctor changes how you see the world, how you see people, how you see death. It has to. If you're afraid of death, you're going to fall apart as a doctor. I'm slowly learning that it's ok to change the way you see things as long as you don't let it harden your heart. Still battling with this. I work with death. It hangs over all the decisions we make in hospital. I've found a way to accept this without agreeing that it should be easy. I care about my patients. But nothing in work can prepare you for dealing with it personally. It is not the same. Never let anyone tell you that.

17. I've lived in quite a few random places: Edina, MN; Toronto, Canada; South Bend, IN; Mission, Tx; Charlotte, NC; Dublin, Ireland. And I travel a lot. I call both MN and Dublin "home" and that's confusing sometimes. But I think that "home" really is all about the people. Because you can move house a lot. Home is something you share with others. Ok, Dublin is home. Where my family is, home too. I often say I'm going home when I fly to Dublin. I say I'm going home to visit my parents when I'm flying State-side. But I'll be honest, I've put down roots here in Ireland...

18. My older brother is getting married. This means 3 big things: 1 - Dan is a grown up... Weird. 2 - I'm going to have a sister! Yay! 3 - If the whole marriage pressure thing gets put on me, I'm throwing the grandkids pressure on Dan. My older brother IS married! And they are happy and wonderful. Kirsten is an awesome sister (that's right lady, you are). But the grandkids pressure... yeah, that's there... Dan has a lovely job, they're getting a house, they have a kitten. Careful, Dan. You're running out of excuses :)

19. I miss having pets. I miss Abbey and Zadie. I thought about getting a dog, but I don't have the time for one right now, and it wouldn't be fair to the dog. I thought about getting a cat, but I'm sortof allergic to them, and my roommates don't want one. I thought about getting a goldfish, but then I realised that it'd just be a disappointment that I can't pet it and it can't learn tricks. Maybe I need a boyfriend. No resolution here. I don't have time for a pet because of my work schedule. I'd need something a bit more independent than a cat (if that's possible). I suppose the right boyfriend would suffice, but I think my standards are a bit high.

20. I am both ridiculously organized AND hilariously messy. It frequently looks as though a small tornado went through my room, or that my closet vomited on the floor. But I know where everything is, I clean my bathroom to a shine once a week, and I have a schedule and plan for just about everything. I have to in order to keep up with my life. Uh... some habits are permanent.

21. I love music. I sing a lot... just rarely in public. Though I'll sing with the choirs. I sing in church (even if Brent laughs at me). I sing in the shower (sorry roomies). And there's always music playing in my head. I have a soundtrack for my life. Just ask, I'll tell you what's playing. I've returned to playing piano as well... Music is everywhere :)

22. I'm Catholic. I go to church. I pray. Sometimes people ask me how I can be a doctor and still go to church. I couldn't be a doctor without my faith. Still true.

23. The question "What do you want to be when you grow up?" scares the piss out of me. Still does... I'm a grown up???!

24. Right now, my favorite insult is to call someone a "knob." I think it's going to become a permanent thing in my vocabulary. Ok, knob didn't stick. I found too many other amusing ones (I blame Enda... He tends to be expressly creative with his insults)

25. I don't like bullshit. I'm really good at "playing the game" and "being a good listener" But after a while, I like to call a spade a spade. I don't like playing games with people (and girls play SO many games... which is stupid). I can be blunt sometimes. This has worked, and on occasion this has failed miserably. Maybe it goes back to that trusting the wrong people thing. It's all about pots and kettles. Still true. I hate politics as well. Just another game. A guise for getting something from someone else that they don't want to give, and finding a way for it to be "right"... That's right BMont, I'm talking to you.

Back in the Swing of Things

2010-07-04T22:43:00.002+01:00

So... it's been a while. And it's not as though I'm going to be any less busy. So before I try to get back into the weekly updates, I'm just going to throw up an old post from facebook. It was one of those chains that went around yonks ago. I'll update it soon. But for now, a re-introduction to the me that was in SC-I:

25 random things:

1. I'm much more tell than show, much more truth than dare. But I do walk the walk.

2. I'm a rebel... I break rules left and right. Actually no, I don't. I'm a by the book kind of girl, most of the time. But I know how to bend the rules and when to break them outright.

3. I'm trying to travel around Europe as much as possible before I have to really buckle down and work. To some, this will be when I graduate med school. To others, this is when GP ends and I'm into the Paeds-Obgyn back to back slap followed by exams. It's debatable. But I just got back from Prague and have a flight booked for Berlin.

4. I think I've become both more laid back in life and more uptight since high school... Which is weird.

5. Teachers are amazing. I was one, I may go back to that eventually. But I decided that becoming a doctor was easier than being an educator. That's crazy.

6. Speaking of crazy, I am. Admittedly. Which I'm totally ok with. I like being a little out there. I'm not bat shit crazy, but I have my moments of insanity and I think they're unique and special.

7. I keep a blog. Ostensibly, this is to make it easier to keep my friends around the world up-to-date on my random life happenings. Really, it's because I'm so used to keeping a journal and I like to think I'm important enough to read about.

8. I used to think dancing in the rain and jumping in puddles were great ideas. Then I moved to Ireland. I will still play in summer storms back in MN, but the rain here is cold and infinite and the puddles are not good for my work clothes. I think I'm a grown up. When did that happen?

9. Thanks to technology, I watch a ridiculous amount of American TV here in Ireland. I'm up to date on House, Chuck, Dexter, HIMYM, Bones, DSM, Burn Notice, and NCIS (a guilty pleasure).

10. I love to read. In spite of the "in your leisure time" reading I have to do to stay on top of my studies, I still love a good book... or a cheap quick fun POS airport novel. Recently, I've read "25 in Mississippi" by (my friend) William Priestley, "Bonk: The Curious Coupling of Science and Sex" and "Twilight" (sadly, yes... I read Twilight)

11. I've finished 2 marathons and have the sick desire to run another one... or try my hand at triathlons.

12. People absolutely fascinate me. And sometimes I confuse fascination with attraction. I'm working on that one.

13. I have a framed comic on my wall that looks like a poster to promote reading, but if you look closely, the person is reading porn... I think it's hilarious.

14. I've tried my hand at a lot of things, drawing and painting, writing, teaching, dancing, psychology, philosophy, theology, video editing. And there's proof of all of these endeavors. I'm good at a lot of things. I haven't decided what I'm great at yet.

15. I am a bleeding heart. This makes me want to take in strays, heal the wounded, and date the wrong people. It's led to me to trust the wrong people, do the wrong thing when I'm trying to do right, and more than once, I've been badly hurt. So... My heart is a little battered and bruised, and yes, still bleeding. But it's still in one piece.

16. Becoming a doctor changes how you see the world, how you see people, how you see death. It has to. If you're afraid of death, you're going to fall apart as a doctor. I'm slowly learning that it's ok to change the way you see things as long as you don't let it harden your heart.

17. I've lived in quite a few random places: Edina, MN; Toronto, Canada; South Bend, IN; Mission, Tx; Charlotte, NC; Dublin, Ireland. And I travel a lot. I call both MN and Dublin "home" and that's confusing sometimes. But I think that "home" really is all about the people. Because you can move house a lot. Home is something you share with others.

18. My older brother is getting married. This means 3 big things: 1 - Dan is a grown up... Weird. 2 - I'm going to have a sister! Yay! 3 - If the whole marriage pressure thing gets put on me, I'm throwing the grandkids pressure on Dan.

19. I miss having pets. I miss Abbey and Zadie. I thought about getting a dog, but I don't have the time for one right now, and it wouldn't be fair to the dog. I thought about getting a cat, but I'm sortof allergic to them, and my roommates don't want one. I thought about getting a goldfish, but then I realised that it'd just be a disappointment that I can't pet it and it can't learn tricks. Maybe I need a boyfriend.

20. I am both ridiculously organized AND hilariously messy. It frequently looks as though a small tornado went through my room, or that my closet vomited on the floor. But I know where everything is, I clean my bathroom to a shine once a week, and I have a schedule and plan for just about everything. I have to in order to keep up with my life.

21. I love music. I sing a lot... just rarely in public. Though I'll sing with the choirs. I sing in church (even if Brent laughs at me). I sing in the shower (sorry roomies). And there's always music playing in my head. I have a soundtrack for my life. Just ask, I'll tell you what's playing.

22. I'm Catholic. I go to church. I pray. Sometimes people ask me how I can be a doctor and still go to church. I couldn't be a doctor without my faith.

23. The question "What do you want to be when you grow up?" scares the piss out of me.

24. Right now, my favorite insult is to call someone a "knob." I think it's going to become a permanent thing in my vocabulary.

25. I don't like bullshit. I'm really good at "playing the game" and "being a good listener" But after a while, I like to call a spade a spade. I don't like playing games with people (and girls play SO many games... which is stupid). I can be blunt sometimes. This has worked, and on occasion this has failed miserably. Maybe it goes back to that trusting the wrong people thing. It's all about pots and kettles.

Dust and Joy and Sandwich-boards

2010-02-17T22:47:00.004Z

I remember when I was younger, the same message was repeated every year on Ash Wednesday: "From dust you were made, and to dust you shall return." The ashes on the forehead were a sign of our mortality, of the finite nature of our existence... Today, it was a different blessing of sorts. Today, I heard "I invite you to turn away from sin and live the gospel."

It felt odd, that new message. I'm so used to the slight doom and gloom of entering into Lent. Such a dark time of year, cold season, bleak really... And you're staring down 40 days of giving up something you love (well, hopefully not love, maybe giving up something you crave). And to start the party, you are reminded that you came from nothing but ash and dust and one day, you'll be straight back there. I never felt it was condemning, almost comforting. Only certainty in life: Death and Taxes. Life is certainly limited. There is an end point. But... BUT that's merely the physical life. Your body, your belongings, your clothes, your books, your trinkets, your hairstyle, your photos, your computer, your (i)phone, your things, your STUFF... That is made of dust. It's all transient. It is not what matters. What matters is what is inside, what matters is your thoughts, your beliefs, your faith, your soul, your love and your joy. I liked the old message - marking the body for where it was headed while entering a time to whip that soul into shape...

That being said, I don't dislike the new message. I find it quite... happy? "I invite you to turn away from sin." Who doesn't like an invitation?! I hear invitation, I think party! And living the gospel... Hell of a party! Maybe I'm a traditionalist. I'm a creature of habit. I don't like changing things I find comforting. But I think the Church often needs a positive message, especially now. And if a simple blessing can be the linchpin in conversion than who am I to question it?

The homily we heard this evening was a bit of kick in the pants. A call to action of sorts. And one of those homily points that hit home, and hit home hard. The focus of the question was, "How does your life inspire?" It was broken into bits of, "How do people know you're a Catholic?" and "What sacrifices are you making for Lent?" But the message was clear. You should be inspiring. People should want to be you. People should want to know you. (You should be cool, eh?) But what are you doing? How are you inspiring? How are you challenging others around you? How do you live the gospel? ... How are you a good Catholic when it seems so counter-cultural to be even remotely Christian? Think about it. It's a tough question.

Last thing: Sandwich boards. Not a topic I'd expect in a homily. But love the imagery. Why do you wear a sandwich board? So the guy walking up the street and the guy walking down the street both get the message! They're bringing back sandwich boards as a form of cheap advertising. Sweet. Do the same. Be a sandwich board for your message (whatever it may be). Make sure that everyone can read it, no matter if they're coming or going, if they're in front of you or behind you, if they agree or disagree...

So what's on my board then? Good question. Off hand, only one thing pops to mind - - Joy. Forget happy and sad, they're transient feelings. Joy is a way of being, a way of living, a way of loving. So that's it, my message is simple: Joy... and maybe an anti-smoking message too.

"I do it for the joy it brings
because I am a joyful girl
because the world owes me nothing
we owe each other the world
I do it 'cause it's the least I can do
I do it 'cause I learned it from you
I do it because I want to
because I want to."

Music for the New Year - 2010 edition

2010-02-14T12:29:00.003Z

So I know this is mucho delayed. As some of you know, Lappy (my trusty MacBook) has been in the shop with a series of minor hardware problems. Turns out that most of the hardware was fine, but the motherboard was having a small meltdown causing everything else to malfunction. Well, Lappy is now home, programmes papers and music are re-installed, and he's happy as a little white mac clam.

I put together a playlist for the new year. Most of it is stuff I've been listening to, some on heavy rotation while studying for exams... don't worry, I've spared you the Glee Soundtrack, but only because I couldn't pick and I'm not allowed to just use a single cd (PS: Thanks Mom, Awesome Christmas Present!!!) I've a few comments for the songs that are on there, so here goes:

Farewell Ride - Beck
[dedicated to my RCSI Final Med class... it is our farewell ride, let it be a good one]
Coyotes - Jason Mraz
[I had trouble picking from this album, as I'm sure you can see. Everything had a different sound and I really dig it. It's hard to say why exactly I like this song, but it's new, it's different, and I think it's brilliant]
Crazy (James Michael Mix) - Alanis Morissette
[For my girls! It's so true... we're a bit crazy, perhaps me more so than others, thanks for letting me be crazy]
Flame - BellX1
[Never understood why Mark loved BellX1 until I heard this song. Frankly, I first copped onto this because of the line "and toast marshmallows on a cold dark night." But the more I listened, the more I liked. The beat is great, the lyrics are subtle but also great.]
Say When - The Fray
[First time I heard this song, I latched on. Anyone ever through a rough patch can feel this. With all the stress and intensity of this year, I just found this to be so apt. We all need to know when and how to "Say When."]
Dig - Incubus
[I hadn't listened to Incubus in ages, so when someone handed me Light Grenades it was like a flashback to freshman year of college. But strangely, the songs I'd rocked out to then sounded different. And Dig really really stuck out. Oil and Water is another good one from the album, but Dig won out. Mostly because I feel like I've been dug out from a pile of crap that's been weighing down my life.]
Turn to Stone - Ingrid Michaelson
[I'm really liking music with piano as the lead instrument. Nod to the logic of speaking your mind, and more to the point, of speaking your heart. The more you keep it in, the tougher it is to get it out. So sick of choking on words that are never spoken.]
Love for a Child - Jason Mraz
[Here's #2 from "We Sing. We Dance. We Steal Things." It's a lemons to lemonade type of song. Bittersweet, tad jaded, tad sad, and hopeful. Here's to innocence.]
Unplayed Piano - Damien Rice & Lisa Hannigan
[Beautifully bittersweet. The piano is fantastic, the vocal duet is gorgeous... I want to learn to sing and play this. Anyone else for a duet?]
A Beautiful Mess - Jason Mraz
[You know, there are these people that come into your life and leave such a mark on you that you could never ever be the same. And in spite of everything good and changing and strong about it, life can get in the way. Welcome to my life. This song is almost too close to home, and yet it's beautiful. "Like picking up trash in dresses."]
The End - Pearl Jam
[Who can argue with Eddie Vedder picking up the acoustic and giving a slow jam? And such a dark, moody slow jam? Tribute to those who've left us this year. To the changes that are coming. And to taking the knocks on the chin and going forward anyway.]
New Soul - Yael Naim
[Leaving the bittersweet for something very fresh sounding. Yes, I know this is the music used for the Mac commercials. I don't care. I've had a few moments of this feeling... feeling new, feeling young (and maybe a touch inexperienced), but hopeful. Very hopeful.]
Hey, Soul Sister - Train
[I heard this song quite a few times before I had ANY idea it was Train. It reminds me of Michael Franti's "Say Hey." I like the rhythm. I like the upbeat key. I like that it's different from what Train tends to do.]
I Don't Know - Lisa Hannigan
[Lisa Hannigan has one of those voices that is so beautifully haunting. I have to credit Thom for introducing me to her music (though I introduced him to her after the little concert). But when she sings live, it's totally effortless and engaging. And this is one of her fun, happy, a little silly songs.]
Crack the Shutters - Snow Patrol
[I've learned the piano chords for this song. It's remarkably easy. But there's something about the crescendos in this song that absolutely catches me. I know it's a repeat from the summer soundtrack, but it was heavy play for exams as I was learning the piano. I also think the lyrics are hot. Sue me.]
Your Love Is a Song - Switchfoot
[Switchfoot's new album, "Hello Hurricane" is like a throwback to the rock they used to do when they first started. They seemed to get stuck in the ballads (which are always good from them) and softened everything. Welcome back to Christian ROCK fellas, and this song was one of my favourites on the album. The feeling of all encompassing love, beautiful.]
Sunburn - Owl City
[Ok, Owl City (aka Adam Young) is so sweet that dentists and endocrinologist have banned his music, but... Oh come on! It's adorable. Owl City has a tone of Postal Service, mostly major key songs, that are hopelessly naive and hopeful without any of the smutty leanings of what was Brittany/NSync/Backstreet Boys/Spice Girls teen pop of my high school days. A sort of cleanness that I've missed as of late. So mad props for being sincere and not bitter or jaded about life yet, Adam. And you're right, sir. Research does cause cancer in lab rats!]
Love You 'Til the End - The Pogues
[A nod to the traditional bad boys of Irish music singing something a touch out of character. Mark this off as a song I'd love to be serenaded with sometime in my life. Clearly we're in the upstroke of happiness here on the list, but coming back to the beginning and the idea of moving on.]
Flowers in the Window - Travis
[And a happier song for my class. It really does only seem like yesterday that we started here at RCSI, and oh my Lord did I fell like I was drowning in information. I felt like there was no way I'd (maybe we'd) make it through... And we're all getting ready to be real doctors... Flowers in the windows guys.]
The Night I Punched Russell Crowe In the Head - Gaelic Storm
[And a tribute to the stupidity that has come from the 4 years here. With the Irish roots of Gaelic Storm, singing about how he punched Russel Crowe (true story), it's silly, it's funny, it's fast and ridiculous. So has been RCSI.]

Music for a new decade and all the change that's brewing in the next few months. So... That's where we are musically for the year. A little sad, a little crazy, the tiniest bit angry, and very very hopeful.

Profiles...

2010-02-07T22:43:00.001Z

I am like the duck: calm, collected, indifferent on the surface, under the water, my feet are paddling like crazy, but the water (like insults) just roll right off my back. I don't have favorite things, only those that are currently on heavy rotation. Anything worth doing is worth doing poorly (for type-A personalities only). I am a human speedbump, a no-talent-ACE-clown, the short-stack. I hug. I pray. I jump in puddles and play in the rain. I think people are amazing and wonderful. I forgive others easily, I rarely forgive myself. I play with boys. Any sport is made better if there's contact. There should be pulitzer prize fighting. I bake whenever I can. I have a ridiculously inappropriate sense of humor. I giggle like a small child. I miss my pets back home. My brothers are crazy and I love them for it. I run, it's an addiction, it's my zen. Sanity is a subjective term. I dance all the time, whether sitting or standing, with or without music. There is always music playing in my head, the permanent soundtrack of my life. I'm weird... I know it... Learn it, Live it, Love it.

How Time Changes Things

2010-01-31T20:39:00.003Z

Or... it doesn't really, does it now?

Some things never change...

I'm having a laugh over this.

Resp and onto more ADD Medicine

2010-01-31T18:12:00.002Z

One week of resp medicine down... including a Friday night call and 7:30am post-take ward rounds (yeah... on Saturday). I never knew the hospital could be so quiet. And yes, I know I was on a study strike. But it wasn't a keener strike. And my boss really really really really really likes his students to be present for post-take ward rounds (read: be there or else).

Other things ticked off the docket include changing my name on my diploma (I really wanted my middle name there), getting my yearbook picture taken, writing a blurb for the yearbook (for surgsoc), and a trip to Ikea for some extra wine glasses. Tomorrow, I'll "break" the study strike to do some ECP reading. But I figure that's about all the work I'll do this week, so it's ok. I think this week long ethics/communications course is going to be... amusing? Just based on the group I'll be in with, should be either intense and challenging, or an absolute gong show. I've my fingers crossed for a gong show. Bring it on. Now, if only the boys will behave themselves... maybe just a little bit?

I'm glad to have an easy week of work though. I'm still getting over the exaustion of exams. Stupid exams. By the end of this week, mom is in town and I plan to be firing on all cylinders. Can't wait for mom time. Perhaps I'll get the car fixed before I go pick her up from the airport...

Anaestheti... Ooooh look at the Kitty!

2010-01-24T16:24:00.003Z

(If you don't read A Softer World - asofterworld.com - I highly recommend it)

Week 1 down, which means I'm done with anaesthetics. Nice.

I wish I could say that I enjoyed Anaesthetics. Before I dump on it though, let me say this: The SPR in charge of the rotation right now is brilliant. She's lovely, an excellent teacher, and she makes the whole thing extremely accessible. I learned more from her than I did with the lectures on my own before my writtens and she made it a point not to waste our time by just re-teaching those (seeing as we had already studied them for the aforementioned and completed written exams). So to her, a solid tip of the hat. Now, why I didn't have a good time - quite simple really. I am 100% exhausted and wound up running a fever Wed-Sat. I don't know that it's appropriate for me to be bouncing around the ICU with a fever (read: it's not appropriate). But I only get one week of anaesthetics teaching all year, and I feel like 1) I'm not really allowed to miss it and 2) I don't want to miss the only opportunity to learn how to intubate before I stumble across it in an emergency situation. Fingers crossed we re-learn at ATLS later this year. But for those of you who still have that week of anaesthetics, it's not as horrendous as it was last semester. I promise.

I haven't managed to accomplish very much this weekend. Partially from feeling crummy and sick, partially from being at the intern exam in Bmont yesterday, partially from an afternoon meeting, and mostly because I didn't get out of bed until noon today (but really... When do I EVER do that?). I did, however, manage to pack up the christmas decorations and start the cleaning process that HAS to happen before my mom gets here. I refuse to let my flat be a mess for my mom... Plus, dinner party on the Sat, and I like it to be clean for that kinda thing too.

Week 2: Resp med. With whom? I don't know. I actually asked and the request for information blew up the computer on which the information was contained... Not sure what to do now. Maybe I'll just pick one? I'm going to take it easy this week. I'm getting better. Not 100% yet, but I'm getting there. I feel like there is just SO much life stuff to get done, and not much time allocated to do so. Like, oh, loans. And a PPS number. And... who knows what else. Need to get on that. Then I'm going to start learning some new stuff too, or at least start studying something again.

(Proof that I actually go out sometimes. Thanks Joan! And the Swan... Cheers meets Backer)

Writtens down... On to clinical

2010-01-18T19:54:00.003Z

So... I've finished my written exams... Crazy. I have (almost) no more tests between me and graduation. I say almost because my Data Paper is somehow a written paper. It's much more like a hybrid between an exam and an osce. But here's the low down on what's left for Semester 2 SCII:

The next few weeks is like ADHD Medicine (in my mind)...

Week 1 - Anaesthetics
Week 2 - Respiratory Med
Week 3 - ECP1
Week 4 - ENT
Week 5 - ECP2
Week 6 - Ophtho
Week 7 & 8 - Sub-i Paeds
Week 9 & 10 - Sub-i Med
Week 11 & 12 - Waterford (misc) Med
Week 13 - 16 - Blanch Surgery
FINAL CLINICALS... OSCEs, Long Case, Data Paper...

May vacation x 3 weeks. (? Travel all over Europe)
June week 1 - Graduation week!!!
June vacation x 3 weeks. (? Home in MN for a bit)... Back in time for PEARL JAM!!!
July 1 - Start actually working for a paycheck! (woot)

After July 1, there's really almost nothing on my calendar. That scares me a little. This year is very much up in the air. Next year even more so. Bonkers. What am I going to do with my life?! (No, really... I'm open to some ideas here)

As I promised a few people, a lovely view of Dublin (and my car, Timmy) on New Year's Day.

Welcome to Dublin 2010... A place that feels strangely like a 3rd world country for about 2 weeks... I had an eventful start to the year though. Break-in, power failures, water shortages/outtages, car won't start, car starts, exams... *sigh* Onwards and upwards.

Bring it 2010... Bring it.

Where were you 10 years ago?

2010-01-04T16:26:00.002Z

Q: Where were you 10 years ago?
A: Probably avoiding studying then too.

I've written my letters... Two this time. One for next year, and one for 2020 (AH! 2020!). And while some of the things in them are too personal to share here, there are a few I'm willing to answer.

So here are a few excerpts (cut down for censorship reasons) from my "Decade letter":

1st off... I miss-wrote Jan 1st... so I pointed out my "typo" and called myself a spa.

Where were you 10 years ago?

Darn that Y2k nonsense! If I remember correctly, I spent NYE at Drew's house as per usual... black tie?

Highlights: Slinky black velvet dress, Glen in a tux, Soooo many cookies... Sleeping under the Christmas tree, leaving at 8am for basketball... And frozen Mt.Dew as a breakfast slushie

That was mid-senior year of high school. Accepted, but not committed to Notre Dame; captain of basketball and upcoming softball; working on yearbook, SEB, Student Council, Peer Helpers (Eve is fuzzy); and 2 steps shy of an absolute burnout... 17 years old and you thought the world would stop turning without you. Guess what, it didn't. But there was a minor slow-down...
Where do you see yourself in 10 years?

Alive. Let's start there. 37 years old... geographically speaking, I have NO idea...
What have you learned in the past 10 years?

Making plans is like peeing in the ocean...
You're loveable...
You're smart...
You're a tough cookie!...
Finish the following: 2000 was the decade of ____, 2010 will be the decade of ____.
Growing pains... Chaotic peace...

That's all I'm really willing to share from that letter. I'm hoping I can hang on to it long enough to have it come 2020... Perhaps it's time I invested in a safety deposit box?

Hope the new year is treating you all well!
Peace,
~Liz

Happy New Year!

2010-01-01T18:33:00.002Z

Welcome to a new decade!

I have to say, I rang in 2010 with much less pomp than most new year celebrations of my past. But hey, I have exams coming up. There's stuff to do. And the weather in Dublin, though entertaining, was not conducive to travel. I'll have to put up some pictures of the snow and ice (I took plenty). What I did do last night, was read the letter I wrote to myself Jan 1, 2009. It's a tradition I have... one of my newer traditions, but a tradition none-the-less. I was very gentle with myself last year. Very nice to myself. I actually almost cried when I read the letter. (that could have been the Prosecco talking). So now I'm going to sit down and write one for Liz - 2011. Before I do that, I have a few questions for everyone to ponder.

Where were you 10 years ago?
Where do you see yourself 10 years from now?
What 3 things do you want for 2010?
What did you accomplish in 2009?
What did you learn about yourself in 2009?
Finish the following: 2009 was the year of ____. 2010 will be a year of ____.

I'm going to think about these and send some love to myself for next year!

Peace,
~L

White Christmas!

2009-12-23T14:41:00.002Z

I'm not sure whether this is really exciting and fun... or what? I do remember the storm of 1991. We had a snow day. My little brother almost got lost in a snow drift.

Issued by The National Weather Service
Minneapolis, MN
4:26 am CST, Wed., Dec. 23, 2009

... WINTER STORM WARNING NOW IN EFFECT FROM 9 PM THIS EVENING TO 6 AM CST SATURDAY...

THE WINTER STORM WARNING IS NOW IN EFFECT FROM 9 PM THIS EVENING TO 6 AM CST SATURDAY.

* TIMING... SNOW WILL BEGIN LATE THIS AFTERNOON INTO EARLY THIS EVENING... WITH ACCUMULATING SNOW MOST LIKELY AFTER 9 PM TONIGHT. THE SNOW WILL CONTINUE THROUGH FRIDAY NIGHT. SOME SLEET IS ALSO POSSIBLE FROM LATE WEDNESDAY NIGHT INTO THURSDAY AFTERNOON... MAINLY IN EAST CENTRAL MINNESOTA AND WESTERN WISCONSIN.

* ACCUMULATIONS... SIGNIFICANT AMOUNTS OF SNOW WILL OCCUR WITH PERIODS OF HEAVY SNOW LIKELY AS THE STORM INTENSIFIES THURSDAY AFTERNOON INTO FRIDAY. SNOW AMOUNTS BY THURSDAY MORNING OF TWO TO FIVE INCHES ARE EXPECTED. TOTAL SNOWFALL ACCUMULATIONS BY SATURDAY MORNING WILL LIKELY EXCEED ONE FOOT IN MANY AREAS... WITH SCATTERED TOTALS IN EXCESS OF 20 INCHES PROBABLE. THIS EVENT MAY BECOME COMPARABLE TO THE HALLOWEEN SNOW STORM OF 1991.

The Donegal Break!

2009-12-22T21:55:00.001Z

Girls' weekend away!!!

ACE Reflection - Christmas Time

2009-12-12T13:40:00.003Z

So... As promised, here's the reflection I read at the ACE Fellowship mass last night.

Peace,
~L

Christmas Reflection

The Holiday season means many things to many different people. In fact, it can mean many things to each person. For example, the doctor in me knows that the Holidays are notoriously bad for health. Highest rate of heart attacks falls between Thanksgiving and New Years, highest depression and suicide rates in December, homelessness, burns and house fires, theft, vandalism, and don't get me started on the alcohol. The Minnesotan in me knows that December means about seven hours of day light, subzero temperatures, and shoveling a half foot of snow every other day. The days are getting shorter, darker, colder, and the weather here... well, it can be abysmal. So, in this winter of more than just season, we surround ourselves with the warmth, family, spirit, and celebration of Christmas and the New Year... And HOW!

Everyone has their own holiday traditions, borne of their family, friends, peers, country, and church. But inevitably, they involve gifts, food, decorations, celebrations, and a spirit of joy. So, for the sake of the little kid in us, I just want to imagine fulfilling these traditions.

Shopping for presents. At home, the day after Thanksgiving is THE day to do about 50% of the Christmas shopping. Packs of humanity swarming around sales that pop up and change hourly at the retailers. I need to pick up a gift for my brother, and his new wife. My roommate, my boyfriend, my best friend, my little brother, my mom, my cousin that was married last year... oh wait, they've a new baby too, what the heck am I going to get for my dad? He says he doesn't need anything... hm... And there's the office secret santa/white elephant party, and do I have to get something for my boyfriend's little sister? I think that's everyone. No wait, I forgot my aunt is coming to dinner next week. Speaking of dinner...

Make a huge meal. At least one huge family meal. It might be on Christmas Eve, or Christmas day, or even the eve of Christmas Eve or St. Stephen's/Boxing day, whatever is your tradition. But you need the huge family meal. And probably about three separate dinner parties, or office parties, or festivus for the rest of us, all events requiring you to prepare soups, hors d'oeuvres of Christmas theme, Ham, Goose, Turkey, minced pies, mulled wines, fruitcake? Christmas crackers, candy canes, chestnuts roasting on an open fire, egg nog, yule logs, and of course trays and trays of cookies. And as your home is filling with the scent of freshly baked cookies...

Decorate your house. I want a tree, preferably recently living, with tinsel and lights, ornaments, garlands, and a star on top, or an angel or a Santa, whatever floats your boat. I want stockings hanging from the mantle, I want a wreath on the door, I want candles, I want fairy lights, I want mistletoe, I want snow flakes, I want reindeer, jolly weird garden gnomes, and there darn well better be a manger scene in the bay window. Don't forget to decorate the outside of the house too. And with all that done, bundle up against the winter chill, grab about ten of your mates and head outside...

Go Christmas carolling. Wander up and down your street in a gang of wolly scarved merrymakers, armed against the jack frost's nip with a thermos of hot chocolate (perhaps with its own special bite) and mittens, use the big brass knockers, ring the ding-dong merrily on high doorbells, and sing to whom ever will listen. Tell them about the little drummer boy away in the manger in royal David's city where, Hark, I hear an angel singing. And the glowing reindeer dreaming of white tannenbaums and talking snowmen decking halls with figgy pudding. Do they know it's Christmas time at all? Jingle some silver bells there, Wencelesslas, dash through the snow, and have yourself a merry little Christmas. And when your cheeks are rosy and your fingers have lost sufficient circulation, you head back inside, 'cause baby, it's cold outside. May now it's time to think about those who don't have some place warm to thaw tonight.

And this is the month when more people donate to charity than any other time of year. We bring in our food to stock the shelves of local kitchens, drop our spare change into the red bucket for the salvation army, sure the poor fellow stuck outside ringing that bell looks cold enough for the both of you. Purge closets of big puffy sweaters that may be a little out of fashion but sure are warm and could well serve someone else that needs them. We give to locks of love, and toys for tots, coats for kids, St. Vincent de Paul, unicef, Focus, Oxfam, Bothar, and Simon. We give and give and give and to do our duty properly, we give until it hurts. We give of our money, our time, our hearts, and in this season charities have to turn away volunteers. So we slip in the good deeds where they're hard to notice, like buying charity Christmas cards.

Speaking of cards, I want you to write cute, clever, and touching cards to anyone you've ever known, but be sure to make them personal because at the end of the day, they all know each other and they'll be comparing notes. Also, I hope you've updated your address book so that you can mail those letters... Lord only knows where your next-door neighbour who used to share your tree-house has moved in the past 15 years. Also, you'll need boxes to ship the wrapped presents for friends and family that don't live next door. This season keeps the post office in business.

And then... somewhere in all of that chaos... We are supposed to carve out time to worship, time to give thanks, time to wait in wonder and awe for the birth of the Lord. It feels like running around, juggling snowballs, while holding your breath... and a partridge in a pear tree.

Now think about doing all of that in the middle of August. Or on July 15th (hey, that's my birthday, I hear Hobbits give everyone else presents on their birthday). Or what about May 7th. In that context, it sounds almost ridiculous. How far we stretch ourselves this time of year. How much we give and we fit into the short days. How willing we are to say yes to friends, to family, to food, to parties, to wrapping paper and ribbons, to cards, to caols, to cooking, to wanting and to giving. And how obliged we feel to attend mass for Advent.

Advent is a time of waiting. A time of anticipation. A time of expectation, excitement, and hope. A time to take stock of what we have to be thankful for as we count down the days until our Lord is born. When he brings this light and joy into the dark days of winter. There's a fresh, clean (and somewhat full ) feeling that comes with this time. And I suppose my small bit of advice is to hold onto the sense of wonder, the sense of joy, the attitude of giving. Carry it with you. Bring it into the new year, into the spring. Anticipate the beauty of all times of the year. Expect joyful surprises. Be excited to give of yourself. And at the advent of a fresh canonical calendar, allocate, dedicate, spare a moment or two for some quiet reflection, for peace, for prayer, and for God.

Revisiting

2009-12-10T13:59:00.002Z

So... I'm going to post my Christmas Fellowship reflection here tomorrow (I figure it's only fair to wait until I've actually given it before putting it up here). In the mean time, I've been a bit lax in this blog. Mea Culpa. Not gonna lie, final med is way busy. I've been burning the candle at both ends (and in the middle too). Basically haven't slept much in the past 3 weeks. Running around like crazy. And when I actually had a day off, I slept till noon. And think about it. When do I EVER sleep until noon? More on that later.

For now, I was cleaning up my room and came across something I haven't seen in ages. It's a song I wrote maybe 6 years ago. I'd forgotten that it was something I enjoyed. Maybe it's about time I get back to that. I think I'll have to wait until final med is over to really give it any time... So until that happens, here's one from the archives (and yes, it's very God-ish. But it's one of the better things I think I've ever written... really ought to put it to music).

Dancing in the Trenches
I stumble and I fall, but your Simon picks me up
He shares with me the Body and we drink from Your cup
Lost and blindly wandering I hear you calling me to be
A child in the journey, faith realised in me
When all is forgiven in infinite true love
No matter how I falter, you are there to pick me up

When I am witness to your glory
Fill every corner of my soul
Your Grace will cure my stumble
Your Love it makes me whole
And I fall down to my knees
The beauty of your Truth
The gift of being human
Heaven comes to life in you

Your Love is an ocean, let it wash on over me
Crash into the shores, drag me out to sea
I'm not afraid of swimming, I'm not afraid to be
A member of your family, the hands of His community
When all around is darkness, let me reflect your Love
Glowing like a stained glass, shining in the night

Here on Earth
We will praise your name
Dance along the trenches
Light the darknened way
We will share you Love
We will swim in your sea
We will teach your Word
We will bring you Peace
By Word and by Land
By Song and by Sea
Dancing in the trenches
As we are called to be

Celebrate life
Live in the Love
Dance in the trenches
To the songs of heaven above

Dance in the trenches
To the songs of heaven above

Deep Breath!

2009-08-29T17:11:00.002+01:00

I'm on the down stroke of energy as I've just finished a one month elective at Children's Hospital in the ED. It was a fantastic elective. I saw a great many things, and everyone I worked with was lovely (very willing to teach and offer constructive criticism and they were great). I can't say there was anyone I didn't get on with.

I am now about 98% sure I'm heading into pediatrics. Now... that's not exactly a complete decision since there are just about a million specialties within peds. And I'm not saying that surgery is off the table... but... well... I dunno. I really really love ED. It seems to fit so well. Almost as well as peds fits. So lord only knows what I'm going to do now.

I'm wrapping up my life here in the States and gearing up to head back to Ireland. Final Med... bring it! I'm going to have to hit the ground running on this one since I'm a week late. But, I think I can handle it. Play like a champion... play to win.

Fark this!

2009-08-15T01:07:00.002+01:00

While I have many MANY opinions on this "health care reform" debate, I'm not going to lay out my own personal plan as of yet. However, I did see this on Fark dot com and thought I'd share it... because it makes me laugh in a good way (not the way that Fox news makes me laugh... which is a bad way).

"This morning I was awoken by my alarm clock powered by electricity generated by the public power monopoly regulated by the U.S. Department of Energy.

I then took a shower in the clean water provided by a municipal water utility.

After that, I turned on the TV to one of the FCC-regulated channels to see what the National Weather Service of the National Oceanographic and Atmospheric Administration determined the weather was going to be like, using satellites designed, built, and launched by the National Aeronautics and Space Administration.

I watched this while eating my breakfast of U.S. Department of Agriculture-inspected food and taking the drugs which have been determined as safe by the U.S. Food and Drug Administration.

At the appropriate time, as regulated by the U.S. Congress and kept accurate by the National Institute of Standards and Technology and the U.S. Naval Observatory, I get into my National Highway Traffic Safety Administration-approved automobile and set out to work on the roads build by the local, state, and federal Departments of Transportation, possibly stopping to purchase additional fuel of a quality level determined by the Environmental Protection Agency, using legal tender issued by the Federal Reserve Bank.

On the way out the door I deposit any mail I have to be sent out via the U.S. Postal Service and drop the kids off at the public school.

After spending another day not being maimed or killed at work thanks to the workplace regulations imposed by the Department of Labor and the Occupational Safety and Health administration, enjoying another two meals which again do not kill me because of the USDA, I drive my NHTSA car back home on the DOT roads, to my house which has not burned down in my absence because of the state and local building codes and Fire Marshal's inspection, and which has not been plundered of all its valuables thanks to the local police department.

And then I log on to the internet -- which was developed by the Defense Advanced Research Projects Administration -- and post on Freerepublic.com and Fox News forums about how SOCIALISM in medicine is BAD because the government can't do anything right."

One Month Countdown

2009-08-06T12:51:00.003+01:00

I can't believe that it's now less than a month until I'm back in Ireland, back at school, back for FINAL MED! AH! It's kinda scary. But somehow, I feel like I'm ready for it. Big decisions though, this year. Lots and lots of decisions. Some I'm not sure I'm ready for.

I started at Children's on Monday. After a bit of culture shock (a bit = head spinning), I feel like I've got my feet under me again and can be productive. Because I'm not actually attached to any one Attending, I've trying to get a feel for what each one wants in a presentation. It's hard since a few just want the problem and my differential (like, forget HxPC/PMHx/Meds blah blah blah). So to them I say, "Room 4, 12 year old girl with a bad migraine." Others want the whole shebang, which I'm much more used to. The strangest thing, in my mind, is the way that we discuss the differential, the diagnosis, the plan... then I magically type the plan in the computer and it happens. I don't actually have to DO anything (no bloods, no lines, no samples, nothing). Granted, probably more efficient... I feel a bit removed though. Oddly enough, there's a Surgeons Doc that works in the ER with me. She's cool. And she's going to sit down for a chat at some point so I can get a different perspective... maybe figure out my life.

So far, I've seen a few interesting cases, a few zebras. Yesterday was intense. Slow to start in the morning, learned rapid sequence induction, then spent the ENTIRE afternoon on one total heartsink case. It was a "Good learning experience" for me (I thought my attending was going to kill someone, probably herself), and it put one mark in the '-' and one in the '+' for peds. The '-' was the 3 hours on what should have been a simple case, complicated by a PCP threatening to call CPS, parents being unreasonable, culture mismatch, and practical issues. We had our social work involved to mediate and it all worked out in the end, but it was insanely frustrating. The '+' is something that I've know about peds for a while. And that is that through this entire annoying situation, I was never once frustrated or angry with the child. It wasn't her fault that she was sick, it wasn't her fault that she was in the ER, it wasn't her fault that her parents and the docs were having these issues. Not being upset with the patient helps me stay level. Because no matter how annoying parents are, you still want what's best for the child. In adult medicine, I sometimes lose that perspective, because it sometimes IS the patient's fault that they're sick, it IS their fault they're in the ER (say, instead of the GP office), and it IS their fault that they're a difficult bastard that won't listen to you. (and yes, clearly, sometimes, it's is the doctor's fault too).

I will tell you this though: "My child doesn't want to..." is NOT a valid excuse. Parents, please, for the love of all that is holy, if your child is 4 years old it is NOT their decision. You are the PARENT. This means that sometimes, you have to force your child to do things they don't want to do. That's your JOB. It includes things like making them go to school, making them brush their teeth, making them bathe occasionally, making them eat vegetables (Oh the HORROR!). They might not like it. They might not like you. Too bad. A little ire at 4 will be easily overlooked when they don't have scurvy at 12.

Ok, I'm done with my soap box... if anyone else needs it, have at. I'm on an evening shift tonight, so I have the morning to collect myself. Good thing too. I've a touch of gastro. It seems that just about all the Residents have had it in the past 2 weeks, and now I have it too. Welcome home, Liz.

Home Alone

2009-07-29T15:36:00.002+01:00

This week has been weird. I'm home alone, minding the "children" (ie: the cat and dog... who are acting like little brats. Apparently, they do that when my mom is gone). It's strange being in the house alone. I don't think I like it.

Studying... is going...

I start work on Monday at Children's. I'm pumped about that. Need to get off my butt.

Speaking of... Met with the Trainer on Friday. He kicked my ass. Full out, on the ground, thought I was going to faint or hurl, butt-kicking. I can run 10k, but I'm out of shape. So I chugged some water, sucked it up, and finished out the hour. I haven't been in this much post-workout pain since the suicide practice in high school basketball (our coach was pissed at us missing our free-throws during a game and he told us that we'd have to run a suicide for every one we missed in the second half... Our point guard had an off day. My shots weren't dropping either. And we had 45 minutes straight of suicides... Resulted in one girl with a strained hammy, 2 people puked, and I didn't want to move the next day... So SORE!) Anyway. I said "please sir, can I have some more." I have another round with the trainer in 2 weeks, and I fully intend to have it go much better (and I plan on having breakfast before I go to train). The yoga is going really well too... kicked my butt yesterday, but it was HOT in the studio.

I've also been icing my knee. It seems to be helping the pain issue. Not fully fixing the clicking, but I can deal with that if I'm pain free. So... only other thing to add is the final Summer Soundtrack for 2009. It's more chill than my recent stuff, but that's because I'm not running. Workout music tends to drive things a bit faster on my itunes. Studying slows it down. But... it's great music.

Summer Soundtrack 2009:

Paralyzer - Finger Eleven
Morning Nightcap - Lunasa
Fireflies - Owl City
Next in Line - Meese
Show Me What I'm Looking For - Carolina Liar
Look After You - The Fray
Somewhere Only We Know - Keane
Sweet and Low - Augustana
Say When - The Fray
This Town - O.A.R
Crack the Shutters - Snow Patrol
First Time - Lifehouse
Say Hey - Michael Franti
Say - John Mayer
Time to Go - Keane

The low down on the knee

2009-07-23T22:34:00.002+01:00

So... Knee problem - not fixed, but in repair. Here's the blow-by-blow of the past 2 weeks. Please disregard my sarcasm. I'm a horrible and ungrateful patient.

1) After the MRI was reported, I got a call from my Ortho. He tells me the MRI is "clean" except for "beginning chondromalacia" and I'm welcome to run if I want and it doesn't hurt. Maybe some physio to make the clicking go away.

So... his job is done and I never need to see him again. Pro: No surgery. Surgery is a bad thing, right? Con: This doesn't explain the pain pattern (being quite consistent with a medial meniscus tear) or the fact that he could pop my meniscus back and forth during exam (something he ignored when we spoke about the MRI)

2) I schedule an appointment for physio therapy and make a call to get my own copy of the MRI (you know, just in case something happens when I'm in Dublin... then I'll have a baseline, right).

MRI Report (gist): Changes of chondromalacia along mid patellar apex and medial and lateral patellar facets, surface irregularity and tiny shallow chondral fissures (no instability). Small knee joint effusion with mild synovitis [NB: no mention of this in the phone call?]. No evidence of meniscal tear.

... Ok, so this still doesn't explain the pain. Does explain the clicking and grinding and small swelling.

3) Went to physio today. I like the woman I'm working with. She's sound. Her assessment is that the chondromalacia and pain is a byproduct of running a lot (well... duh), the injury to my left foot, and my built-in body mechanics. Apparently I have ridiculously high arches in my feet (this I knew, but it's surprising to other people). But those in conjunction with little to no internal rotation from my R hip (it's like 10* on the R and 25* on the L) and the bigger sacrolumbral lordosis... This stresses the knee.

She agrees that the pain and the instability I've had is a meniscal problem, and w/dye injection, it could be picked up on scan... but I'm not sure I'm willing to risk my kidneys and knee to confirm what we already know (plus, there's be little change to management) - that I have damage to my medial meniscus that's not a full blown tear (yet).

So... new plan... I'm working with a trainer tomorrow at the gym to put together a lifting/cardio routine (must emphasize glutes/core/hamstrings). I have a series of stability exercises I'll be doing to help with the hip and chondromalacia bit. I'll keep doing alternate yoga - gym days (for my own sanity). And I'll not be running...

I dunno how long I'll be able to keep off running. I miss it, even if I'm doing other things to stay in shape. But... BUT if the pain goes away (for a consistent amount of time), a little light running should be ok. I interpret this as no races or running-training until after new years at the ABSOLUTE earliest. I dunno if I'll train for something in 2010, but the option is there. Running once or twice a week over "short" distances (which I feel is about 3 miles) when I'm back in Dublin (provided I'm pain free) is ok. And I'll need to find a yoga studio in Dublin. Any suggestions?

I have two more scheduled physio appts in August to add to the stability exercises and make sure I'm actually doing it right (cause let's face it, I'll probably cheat). I can add another before heading back to Dublin if I want, wait and do one when I'm home in Oct for the wedding, wait till I'm home for Christmas, or just not go back... We'll see. But I do like my Physio, so it won't be because of a personality clash.

So... that's the story. Chondromalacia + effusion + synovitis + meniscal damage (but no discrete tear). ... so no Dublin Marathon 2009 :(

C'est la vie.

Head - Shoulders - EFF!

2009-07-12T19:18:00.002+01:00

Let's play a game called "What's wrong with Liz's knee?"

a) chondromalacia
b) medial meniscus tear
c) lateral meniscus tear
d) all/more than one of the above...

[initial ortho asseessment done, MRI done... vote now!]

I'll give you a bit of background if you want to play with more detail than is possible on fb status updates.
1 - We're talking about my right knee.
2 - Yes, I've run 2 marathons, including the Dublin marathon back in October. I ran the Flora 10k June 1st and that's the last time I've been out for a run. (I may or may not have been injured following my left foot getting clipped by a cab about 2 weeks prior)
3 - There was never any specific trauma to the knee. BUT, I have played basketball for about 17 years, been running for about 15 years, played tennis for nearly 20 years, and was a catcher in softball for a number of years as well.
4 - My knee makes lovely crepitations (you can hear and feel - mostly just behind the patella) whenever I extend it, and it is loud enough to be heard going up AND down stairs over the sound of flip-flops.
5 - Pain is a transient thing, but it's mostly achy, about 3 hours post run, or after 3 days without running... Or for the past 4 days straight. It's both medial and lateral along the joint margins, and it's tender over my lateral and medial meniscus.
6 - Apparently, that little moving/popping thing all the way on the inside of my knee... That's my medial meniscus (as according to the ortho)

Other things I'll tell you: It was brilliant that on my first week back in the States, I was able to book an appointment with an orthopedic knee surgeon, have said appointment, book an MRI and have said MRI. I'll probably get the results tomorrow (Monday), about 2 business days following the procedure.

We'll see what the results are. Updates to follow.

Bit more from Donegal

2009-07-08T05:46:00.001+01:00

On Travelling

2009-07-05T14:49:00.013+01:00

First off, I'm no longer in my flat in Ranelagh (not now, not in the fall). I have moved! So if you need that new address, let me know.

I actually spent last week bouncing between 5 different places: Ranelagh, the new flat, the flat in Mullingar, Donegal with Sinead, and IFSC with Deter. Now... it's home in MN for the next 2 months. I don't like living in a bunch of different places at the same time (I've decided it's quite stressful), so I'm going to avoid that in the near future. But on the up side, I had some fun times travelling!So first stop: Donegal! After about 5 hours in a car to get there, a heaping pile of food from Lidl, and two bright pairs of leg-warmers... Ridiculousness ensued.

(I got stuck in a bog)

(We took over a castle)
(We ate a whole cow)

All in all, great times! Thanks Sinead... And to our credit, we did find Bloody Foreland eventually.

No sooner was I back in Mullingar when I had to pack up and move on out of the flat up there to head back to Dublin... And move out of my flat in Dublin. Big mega thanks to Deter for helping me move all my shmaz and Jim for letting me litter his room. Because ND is doing work on the O'Connell house flats over the summer, my stuff is split between Jim's room and the sacristy (It's weird to leave your stuff in a sacristy). Deter and I had a slumber party the last night in town (again, thanks for tolerating me).

I woke up around 4:30am to pane shaking thunder. I was 100% confused (not being in my own room, thunder and lightning in Dublin... what gives?!). It was the start to a very long day of travel. It continued to rain all morning, so I did have to walk across the tarmac in a white tee-shirt in order to board my plane home. Clearly, there was a delay and I was a bit strapped for time when I reached Chicago. I hit the ground running and managed to just make my flight to MSP. I love getting into the MSP airport. It's like once I'm there, I don't care if my luggage shows up or if the weather is crappy... I'm home.

We had a family dinner (minus Joe, plus Kirsten). Totally the best thing ever. I was nearly asleep at the table by the time we had dessert, but I couldn't care less. I love my family.

Last night (being the 4th), we went to the club for dinner and fireworks. We've been going there for over 20 years and I can't remember ever being rained out. It's brilliant.

So... It's good to be home. Time to get cracking on the work that's piled up lately. And for the time being, you can find me in Minnesota (and can reach me on my MN cell or my Dublin mobile).

~L

Tiny Babies

2009-06-18T17:39:00.002+01:00

There are days that being a med student is really frustrating. Frustrating because you see need that you can't help (YET), and there's so much going on that you don't understand (YET), and you find things that you've learned aren't really true anymore but you have to know them (FOR NOW), and people around you would really benefit from a second pair of hands, but your hands aren't qualified (YET).

Today was not one of those days.

We had mom with PET go into an APH at 27 weeks with a previa. For those of you that don't know, normal gestation for people is 40 weeks. In Ireland, the cut of for viability is 24 weeks (some places in the States use 20 weeks). So 27 weeks is really really early. Thankfully, it was 8am, the consultants were awake and some of them in hospital, the Regs and SHOs were on the ball, mom survived, baby survived. We had to call a transport for baby to get it down to Dublin (where they have the training and facilities to care for a baby this small). Let me tell you just how tiny this little guy was (and yes, it was a guy). He was <900g at birth, his head a bit smaller than a tennis ball. we had a miniature BP cuff on him and could only fit 3 leads of a neonatal ECG monitor on his chest. I got to see him in the SCBU (like a NICU in the States) as they were prepping for transport. As a result, I bagged while we intubated. I've never been worried about squeezing and AMBU too hard or really paid that much attention to the timing before. I did today. I thought intubating an adult, or hell, even a child was tough... this little guy's chest tube was only 7cm long. But he was very responsive, he opened his eyes, his vitals were solid enough for being 27weeks, and he peed on me. Go little man go. I think that's actually a good sign for the kidneys. After that, he was NGed, CXRed, and bundled for his first trip in an ambulance. All this before noon.

The best part about days like today is that it reminds me why I've been in school for so effing long. It makes the all nighters, the gray hair, the ulcers, the stress of exams... all totally worth it. It gives me a high (a good type of high). The worst part is that I leave a day like today and think, maybe I should be a neonatologist, maybe I should work in a NICU. (it's not that bad, but it makes me feel a little flippant about my intended specialty).

So it's 6pm now. I've been on a dinner break (we finished clinic early, woot! my consultant is awesome) since half four. I'm headed back to A&E in about 30 minutes to do another call. And I'm not tired. Really, 100% not tired at all. I love my job.

To Nancy

2009-05-30T20:59:00.004+01:00

"I'm not sure how it's going to turn out, except I'll die in the end, she said. So, really, what could go wrong?"
I don't think I ever saw Nancy away from Boston. So the majority of my memories with her are from Humarock.

I remember when I was about 4 or 5, we went into Quincy to meet up with Nancy and she took me through Faneuil Hall to "window shop." We stopped at just about every jewelery boutique and clothing display and she would critique the style, most of them being too subtle or too boring for her taste. She would ask me my favorite colour and then set out to find something "Gorgeous" to wear that was generally too excessive (even for my 5 year old self). I do remember that by the end of that shopping trip, she had found this little plastic purple box that had a purple notebook, purple pen, purple dice (I don't know why that was in there), purple bubble necklace, and purple pin with a panda on it that said "Purple makes life bearable."

At least once every time we were down at the beach, she would come visit. And that meant one thing, and one thing only when we were younger... Lion hunts. I don't remember exactly when we out grew those. But we would all sit in a circle (even Dan and Mike loved it... Well, Mike grew to like it after he stopped being scared of the Lion. And the Gradys normally would come over for them too), and pack our bags, and walk down the road, and through the big dark trees, and across the bubbling brook, and through the tall tall grass... She normally would convince me to get "Dressed up" for dinner. And she would help me do my make-up. And everything was glitter and shiney and colourful. As I got older, we would sit out on the porch with a drink (mine normally juice and I highly suspected that hers was not). She would take a long drag on a cigarette and say "Elizabeth. Tell me about boys."

I think the last time I had a good chat with Nancy was at Dan's graduation. And we spent a brief amount of time at John funeral together. She was such a character. She was dramatic, and wild, and larger than life. I love Nancy.

Little Bundles

2009-04-19T17:42:00.003+01:00

Work:
I'm moving from Obs to Delivery Suite this week (aka, Baby catching). The good news is that I'm on a decent shift from 3pm-11pm. It won't mess up my sleep-wake cycle too much. Plus, I'm a morning person. I'll get up, run, eat, study, nap, then head into work. The only problem is the conflict with the evening meetings (and such) that people kindly schedule for after 6pm... Oh well. Here's hoping I see some cool stuff, and deliver a few babies.

I've been struggling to set up summer electives so far, but I've recently made contact with a wonderful, helpful surgeon in Mpls... and (fingers crossed) I may get to be home for August. I'm so excited! I'm actually trying not to get my hopes up. If it falls through, I'll be up a creek. So keep me in your prayers, eh?

Surg Soc:
Managed to get myself elected for another year of running SurgSoc. The elections were far less of a disappointment than last year, and I'm thinking we can do even more stuff for 2009-2010. Here's hoping. The Inaugural is fast approaching and I'm feeling the crunch, but it should be a fantastic event! Mr. Barry O'Donnell is going to speak and he sounds absolutely brilliant.

Running:
I managed to finally find a new Running Journal and it's sitting in a post office waiting for me to pick it up (or rather, me waiting for the post office to be open so I can pick it up). It's the same one I have from last year, but I'm pretty pumped to get a new one. It keeps me honest, and it makes me accountable... It's an accountability partner without the same interpersonal guilt.

I've also (perhaps unwisely) registered for the Flora Mini Marathon (a 10k race on June 1... right in the middle of exams). But, it'll give me a reason to keep running through the stress. Here's to getting in shape!

Starting next week: The week rundown in running.

Count downs
* Days to the end of OBGYN: 19
* Days to the Flora 10k: 43
* Days to the end of Exams: 47
* Number of Exams: 7
* Days until Mullingar: 50
* Days until I go home!!!: 75

Spring is finally here!

2009-04-11T13:09:00.002+01:00

I'm going to probably eat these words... But spring seems to have settled in Dublin. Not only do I have a horrible case of spring fever (I swear Tom, if you say anything I'll kill you), but my allergies have arrived, the temperature seems to be solidly above 7, I'm itching to clean EVERYTHING in sight, and I've picked up running again.

I actually just got back from my first run. I've dabbled on and off all winter on a treadmill with a few miles here and there, but let's be honest... For a road runner, it doesn't really count until you're on the road, pounding pavement. I've set the next goal as the Flora Women's Mini-Marathon on June 1st. It's a nice 10k that I've done in the past, and it strikes me as a good get-back-to-running for spring type of event. Plus, once I sign up for that, it'll keep me running in spite of OBGYN work bearing down on me. (let's not mention exams yet please?)

I bought a new pair of running shoes just before the marathon in Oct (No, I didn't run in them, lessons to that effect were learned in the past, thankyou), so they're being broken in. And, as I found out today... I have one page left in my running log. That means it's time for a new one. It's always exciting getting a new training log (until I fall behind in my writing...)

So... Here's to the idea of a new running day! Joy!

On to cleaning, moving, getting a car, setting up electives for the summer, Step 2s, the rest of my life... AHHHHHHHHHHHH!

Ahem. Happy Easter!!! Tomorrow, in addition to Easter, my parents will be celebrating the sale of our house (it's been a long time coming) and their 29th wedding aniversary! They're a great team. I love them very much. And I don't think "Congratulations" is really the right sentiment. But I'm very very happy for them.

On to the studying...

I'm not Handicapped...

2009-03-22T20:05:00.004Z

No... no... You're not handicapped. You're an asshole.

I know it sounds rude... un-PC... a little bit like maybe I'm having a bitchy day. But I met a woman in a wheelchair today that actually created an awkward silence on a public bus by being absolutely rude (and rather racist) to a mother with an infant in a stroller.

Yes, the stroller was kinda big and the mother had stationed it in the "handicapped" cubby on the side of the bus (with her infant IN the buggy). There really was NO other place for the stroller to go. And when the woman came on the bus, she demanded the mother move (not ask, not wait for her to unlock the wheels of the stroller as she was in the process of doing, but demanded), then the stroller couldn't move far enough down the aisle to let the wheelchair into the cubby (because the arm on the elderly seat was broken and locked in the down position). So the woman in the wheelchair tells the mother to stop being stupid and move the buggy straight back down the aisle (where it clearly did not fit). The mother, who was asian, started to explain that she couldn't go back any further (and forward was out because the wheelchair was nearly ramming her infant). The woman then points to the sign that says, "Please allow for handicap access" and doesn't quite shout, but raises her voice saying, "Can't you read! You have to move!" The bus at the time was back in motion and the entire population of the lower level of the bus was suddenly fascinated with things outside the window.

The father, who was sitting in the back of the bus with a 2-year old toddler and a 5 year old child has finally managed to free himself of the children and other passengers and trades places with his wife. Then physically lifts the stroller 3 feet off the ground so the woman in the wheelchair can get into the cubby. (She backs in, btw, and stares down the entire bus). The father then sets the buggy back down and somehow manages to allow space for people to pass to get on/off the bus. You'd think that'd be the end... but no.

5 minutes later, the woman in the wheelchair looks at the father and says, "You might want to explain to your wife that this space is for handicapped people, not her bags."

I almost choked...

To his credit, the father was quite calm, and said, "No, I don't think that was the problem. There was no where for the buggy to go. She couldn't lift it like I could."

The woman scoffs and says, "Maybe if her English was better we wouldn't have had this problem."

Again... I almost choked.

Thankfully, my stop was next and I got the hell off that bus. In the back of my mind I was wondering who was going to help that woman get OFF the bus... The wheelchair ramp wasn't working and it took the driver and one very nice passenger to get her on and in the cubby to begin with, and that good samaritan had already departed.

I don't want to use the word entitled... but she was a bit of a bitch. And no, being in a wheelchair doesn't give you the right to be a racist bitch.

Swirling Dervish

2009-03-08T09:10:00.005Z

I really don't know what happened to the rest of February. But I can touch on a few of the highlights that I do remember.

1) Superbowl Sunday at my place... followed by some nasty food poisoning. Boo. To be honest, it wasn't THAT great of a game, especially in light of the fact that the 1st half didn't end until after 12:30am. Most people stuck around for the ridiculous full field returned interception to end the half and to see the Boss tea-bag the camera guy during the half-time show. PS: The Boss, still rocks hard. So I curled up in my bed, feeling a little queasy (chalking it up to the two beers I'd had), and watched another quarter of football. I couldn't keep my eyes open for much more of it. Then I woke up to (vomiting, boo on bad chicken from Superquinn) the ESPN highlight reel showing a crap load of amazing in the 4th quarter. I do like Warner. Part of me wanted him to win. But again... The Cardinals? Really? On another note, it's a good thing that Ben's a big dude. Otherwise they might have had to run his name down his arms. I'm always surprised to see that Rothesburger can fit on the back of a jersey.

2) The GP case presentations were the first time I left my flat since the Sunday. Then the MCQ, which was an absolute disaster... followed by a weekend in London with my cousin Kate. Kate has been living between London and NYC for the past few years, but after getting married last summer, she and Beck have set up a permanent base of sorts in London. I was really just back on solid foods at that point and not up to a huge crazy weekend, but that's cool because neither was Kate. We ended up seeing two movies: Slumdog and Doubt. Two totally different genres, two absolutely fantastic films. Doubt just reinforced how incredible the actors are, and the writing is even more impressive. Slumdog somehow shows the worst of India for two hours and you leave the theatre feeling good and uplifted. I don't know how that works (probably the dance sequence). But what a great story-telling mechanism. It was really intense. Anyway, aside from the movies, we went out for food and slept in and walked around Hyde Park. It was a chill weekend (and cold... My flight was uber delayed due to snow everywhere), and a good way to not spend all weekend in my room sleeping, but not draining myself entirely.

3) GP OSCE... was ok. Followed by the ICC for Surg Soc (huge undertaking, so glad it's over), then a trip to Berlin. It was Friday the 13th followed by Valentine's day, and I figured it was a good idea to get out of Dublin for that kind of weekend. Plus, I hadn't seen Heather since 2002 (at her wedding)... and that's a long time ago. We did a "walking tour" of Berlin that entailed walking, getting coffee, walking, getting breakfast, walking, getting more coffee... you sense a pattern? Yeah, it was really really cold.

Yeah, I'm totally clutching a coffee... and I was a little bit cold. I didn't have much time in Berlin, but I thought it was a great city. Again, it wasn't really what I was expecting from a capitol city, but it was really fascinating. It's a strong reminder that some things I've regarded as ancient history are really rather recent... Like the Wall, which came down in my lifetime, and I do remember.

3) I came back and jumped right into Paediatrics. New rotations = ++ work. And the super scary thing that I've been avoiding happened. I fell in love with one of my rotations. It didn't happen at first. Actually, the first week was just lectures, but it happened. Anyway. A week of lectures then it was the Trauma Module for Surg Soc (that's right, Liz does not have weekends off... ever.)

Let's thank Jack for being a good sport and letting us truss him up in the board. The Trauma module was quite successful and well received. But it did take most/all of my day. I was pretty beat.

The second week on Paeds wasn't great. It was split between lectures/tutorials and team work. My team wasn't terribly available (not that I blame them) so there was a lot of wandering around and being in the way. Plus, the winter-vomiting bug hit the wards and a bunch of kids and staff were sick, so it wasn't a good time to be on the wards. Bunch of my classmates caught paeds-flu (the "I'm around kids and suddenly I'm sick all the time" type of illness. I think I shook that back when I was teaching).

Last week I was up in Mullingar (small town west of Dublin), on part of my Paeds rotation. I loved it. I took 2 extra A&E calls because I wanted to be around the hospital and hang out with these kids... hm... Now I need to look into all the Pediatric options in the states... Scary.

And that brings us up to now... March... crazy... I'm in Crumlin hospital this week, Cavan next week, and back to Crumlin before the Paeds exams to wrap up the rotation. Then it's on to OBGYN, then exams, then it's June and I'm going... Lord only knows where. AH! Anyway... I've put off work long enough. Time to get cracking.

Praha!

2009-02-01T14:57:00.009Z

Since GP is just about the last taste of freedom I'll have until the end of final med exams, I've taken it upon myself to travel around Europe a bit. What good is it going to med school in the EU if you don't take in the sights, right? So last weekend, Mary and I took a random trip to Prague. When I say random, I mean it was on the list of about 20 different cities that neither of us has been to, and we both wanted to see... and the flights were cheap. (woot!)

I had no idea what to expect from Prague, save for what little I'd skimmed out of a travel book picked up at the last minute (in case I wanted a map of the underground... it was a good idea). Most of my preconceived notions came from imagined former eastern block type photos I'd seen... I don't know why, but that's what I was expecting. To be honest, after landing and hopping on a bus into the city, I wasn't really disappointed. Between the airport and the subway lies a bus ride through the concrete of state constructed housing, clearly meant to be functional, solid and warm, but not pretty. This was further reinforced as multiple billboards of a woman, scantily clad in all cameo and armed to the teeth advertising a local military supply store, zipped past the bus windows. And while, thankfully, everyone in the service industry seemed to speak English (as I know exactly zero Czech), absolutely everyone was serious. The people came off as quite dour actually. Much like the first buildings I encountered, I figured they were functional... but not all that pretty.

The airport bus dropped us off at the distant reaches of the subway system. This made me wonder why Prague had multiple layers of fully functional and efficient public transport, and Dublin was still trying to figure out the buses. So, down into the subway we went. At the airport, we had obtained 3-day travel tickets that allowed use of the subway, buses, and street cars (which sadly we never risked the journey on) and those tickets more than paid their way. After a minor detour and coffee and food, we managed to find our hotel. Now, the hotel was very nice. We had found a great deal on expedia and the location alone would have made the price, but the inside was lovely and the staff very friendly. I rarely see hotels where you leave the key at the front desk when you leave, but this was one of them. By the second day, they knew who we were and what room we were staying in. And breakfast was included (any economical traveler knows the value of an included breakfast) and was a lovely spread.

I think the first thing that struck me about city centre Prague was the architecture, the old and beautiful buildings that had clearly been around for centuries housing stores like H&M, Lacost, Sunglasses Hut, and KFC (yes... there were a lot of KFCs). It was such a strange juxtaposition that I did double takes just about every corner I turned. This is the first real thing I learned about Prague: It had been spared the massive bombings of WWII leaving the original city design and architecture untouched. And it was pretty.

We wandered around for the first day, taking in Old Town and Josefov (the Jewish Quarter), mostly gaining our bearings and trying to figure out what Prague was all about. For the evening, we found a nice little Italian place (great gnocci) and headed out for a ghost tour. Now, I know what you're thinking... what an effing tourist. But I've come to find that tours like this are a great way to learn a little something about a city (and in a way that I personally will remember it). Where else do you hear about famous defenistrations? According to the map provided by our hotel, there was a ghost tour leaving the town square at 8pm. Great! ... Then there was no tour guide... we were a little confused. Then we noticed a fellow leading a small pack of lost souls while carrying a lantern and umbrella. This screams ghost tour. I pop over and find out that he's actually just finishing the tour. (Massive disappointment!). But the next one starts at 9. Obviously, that means it's time for a drink.

I was told I had to drink the beer in Prague. I figured, hey, why not. And I will say that the beer is quite good. Now, I'm not particularly partial to beer and when I do drink beer, I tend to like the stouts and laggers rather than ale. But Czech beer is good. If you're there, try some. Even the Irish bar in town (there's one in every town) serves Czech beer... Go figure.

After our soul warming beer, we returned to the square to partake in the ghost tour. Now, for a bit of a shameless plug. If you're in Prague and you want to do a ghost tour, do McGee's Ghost Tours. There are a few good reasons for it. 1) Tyler is hilarious and brilliant. He makes the tour fun, even when you're dodging a Czech police car, furniture cart, and compact while trying to take a picture. Plus, you won't spend your time trying to figure out his accent. 2) You're going to have a good and interesting tour that skeptic and believer alike can enjoy. There is plenty of history and architecture discussion involved... and a little American College Football too. 3) You're not paying 350kr to have someone in a mask jump out and say boo. And while McGee has a bit of a flair for the dramatic (and a great evil laugh), you're not going to get a cheap scare. It's totally worth it.

(my sufficiently creepy picture of our guide)

(and a nice picture)

By the end of the tour, we were both pretty beat and kinda wet and cold (the temp was hovering just around freezing), so we headed in for the night. It only took a little while to figure out the heating in the hotel room, and I basically fell right to sleep.

The second day was spent on the opposite side of the Vltava touring the castle and surrounding neighborhood. The castle in Prague is beautiful, and a good portion of history in the castle is contained within the Cathedral. Mary and I traipsed around the grounds of the castle listening to oversized tv-remotes (audio guides) and trying not to let our fingers freeze. It was quite cold, and at one point, I actually tried to punch the buttons with my mittens on to save my fingers from the temperature.

(check out those buttresses)

We took our time taking in the sights of Hradcany and Mala Strana before crossing the Charles Bridge yet again to head back to the hotel. We changed into something "fancy" and headed out to the Opera. Now I have to give Mary all the credit here. It was her idea to take in a show while in Prague. It turns out that the government subsidises most of the arts to make them affordable to the masses. As a result, we took in Carmen for about €2. Can't argue with that. Granted, we were up in the nose-bleeds, but it was in the beautiful Narodni Divadlo so even the heights couldn't take away from that. Besides... I think Mary had wanted to take in some culture ever since Eddie and Aidan nixed the idea in Paris. Boys... (shakes head).

We set out early the next morning to get to the airport on time. We were way ahead of schedule, so camped out in a Starbucks (it's really weird to see Starbucks in places like Prague) and waited for Ryan Air to be ready for us to board.

You can see a heck of a lot in Prague over a weekend, but it's one of those cities that I'd love to go back to. I definitely don't feel like I had my fill of it in the two days. So... go see Prague. Great place.

A little light reading from my trip

2009-01-25T22:33:00.002Z

25 in Mississippi by William M. Priestley

This book was written and published (through Lulu.com) by a friend of mine that managed to survive his two years of being transplanted from Dublin (in the palest of the pale) Ireland to Pascagoula, Mississippi. And in spite of conspiring fates, hurricane Katrina, American women, broken down cars, broken collarbones, and the on-going challenge of a constantly changing classroom, he somehow emerged the other side with words of wisdom.

It's a great read for a teacher. It's a great read for anyone who's giving up a bit of their life for service (ala ACE, PLACE, PACE, JVC, TFA, Americorps, Peace Corps). It's adventure, romance, drama, and comedy written tongue in cheek with (what I can only assume is) a well restrained wit.

Will - Kudos!

Everyone else - Have a read!

View all my reviews.

Obama

2009-01-20T17:51:00.003Z

Speechless... I'm absolutely speechless.

Proud to be an American. A little unnerved having a president that is articulate and well-regarded. Breathing a sigh of relief as I watch Cheney wheeled out and Bush flown away.

But wow...

Predictions and Predilections

2009-01-19T18:21:00.003Z

First off, let me say that I have the utmost respect for people who put their names and asses on the lines to bring us the sports predictions every week. I don't have the guts to put stuff like that in writing. And beyond saying that I'm a HUGE Boston sports fan (Thanks to my father's hometown of Quincy and my childhood summers on the South Shore), Go Sox! Go Pats!... Ok, maybe the Bruins are just getting lucky this year. And I'll admit that the Celtics are a bandwagon that I've tried not to jump on. I'm not going to risk my pride by promising wins in any sporting events.

That being said. Bill Simmons (aka The Sports Guy) went 0 for 4 on his second round NFL picks. That alone could be demoralizing, but the man came out with a column to appease even the most cynical (and now deeply in debt to a bookie) fan. Here's one of my favorite bits:

The good news: We have to redo the Mount Rushmore of Faces. I can't narrow it down to four from these seven: The Troy Aikman Concussion Face (really, the face that got this running joke going 10 years ago); either the Joel Goodson "I Can't Believe I'm Having Sex With Lana The Hooker On a Train" Face or the Thomas Hill "I Can't Believe Laettner Just Made That Shot" Face (they're basically the same face); the Mike Myers "Did Kanye really just say that?" Face; the Manning Face (bonus points because not one but TWO brothers use it, as we saw these past two weekends); the Art Shell "I Died Two Quarters Ago" Face; and now, the Jake Delhomme "Seriously, I Might Get Beaten Up In My Own Locker Room After This Is Over" Face. If you think you can top any of them, knock yourself out. You won't.

He followed it up with a solid and 100% correct prediction for the AFC and NFC championship games, and I'm looking forward to the Superbowl suggestions. (The full article is linked to the title of this blog and has an amazing list of awards... totally worth the read).

After all that, may I say that I think the Steelers are after winning another Superbowl. My only justification for this is that being from Minnesota, my wardrobe is well equipped to handle some of the worst weather when it comes to cold. And I don't think that the devil is that good to me. I mean, what is the temperature in hell right now? -10? I mean... the Cards? Really? Sure, maybe the same Arctic cold front that's hit the States and Ireland has blown through hell as well. It's possible. But a Cardinals' win would make it a permanent winter there, and I think Satan only owns a banana hammock.

Onto things that govern my life a little more than American Football (sadly, yes, there are other things). Right now I'm on a GP rotation (GP=General Practice... much similar to Family Practice in the States). As with any medical specialty, there are pros and cons to GP.

Pros: The hours are great, 9-5 on most days; there isn't much stress or emergency; the GP I'm working with lives across the street from his clinic, is raising 5 kids, and takes a few minutes off to pick up the kids from daycare and drop them back at home while most people are on a tea break. Basically, the life style is nice. The money is nice. And if you have a good office assistant to grease the wheels, the business end of things can run smoothly.

Cons: You spend about 30% of your day on small talk (that's great for some people, but not my thing). You spend another 30% of your day trying to convince people to quit the bad habits that are slowly killing them (ie: no, that's not an infection... your cough is from smoking 3 packs a day). If you do your job well, you don't see your patients very often. But I'll tell you, the ones you don't want to see are the ones that keep coming back.

I really get why people like GP... But I don't think it'll be my thing. 2 more weeks in the surgery then I'm back in the classroom. I like working with my GP (he's great and let's me be ridiculously hands on), so don't get me wrong. I'm also learning a lot. But on the heels of Psych, I'm starting to itch for "real" doing. (Don't get mad. GPs do really important things... but for a student, it's not the glitz and glamour that I'll remember on my exams).

Music for the New Year

2009-01-10T13:23:00.002Z

Before you read the list, let me say that this has everything to do with my mindset on the 1st of Jan. Not all of the songs on the list are "new" per se... In fact, some are quite old. But I think you'll get the gist. And I listened to the list again last night when I was getting ready to go out... Excellent! I don't always dance around in my underwear when I'm getting dressed, but I did. Rock on.

Music for the New Year

Pony (It's Ok) - Erin McCarley
Suddenly I See - KT Tunstall
Live Your Life - T.I. (featuring Rihanna)
Lose Yourself - Eminem
Breathe, Stretch, Shake - Mase
Tequilla - Big Bopper
Hot N Cold - Katy Perry
Single Ladies - Beyonce
Shake It - Metro Station
Sex On Fire - Kings of Leon
Remember the Name - Fort Minor
Burn It To the Ground - Nickelback
So What - Pink
I Don't Care - Fall Out Boy
My Hero - Foo Fighters
Thunderstruck - Sprung Monkey
Stay Young - Oasis
Holiday - Green Day

So... there you have it. My musical attitude for the year :)

HAPPY NEW YEAR!

2009-01-06T22:18:00.002Z

Ok. So this year I made the decision not to make any resolutions. No list of rules. No restrictions. No ridiculous goals (and no... probably not another marathon... but don't hold me to that, because I didn't make a resolution NOT to run a marathon). Instead, I wrote a letter to myself. Yeah, weird right. I know. But it was actually a fun thing to do. I took a piece of paper, addressed it to me, and wrote to me. I said some nice things to me about me. I made a few comments about how I did last year. I made some suggestions for next year. And mostly, I told me to be nice to me. Neat, eh? I thought it was cool. And no, Annie, I'm not going to kill any snow lepoards.

I'm not going to put the letter up here. Sorry, it's kinda personal. But what I will do is post my list of new years songs on the side bar. That's right, to over-shadow the summer soundtrack, there's a NEW YEARS PLAYLIST! Rock on. There's a bit of attitude in it... that's cause I've been feeling a little sassy. But I started off new years day, in the gym, rocking out to this mix. Enjoy!

In other news, my rotation on Psychiatry is officially over. I'm grateful for this. I did not enjoy it. The teachers and tutors were great, and supportive, and encouraging, and excited about psych... but there's something about having a chair thrown at me that just puts me off. I wouldn't cut it in psych. Give me blood and guts and a knife and a needle and thread. Liz would be happy. Crazy people make Liz more crazy than she already is, and we don't need that... Look, I'm talking in 3rd person.

But, because I feel the need to make a tribute to psych, here is my parting contribution.

HOW NOT TO TALK SOMEONE DOWN

Worst Suicide Intervention Ever -- powered by Cracked.com

Who throws a Shoe? Honestly?!

2008-12-15T20:00:00.002Z

I have to say that the shoe throwing (in my mind) has eclipsed the whole choking on a pretzel incident as one of the dumbest and most amusing events in Bush's presidency. That being said, it was wholly insulting (read the NYTimes article linked to the title of this post). But again... the dude threw a shoe.

So, I've been a bit MIA. My bad. I've been on a psych rotation, and it's taken all of my energy not to hurl myself out a window. Note to self: Psych is off the table. It's been the most depressing 6 weeks of my life, and I've found more crazy in myself than I ever thought existed... and ever want to discover again. Did you know I have a problem with open cupboards? I mean... I really do. *sigh*

The good news is that I've been getting out of Dublin from time to time. I went down to Kerry on Thanksgiving weekend with a horde of peeps that was an amazing group. We cooked a 17lbs turkey (17-lbs!!!) in a little bitty oven. We went swimming in the sea (and as you can imagine, it was quite cold) twice! We did a pub crawl through the town's two pubs. And we did it all with child like glee... at least, that's how I did it.

The following weekend, I took off for Paris. Why Paris? Why not Paris! It was a great time. Though it turns out my french is a little worse for the lack of wear. Maybe 6 years away from a language is a little much... But I still understand a lot of it. I just can't speak it very well. Anywho, a weekend in Paris was just what the crazy doctors ordered.

The Tuesday I got back was the Christmas Concert followed by mulled wine and minced pies (yum!). I think we put on a kicking concert! I managed to sing a quasi-solo in spite of my near vomiting nerves about singing in front of people. I've overcome the whole singing thing as long as I'm not the ONLY one singing.

I threw a little Christmas party on Thursday that involved egg nog, mulled wine, christmas cookies, and decorating my apartment for the season... I'll have to take a photo of that before I head out. Then had a dinner party on Saturday (I'm so civilised). Now I'm looking at the last week of the semester, last week of psych (thank God), and last week in Dublin before heading home for Christmas. I'm so ready to go home. It's -17 in MN (-8F). And there's SNOW! I love snow. One more piss-up (Thurs), one more party (Fri), one more day to shop (Sat) and a day to clean and pack (Sun) and then I'm home! Can't wait!

Peace,
~Liz

Shout Out!

2008-11-02T00:23:00.002Z

If you click on the "Shout Out" above... You'll hear the interview on the Will Leahy show that Rob Maschio did. We at RCSI, the Surgical Society, and ME!!! We got shout outs... awesome.

Back in the Game

2008-10-27T18:26:00.004Z

Ok, I know it's been nearly a month. Sorry. I got back to Dublin and was sent out to Kilkenny for a 6 week Med/Surg rotation. But I like Kilkenny. St Luke's Hospital is great, the people down there are wonderful, and the town is a cute little medieval place. I just wish I had internet and tv down there. Living out of a suitcase gets old very quickly though. It's almost over though, and I'll be back in Dublin full time (at least until Christmas)

I have 2 cool things to talk about that have happened since I got back to Dublin.

1) I managed to pull off the Todd event. Rob Maschio came to RCSI and gave a one hour chat to a packed lecture theater, we took him out to dinner, then out for a night on the town. And, in spite of the fact that it was a Wednesday, we were out until 3am. I was asked, and conducted, an interview over a late breakfast and coffee... I'll post the article when I get done writing it. And then we did a group dinner on Saturday night. It was great week. It worked out surprisingly well.

Yeah... that's me and Rob, probably at the Swan (I know this because I don't look entirely intoxicated).

2) I just finished the Dublin marathon. I'm ridiculously sore (mostly because I didn't train as hard as last time, and I'm carrying around a little extra weight that I didn't have last time), but I finished in 5 hours. Finished being the operative word. It wasn't pretty, but I finished. I'm quite proud of myself :)

That little red blob is the victor of "Survivor: Gummy Bear." I had 27 gummy bears in a bag, and ate one for every mile. So, if you guessed "red," you won.

I spent about an hour last night putting together a playlist for the marathon. I ended up with like 8 hours of music (and obviously didn't need that much), but I have a few highlights from the race.
* Mile 0 (at the starting line): Erasure - Respect. It was a great start song, and... the start of a marathon is ridiculously anti-climactic. The gun goes off and you stand there for a few minutes before you move. Then you start trotting for about a mile before the crowd thins enough to actually pick up to the normal pace.
* Mile 8: Kanye West - Stronger. This is one of those songs that's brilliant to run to. And at mile 8-ish there are a series of hills that are quite rough. But it's an amped up song that helped me get through the hills.
* Mile 10 (I think): MIA - Paper Planes. Enda, this is what I was rocking out to when I nearly missed you.
* Mile 18: Kansas - Carry on My Wayward Son. I was suffering around mile 16, so 18 was just getting worse. And I really wanted to walk. But this came on and helped me keep going for a bit longer.
* Mile 20: Simon & Garfunkle - Cecilia. This song is impossible to stand still to. It was a nice little kick at the time, that and Knut and Hana waving.
* Mile 24: Pretenders - 500 Miles. I know this song is pure cheese. But seriously, I was dying. The irony is too much and I started to laugh. Now, laughing is a little painful at 24 miles, but smiling when you run helps your running posture and relaxes you.
* Mile 26.2 (Finish Line): Journey - Any Way You Want It. I only remember this because it took me a while to turn off the ipod... mostly because I couldn't find the buttons, then I couldn't get my headphones off. *sigh*

Other interesting intrusions: The Doors - Riders on the Storm, Offspring - Pretty Fly for a White Guy, and Dr. Evil and Mini-Me - Hard Knock Life (hilarious).

Anyway, that's my run down on that... Now I'm going to lie flat for the rest of the day :)

On Mac Trucks and Other Large Vehicles

2008-09-27T23:22:00.003+01:00

Have you ever felt like you've been hit by a Mac Truck, but you can't be sure... and the fact that you can't be sure just makes you a little more convinced that it probably did happen? Well, that's where I am right now.

Since I last updated, I've gone through a whirlwind adventure of ... um... sugar and shit? With my health questionable, I had a rough go of studying. I did get a massage, which helped a bit with the migraines. That was a nice relief.

I went to ND. Studied on the drive down. Hit South Bend (official No-Study zone), went to dinner with my friends, had a beer, and fainted again. (Vito, I'm so so so sorry for freaking you out). Apparently, my blood pressure and heart rate were so low that sitting in a car for 8+ hours, being a little dehydrated, having a bit of a low blood sugar moment, and feeling like I'm going to be sick adds up to fainting as well. This has led to the conclusion that it's vaso-vagal and probably a relic of last years erosive gastritis. Couple that with the running I was on a break from and I just hit the floor. I really need to be careful about these things. The worst bit was that we were out at a bar. Anywhere else and I'd have laid down until the sensation passed. No such luck, and I still wound up on the floor. Boo.

ND beat the tar out of Michigan. Woot! It was pouring in the morning until nearly 10. This dampened the tailgate spirit a bit, but it was still a fun morning. I got hang out with the Dillon guys and co., and my little brother (who came down from Ann Arbor to relish in the Wolverine defeat) and his friend Rico (a scrawny, blond, white kid... where did the name Rico come from? no clue). Then it cleared up and we had a dry 1st half... highlighted by paratroopers delivering the game ball, two Michigan fumbles on successive kick returns that led to a 17-0 score at the half. Then the skies opened. I blame the Michigan band for playing *Nsync, 98 degrees, and Backstreet Boys... ND slugged back with a bit of Bon Jovi, a little more appropriate, I'd say. The entire 2nd half was drenching rains. But I still enjoyed it. PS: my seats were absolutely unbeatable (Thank you dad!).

Sunday was an early morning drive in the rain back to MN. I wasn't feeling at the top of my game, but I studied on the way back, all afternoon, all night, and then Mon as well. Tues was the day before D-day, so I did minimal studying that day and tried to relax. Now, seeing a funny movie would be a great way to relax, but the movie I wanted to see had been bumped for a preview of a crappy movie and I had to change plans at the last minute. So, Bill and I saw Bangkok Dangerous... There are no words. I had invasive thoughts about that movie during my Step.

Took the step on Wed. No clue how it went. Really... No idea at all.

Tried to lay low on the last few days I had in MN. I went out with Hayes, met her boy (which was fun to do... I like having faces to go with names). Went to the ND v. MichState game watch and ran into Michael Rossman (haven't seen the kid in ages!) so while the game wasn't great, the game watch was a good time. Went home to a nice, late, Larkin Family Dinner... went until midnight... crazy. And met Garin for coffee the next day (and I hadn't seen her in a long time either). Quote of that conversation: "Now, I don't know how many trannies do this, but..." Hilarious!

I sort of hit the ground at a rough stumble in Ireland on Tuesday the 23rd. This was in part due to general disorientation at coming home after being home for 3 months... it was a little weird. But probably a little more to do with my 9:30pm flight out of JFK was delayed and ended up taking off at 12:30am, they didn't turn off the lights on the flight, and served dinner an hour into the flight... I mean, really? So I had just about the worst jet lag in recent history.

Orientation was slow, brutal and dirty. I found out just how challenging Med/Surg is going to be (and the 30 tests that accompany it). Plus, I'm not down in Kilkenny until Monday week because I'm in Beaumont doing this special one week thing about emergency med. It sounds like a cool course, but I wasn't expecting it, or expecting to do it right away. It's just nuts. I completed my BLS again this morning (CPR and Heart Saver). My instructor was the saving grace of the day... Kept me and Cara laughing pretty much the whole time. I think this year should be great, but at the moment I'm feeling a little overwhelmed. But, my floor still looks like my suitcase vomited, so that's probably a bit of the problem.

Tomorrow I start studying. Monday I start work. So today, I pissed around all afternoon. Yay!

On a side note: Congrats to Mary who is graduating (finally) this weekend from Oxford for all that Masters work she did before RCSI.

Marathon:
So, it's up in the air. I need to run this week, get my legs back, and the final day to register for the marathon is Oct 6th (for the 27th). I go back and forth on it. We'll see... that's all I can say.

Summer Soundtrack:

Life in a Nutshell - Barenaked Ladies
Girlfriend - Avril Lavigne
How Far We've Come - Matchbox Twenty
In Da Club - 50 cent
Handlebars - Flobots
When I Grow Up - Pussycay Dolls
Time to Pretend - MGMT
Vampire Weekend - A-Punk
Troublemaker - Weezer
Viva la Vida - Coldplay
Paper Planes - M.I.A
Breathe, Stretch, Shake - Mase (this is for attitude going into the USMLE)
Chelsea Dagger - The Fratellis (this is for attitude when the USMLE was done)
Her Eyes - Pat Monahan (this was just about the sweetest dedication I've ever gotten... Totally blushing over this one. Thank you)
Wake Me Up When September Ends - Green Day (The closer of this list... so sad... but appropriate. Here's to the end of the summer and the end of the summer play list. It's been a kick. And I will keep this play list on my itunes in memory of the summer that was what it's been)

T-minus 10 days

2008-09-07T23:04:00.002+01:00

This week started strong and wound up in the gutter. After Wednesday, the only time I felt reasonably ok was during the ND football game on Sat (and then, it had nothing to do with what I was watching on the big screen). I have, unfortunately, come down with something of a late summer flu... which set off a series of migraines... which, because of the low-grade fever and aches, don't seem to respond to my normal anti-migraine action... which makes it really hard to read... which means that studying has been near impossible... And that I've been feeling like crap.

I've decided to handle this with the grace and poise of a sick 5 year old and just stay in bed and pout. Plus, I've scheduled a deep tissue massage for tomorrow to help ward off further migraines. So... shit rolls downhill, and this stupid little flu has affected my major summer efforts.

Marathon Week #11: 9/1-9/7
After a light week last week, I attacked this week to hit every run, and I was doing really well. I felt great after the 5 mile runs, and actually really good after 10 miles. This is a little inpart to the change in weather that brought the 6am temp down to 50. BUT... after my run and lift on Thursday, I came down with a fever, malaise, and myalgias. (look at me talk med-jibberish) Friday is my day off, so I did some lite stretching, but I really crashed friday mid-day. That meant no early morning on Sat, no 10 miles on Sat, and certainly no 20 miles today. I was feeling much much better today, but crashed at about 3pm. I'm going to do a light cross train tomorrow, maybe a little lifting and decide if I'm going to run on Tuesday based on how I feel after the massage.

USMLE Update:
Again, studied strong Mon-Thurs... then came the migraines which mean blurry vision. Anyway, I'm pretty much gearing up to take this test. I don't feel like I'm 100% prepared, but I don't think I'll ever be. But I feel like I'm preparing to take this test rather than trying to not fail. It's a much better place to be than I was before.

Summer Soundtrack:

Life in a Nutshell - Barenaked Ladies
Girlfriend - Avril Lavigne
How Far We've Come - Matchbox Twenty
In Da Club - 50 cent
Handlebars - Flobots
When I Grow Up - Pussycay Dolls
Time to Pretend - MGMT
Vampire Weekend - A-Punk
Troublemaker - Weezer
Viva la Vida - Coldplay
Paper Planes - M.I.A (Great song... note to self: don't cruise around downtown Mpls while the convention is going on and the cops are out with this blasting from the car... Cops don't like the sound of gunshots.)

Light at the end of the tunnel

2008-09-02T20:51:00.006+01:00

Is it the end? ...or is it an oncoming train?

Things are still all up and down. I'm going through more mood swings than a pregnant woman (and no! I'm not pregnant). At the moment, I just want this disaster to be over. I'm trying to break up my study days (and I'm up to about 9 hours of studying each day) with some running and maybe an hour of mindless tv (gotta love CSI-Vegas and the Closer for that). Plus, I'm isolating myself in a soundless room for about 3 straight hours so I can get used to working in boredom. That's about my all that's going on in my life.

I go out for a drink every now and then with friends to try and remind myself to be normal and socialized... it works... sort of. But I have my calendar set for the rest of the summer to get things taken care of.

My cousin Kate (who was married at the end of June) emailed pictures from the event. I have two new fave picts from it:

I look so short! (and the sad part is, I'm wearing 3 inch heels)... Oh well. Don't my brothers look classy? I think that second pict looks like something out of a GQ magazine... at least Joe does. Mike looks like he probably has a gun and is threatening someone who made a crass comment. But they're great picts.

In other news, Brent got engaged! So uber congrats to Brent and Kate!!!

Marathon Week #10: 8/25-8/31
I decided to take a light week on the running to refresh myself. I was really burning out energy-wise, and I think I needed the break. I have one tough week next week, then a light week before the USMLE. I'll still have a month when I get back to Dublin to tighten up my training and decide if the marathon is going to happen. I think if the USMLE is done, it'll be a lot easier... Hm... a marathon... easy... I'm sick.

USMLE Update:
After some massive panicking, I've spoken with some people that calmed me down. My test is set for the 17th of Sept, which is just about the last feasible day before I leave for Dublin (Sept 22). I think I want to do this and be done. I keep freaking out though. I'm not sure if I'm more scared of failing or of doing well enough to just pass and being stuck with a weak score. But... I think I can get around a weaker score with Step 2 and my interviews... I hope. I don't think it would behove me to try and take this at Christmas. *Sigh* I just want to be a good doctor. And part of me is resistant to the idea that I need to know all of this crap to do that. I know it's another hoop... but it's high, and it's on fire... I'm sick of jumping through hoops. Here's to two more weeks of studying.

Summer Soundtrack:

Life in a Nutshell - Barenaked Ladies
Girlfriend - Avril Lavigne
How Far We've Come - Matchbox Twenty
In Da Club - 50 cent
Handlebars - Flobots
When I Grow Up - Pussycay Dolls
Time to Pretend - MGMT
Vampire Weekend - A-Punk
Troublemaker - Weezer
Viva la Vida - Coldplay (I'm totally addicted to this song. I just love it, and it's so mellowdramatic)

My Eyeballs Hurt

2008-08-27T01:46:00.002+01:00

It's been a week of ups and downs... Lots of them... all over... and it's hard to say what I think about them because there hasn't been the time to think, except about USMLE High Yield stuff.

For starters, Friday was my baby bro's birthday. He flinches every time I call him my baby brother, so I like to do it as much as possible. But for the record, he's 23 now... what a geezer. Kidding. He's awesome. We didn't really "do" much for his birthday, but we had all 6 Larkins in one room for a meal, and that happens so rarely now. Plus it was great food, and good humor. Unfortunately, I can't repeat things that were said. Either they're too dirty, they're too non-PC, or they name names and that's just wrong. But it was an amusing dinner/drinks.

Jesse was in town (I think he leaves tomorrow), and we went out to dinner to catch up. I feel like I dominated the conversation a little (small side-effect of sitting with books all day and talking to no one... I become more of a chatter box than normal). Jesse's now engaged (I'm super excited for him, because Nora-from what I've seen of her-is great!) and planning the wedding while getting ready to start up a Masters program. Some of my friends are so cool.

Marathon Week #9: 8/18-8/24
Well. Hm. I missed the long run again this week. This is getting annoying. But, I'm cutting myself some slack. I can do hour and a half long runs, but if I'm giving up 3+ hours, it starts to stress me out (see the USMLE below). Plus, Sunday morning was rough. I'm not going to say I was hung over, because there wasn't enough alcohol to do that. But between the lamb (I don't eat red meat all that often), the potato, the garlic veggies (I'm mildly allergic to garlic... but it tastes SO good), the beer, the wine, and the really really sweet cake... I had like a long-running food coma. I was in no shape to run at 7am. Especially not a 12 miler.

I did hit every other run I was supposed to do this week, plus my two days of lifting, and two days of yoga. I changed my run schedule to right when I get up (between 6:45 and 7:15 every morning). It gets me revved up for the day, and I can sit for about four hours after on a nice little study binge. Plus, a spoonful of peanut butter gets me through the run and I can have a big bowl of fruit and cereal when I get home. It works better with my eating and my studying, so I'm going to stick to it. I may take a light jog the morning of the test too... just for the heck of it.

If it really is week 9 (and I'll have to check to make sure that's correct), I have another 9 weeks before the marathon... which sounds right. That's enough time to get my long runs going after the big test day. So I'm sticking with that idea for now. I think a lot will depend on how I work out running with whatever my schedule is at RCSI. But I'm going to keep it on the horizon.

USMLE Update:
This is where I had my worst swings. I took my second NBME, and failed it. I just passed the first and just failed the second. I freaked out. Really really freaked out. (Big thank you to Lianne for being the ever wonderful voice of reason). As a result, I amped up my studying. I'm running about 7 hours of productive studying each day (and maybe an hour more that's a complete waste). It's hard to sit still that long. It's hard to read that much. It's hard to write notes that often (It's how I learn... it's slow and stupid but it's how I learn). But, I'm getting further every day. I turned around and creamed three Kaplan quizzes in a row. Like, killed them. To which I say, WTF?

It's all rumors and conjecture. Who knows what you'll see on the test, how it will be worded, how you'll understand it at the time. But, I've been keeping track of a few things. 1) my overall % is going up. 2) my tests are consistently better. 3) I'm taking more of the alloted time to do the tests. 4) I've stopped changing answers (this was the worst.). Plus, I'm getting the hang of the software. I take a 3rd NBME tomorrow. Depending on how it goes, I'm giving myself Saturday off. I won't make it to the test on this schedule without a day off. It's good to know. I think I'll go see a movie with my mom.

Speaking of the test day, I've pushed that back. It was originally set for August 29th. After my freak out, i moved the test. It's not Sept 9th. It's still before the ND v. Mich game, but it gave me a two week extension that has already been to my advantage. We'll see how I'm feeling next week on this.

Summer Soundtrack:

Life in a Nutshell - Barenaked Ladies
Girlfriend - Avril Lavigne
How Far We've Come - Matchbox Twenty
In Da Club - 50 cent
Handlebars - Flobots
When I Grow Up - Pussycay Dolls
Time to Pretend - MGMT
Vampire Weekend - A-Punk
Troublemaker - Weezer (I don't know why this song inspires me, but it does. It makes me laugh, and right now, that's what I need. So, week 9 = troublemaker)

WTF?

2008-08-18T21:10:00.002+01:00

Hi Friends,

So, I've been MIA for the last 2 weekly posts and a day late on this one... Wtf, right? It's simple, I'm slowly going insane. This has to do with a combination of studying, friends being in town, friends leaving town, me leaving town, studying, trying to get my address changed on every legal document required, studying, stuff for Surg Soc, running, studying... sigh. Needless to say it wasn't all bad.

First, I went out to Taylor Falls (WI) to hang out with Lydia, her friend Sarah, her brother, and the dog up at the cabin. It was a great afternoon/evening/morning of relaxation away from my books... I only brought one with me (it was hard). But we went boating and the weather was perfect for it. We had a huge dinner of just about everything, where everyone made something to contribute, and then just chilled for the night. I got up earlier than everyone else and decided to take the dog for a run with me (4 miles... and the dog put me to shame!). We had coffee and breakfast at a local coffee shop and headed back to the TC. It was a short trip, but it was fun.

Em got back in town just before I got back from Wisconsin. I love hanging out with Em. Actually, it was with Em and Kurt (I sort of assume it's the two of them together) for boating and dinner and catching up on life. I sometimes worry about hanging out with couples (it's getting to be that time in my life where there are about as many couples as singles), but Em and Kurt are so much fun to be around, and I've never felt like a third wheel with them. I think it comes from a certain level of comfort with each other that puts everyone else at ease. Regardless, I'm never worried that I'm going to say something that will spark an argument... and that's saying a lot considering how much time my foot spends in my mouth.

I drove out to Chicago (yes, again). It turns out that Chicago is about halfway between Minneapolis and Saginaw, which is where Aidan is spending his summer. It also turns out that the "Empire Builder" line that runs between Chicago and Mpls is extremely popular (perhaps due to the upcoming Republican Convention) and was sold out. So, Lydia and I drove our little butts out there... made record-breaking poor time in the process. It only took five hours or so to get to O'Hare airport, but due to both the Chisox and Cubbies playing home games at 7pm, it took three hours to get from O'Hare to the South Loop (most of which, I'd thrown my car in neutral and coasted, and I got off 94/90 asap and onto Halstead... which was remarkably fast at 30mph). It was a long drive. BUT Pete ordered Lou's Pizza before I got there and we ate fabulous deep dish for dinner. And again, Pete is awesome and let me crash in his apartment with little to no prior notice.

We drove back to MN the very next day, heavy one goofy Irish dude, whom we subjected to steak sandwiches in Chicago before heading west. I should comment that Aidan's train was roughly an hour late getting in, but I bought myself a Runner's World magazine to keep me entertained in the mean time. When we got back to MN, we rolled into the townhouse to meet Em, Kurt, Hayes and my older bro to watch the UFC fights that were going on at the Target Center (a mere 10 minutes from the house). It was much more fun than I thought it would be (which we've decided is due to amusement of watching in a group).

While Aidan was in MN, he made every effort to see that I kept studying, and I made just about every effort not to, which ended up with me studying when I got up in the morning (I'm an early riser) and most afternoons. The highlight of Aidan's stay (most amusingly) was the Irish Fair. I try to get there if I'm home, and the weather was fantastic. The review of a real Irish person: "It's a bit of pride, a little stroke, and a bit of shame... I'm not sure which one is winning out." I just find amusement in what some people consider "Irish." But I caught a little of my old dance school hardshoeing on the main stage, and we watched a Rugby exhibition. So... good times. Em and Kurt had us over for one evening to watch a bit of the Olympics and a little hottubbing... which ended up in a midnight swim in the Mississippi (it had to happen, and now Aidan can talk about the one time he went swimming in the Mississippi River).

Lydia and I hung out a few more nights, chilled, watched the Olympics, partook in Galaxy pizza (these guys deliver the pizza in these mini-scooter/cars dressed up like superheros... amazing!) and caught up on life. Lydia just left town. So the number of people I socialize with here in MN is dwindling... which is probably good, because now I have nothing to do but study (and attack my mile long To-Do list). But Hayes is here and so is Bill... so when I get really crazy, there are people to bring me back to reality (thank goodness).

I just saw "Pineapple Express" last night... um... HILARIOUS! And I had the distinct impression that the movie would have been even more amusing if I had been high... except, I felt high for most of it, which may have been the point, so maybe being high would have made it more serious... I don't know. Anyone been to see it high? More amusing, I was at the 5:45 showing... the one that followed the 4:20 showing... I'm not sure I'd fit in with the crowd that attends that one.

Now, all I have on the horizon is more studying, more running, more studying, Jesse being in town, the MN State Fair (something everyone should experience), some more studying, and the USMLE.

Marathon Week #8: 8/11-8/17
This week was rough, friends. I should have registered for the marathon at the end of this week. I was gunning for a 16-miler on Sunday. Things don't always go as planned. Now, I'm seriously wondering if I'll be able to run Dublin. And it boils down to a few very serious factors.

First, I was lazy in my running early this week. I suck at running when I'm on the road (traveling, not literally on a road). So I missed my Sat and Sun runs when I was in Chicago... I could have done the Sat in the morning, but I passed it up in favor of getting a much needed pedicure. And while I lifted and cross-trained when Aidan was in town, I didn't do my runs. It's entirely my fault. I'm just bad at prioritizing running sometimes. This makes me worry about what happens when I get back to Dublin... If I'll be able to keep up the miles I need in the month before the race.

Second, I haven't been hitting my long runs. I'm excellent on my short runs and good on the mid-distances. But the long runs are coming up short. Either the heat gets to me or I just wear down too fast. Twice now I've had my body shut down a bit past 10 miles... And, while it wasn't anything like I couldn't walk, it's still frustrating and disconcerting. I have to keep reminding myself of how hard it was the first time around, and that I'm not twenty anymore. I definitely don't recover as quickly.

Third, and please don't freak out over this, yesterday I had a particularly bad experience in my long run. I was aiming for 16 miles, and pulled up short at 13 with chest pain. No, it wasn't a heart attack, or angina, or anything like that. But I'll tell you, that all passed through my mind and I managed to pitch myself into a little panic attack. (I hate panic attacks, I rarely have them, but if you don't know what they're like... they're horrible and they do nothing to calm you down when you have chest pain)... The pain was actually a cramp in my right pec muscle, or teres, or something, don't argue with me on this. Regardless of which muscle it was, the point is that it cramped up (probably because of the knots in my shoulder and neck muscles) and it really, REALLY aggravated the still healing break in my rib. I've been trying to rebuild the muscle I lost after breaking my ribs and every-so-often there's some pain involved. Bony pain is much different than angina pain, Trust me (I'm a doctor). But it still freaked me out. I had to walk and massage out the cramp while trying to get my breathing to return to normal. It scared the piss out me really... And I know it's going to make it hard for me to head out on the remaining long runs I have this summer.

Finally, and this is ridiculous, and I wish I didn't know myself this well, I'm scared. I'm scared of commitment. And I'm terrified of failure. The last time I tackled a marathon, I was out there with something to prove, but it had nothing to do with commitment and it was in attempt to overcome what I viewed as a serious and personal failure. And I was really really angry... I'm not angry anymore, and I'm not trying to run away from a failure (literally or figuratively), which means that it's all about whether or not I can perform. That's scary. Plus, the running is a huge commitment. I hate commitment; just ask any of my ex-boyfriends. I feel like I've already thrown so much into Medicine right now and made huge life decisions in that realm that another commitment is just too much. I know it's just a run. I do. But... this is what goes on in my head.

So... do I run Dublin? I dunno... we'll have to see. Anyone have any advice?

USMLE Update:
I've hacked away at a butt load of Cardio (stuff that I should have learned first year that I'm just understanding now... seriously, how did I pass first year?) and piecewise Immunology, Pharmacology, Embryology, and Biochem (ooh, my fav!). My scores on Kaplan are coming up, but I'm not sure it's coming up enough. I'll take another NBME tomorrow (I keep putting this #2 NBME off... enough!). But, friends, I think I've made the decision to put off the USMLE by 2 weeks. I know this goes against most advice, but it took so long for me to overcome the burnout of the Exams-OSCE combo that I only started being really productive recently. C'est La Vie. I know that it's only a test (and not the most important day in my medical career)... but it's a test that counts for a hell of a lot. I don't want to take it just to be stubborn and have to battle a poor score when looking for residencies. I wish I could just plug my brain into a computer and download all the information (ala Matrix)... that would be awesome. Sadly, it's not how it works. So... back to the book. Btw, I purchased Kaplan Med Essentials at the beginning of the summer. That book is brilliant. I'll be recommending it to many many people.

Summer Soundtrack: (and this is making up for the missing weeks)

Life in a Nutshell - Barenaked Ladies
Girlfriend - Avril Lavigne
How Far We've Come - Matchbox Twenty
In Da Club - 50 cent
Handlebars - Flobots
When I Grow Up - Pussycay Dolls (A little tribute to the fact that all this stupid studying is entirely my fault... Be careful what you wish for...)
Time to Pretend - MGMT (I'm loving this song. It's a summer anthem of sorts)
Vampire Weekend - A-Punk (and this isn't because Tom has put this in about three of his last five pod casts, it's because it's an awesome song and I've been rocking out to it for the past few weeks)

And that's all for this week... I'm back on schedule and will be posting next Sunday again.

Peace!

Papi is Back!

2008-07-29T01:53:00.002+01:00

Yeah... I'm a Sox fan. Who do I root for? The Sox, sometimes the Twins, and whoever's playing the Yankees. (Old joke that never gets old)

I think Youk should have punched Chamberlain in the head. I know Beckett was ready to go. I think Bucholtz looks like he's 12. I think Lester pitches a mad game. And I'm glad Papi's back and in working order. He's a major offensive threat, he's a stand-up guy, and he keeps Manny in line. With Papi back in the line up, they have to pitch to him or Manny, and for some reason, Manny hits better with Papi around. What do I think about Manny? He's not going to be traded by the deadline, he's too much of a hassle. He produces from time-to-time when he's actually in the game and he causes problems off the field. What do I think the Sox should do with him? Keep him until the end of the season and don't pick up the option. Let him go. He's been great, so was Nomar... but let it go. Frees up $20mil for other players (like another bat, or some mid-relievers). But you know what... I love Sox Baseball. Thank God I have a slingbox for next year. I don't know what I'd do without baseball and college football for another year. Good thing I can study with sports on in the background, eh?

Marathon Week #5: 7/21-7/27
This was the first week I was actually on schedule for my runs. As such, I was reminded of how much I hate Thursdays. Friday is a rest day, Monday is crosstraining, so it's not actually a day off. That means that by the time Thursday rolls around, I haven't had a break for 6 days. If I'm not on schedule (ie: I took a rest day on like Tuesday because of a sore muscle or rain out), I may not have had a day off for 10 days. That's what this Thursday was... the 3 miler that should have been cake was brutal. Plus, I've started weights on Mondays and Thursdays, so my muscles are adjusting to that too. Good news, Bad news time. Good news: I ran every day this week that I was supposed to. Bad news: my Sunday 14-mile run didn't happen. I had to call it at about 7 miles due to rain (and I don't mean that it was sprinkling... it was an absolute downpour about 5 miles in. I had to wait it out because I couldn't see... then I cramped up because I was standing still as the temp dropped about 5 degrees... so I called it at 7 miles when I got back to my car). I think I'll divvy up those extra 7 miles over the rest of this week to cover them. But I really need to hit my long runs. I think this week is like 15 miles... rock.

USMLE Update:
I've been working on my Resp med since that's what I really suck at (according to NBME) I've thrown in a little biochem here and there where I've been able to tolerate it. I think this week i'm going to focus on some Cardio... I'm still having trouble studying. It doesn't help that I'm between houses and putting up with various scheduled fix it moments. My pets are very demanding. And I'm very easily distracted. *Sigh* But there's only 5 weeks left. Time to kick it into high gear.

Summer Soundtrack:

Life in a Nutshell - Barenaked Ladies
Girlfriend - Avril Lavigne
How Far We've Come - Matchbox Twenty
In Da Club - 50 cent
Handlebars - Flobots (I think I really like this song... I haven't quite decided. There are moments that are very tongue-in-cheek and extremely American. So, until I decide whether I love or hate this song, it's going on week 5 of the summer soundtrack)

Ups and Downs

2008-07-21T05:21:00.002+01:00

Well, it has been an eventful week.

First, I spent last weekend in Michigan. First, hanging with my lil'bro Joe at his new rocking pad (sponsored by Google). I am now a fan of Guitar Hero and Rock Band... this does not bode well for my studies. If you don't know my lil'bro Joe, he's a cool guy. He really is. It was great to spend time with him (even if I had to go to Michigan to do so)... He promised me that he pisses on the Michigan campus all the time. While there, we caught a Detroit Tigers vs. MN Twins game at Comerica Park with the lovely Colby and Tim. Sadly for them, the Tigers lost. But that meant that the Twins won. Go Twins! (We know I'm a Sox fan, but it is the hometown team). Saturday was dedicated to Emilie and Kurt. Joe drove me out to Leonard, MI... I still don't really know where that is, but it's the middle of nowhere. Then I met a ton of Kurt's family and friends. It was an absolute blast. It was so wonderful to have the opportunity to meet Kurt's "people." Sunday, Joe and I both nursed our late night lazy with Zingerman sandwiches, Speedracer at the dollar theater and Pizza from a small place near his apartment (that was AMAZING). So... While I may not be a huge fan of Michigan, I had a good time :)

I spent Monday driving through Michigan (which did nothing for my opinion of the state) on my way to Chicago. I took a quick pit stop at ND to say a prayer at the Grotto (and if you've never seen the Grotto at ND, you may not understand, but it's a beautiful place... especially in the summer when it's nice and quiet) and to drop off something for the ACE 15 year celebration. Since I can't be there, I thought I'd leave a little something for my class. Then I was off to Northbrook to meet Adam for lunch (thanks for a lovely lunch!). I came back into downtown Chicago to crash with Pete and have a birthday dinner (yay good Mexican food!) with Vito, Shannon, Pete, and Nick (and thanks for a lovely dinner!). So basically I celebrated my birthday a day early, met Tim for breakfast (I owe you dinner now) and spent Tuesday in the car driving from Chicago to Minneapolis. There was some disappointing traffic and a number of cops that slowed the trip a bit, but it was great to roll onto highway 100 and speed home.

Fast-forward to Friday, I helped my parents move house. We haven't sold the old one yet, so my lil'bro Mike and I are living in house and my parents are unpacking in the brownstone. It's a little weird to have these random empty rooms here and be slowly moving my stuff into a new room, but I study at the house and it's nice and quiet. I went out to breakfast with my dad. Resurrecting an old tradition of father-daughter Perkins trips, we had a nice long breakfast and chat. I love my dad. After the move, we had a joint birthday dinner for my mom (her birthday was Friday) and me! Yay! It was a really fun, silly, fancy dinner (lacking Joe... we missed you Joe), with good food, good conversation, good times. I love my family. PS: Dan... you're still in the hole for knowing about shows on lifetime. And my dad lost a bet to Mike over the actress playing the daughter in Commando (in case you don't know who it is, don't bet on Terri Hatcher and don't bet against Mike, I think he majored in "Young girls in movies").

Marathon Week #4: 7/14-7/20
I was supposed to run 31 miles this week. And this week, I ran... (duh duh dah!) 31.5 miles! WOOT! I still have a running debt of like 35 miles (thanks to my travel laziness), but I ran 13 miles today. I'm unashamed to say that took me nearly 3 hours, but I was on a running clock, meaning that I didn't stop my watch for anything (except when I was in the act of drinking from a fountain). So, it's fairly respectable. Plus, I'm good for 6 miles cold now... it's about 1/4th of the marathon distance, and I'm 1/4th of the way into training. I think that bodes well. We'll see if I can chip away at that running debt at all in the next week, but I'm quite happy to be logging 30+ miles in a week.

USMLE Update:
According to NBME, I'm suited for Psychiatry and that's about it. I took my first practice test, and I passed... by like one point. I figure it's my first try, and that's not terrible, but I need to do better. I need to buckle down and really work... Boo... The good news is that I'm doing really well in Behavioral Sciences, GI, and Anatomy (thank you TF). But my worst go was Resp... surprise surprise. So... here's to studying a lot of Resp, and no more BS studying... at all.

Summer Soundtrack:

Life in a Nutshell - Barenaked Ladies
Girlfriend - Avril Lavigne
How Far We've Come - Matchbox Twenty
In Da Club - 50 cent (It was my birthday week... and this reminds me of my 21st, rocking out on a party bus... Go Shorty! It's yer birthday! We gonna party like it's yer birthday...)

Traveling makes me stupid

2008-07-18T00:57:00.002+01:00

Well, that's not entirely accurate. I just don't do what I normally do when I'm traveling. I seem to have so much less energy... Plus, I feel like if I'm away from home, I'm on vacation! And who doesn't need a vacation?!... I do, I do.

Since I missed the Sunday update, I'll just give the abbreviated one here and a big one this coming Sunday. Questions, Comments, Concerns? There's a brickwall ah-that-a-way.

Marathon Week #3: 7/7-7/13
This week went well... until I left town. I could blame the thunderstorms in Ann Arbor, I could blame the heat and humidity, but really... I was lazy. Lazy and on someone else's time. And I don't like to be an inconvenience. But I will say that I was great Monday-Thursday :) Go me! Looking to get back on track ASAP.

USMLE Update:
I am officially in a fight with Biochem... Perhaps we will no longer be friends. Instead, I'm giving two days to Behavioral Sciences so that I can feel better about myself as a person (look at all the diseases I DON'T have!) and then I'll take my first NBME practice test... fun times. Here's to another 6 weeks of this.

Summer Soundtrack:

Life in a Nutshell - Barenaked Ladies
Girlfriend - Avril Lavigne
How Far We've Come - Matchbox Twenty (Mini tribute to the GEPs and the fact that we're basically 1/2 way. Also to all the good friends, old and newish, that I got to hang with this past week... I mean, if I knew you in college, that's at least 5 years, in high school, that's at least 9 years... Dude, we've gone a long way, right?)

Hugs!

2008-07-07T15:03:00.003+01:00

So, just before I left Dublin, I was walking down Grafton street and was "accosted by huggers."

I kid you not, there were people in the middle of Grafton holding signs that said "Free Hugs." While that might be otherwise disturbing, one of my friends told me that it was just about the best hug they'd had in a long time. I have three things to say about that:

1) Mad props to the people giving away free hugs. It's a great idea. It's friendly and warm and happy and makes me think of puppies, kitties, rainbows and carebears. (CareBear Stare!)

2) How sad is it that we get better hugs from strangers than from the people we know?

3) I give great hugs :)

And here's a video of people doing something similar around the world...

Getting Back in the Swing

2008-07-07T00:05:00.003+01:00

Now that I've had a bit of time to adjust to being back in the States, I have a few things to say about it:

A) Driving is just as fun as I remember it... I like driving fast with the windows down and the radio up. Now I just need to get to Detroit next week and pick up my car. I'll be cruising back through South Bend, Chicago and Madison on 80-90... Sweet! 10 hours of rock out drive time.
B) Prices in MN strike me as so much more reasonable than in Dublin. Perhaps it's the lack of exchange rate, but I'm glad I can afford to buy coffee from Caribou every now and again.
C) American news is as self-centered as I remember it, and that makes it somewhat hilarious. And the dominating news story is whatever the latest media outing of the presidential candidates produced, which is normally very little and pointless.
D) Burgers, Pizza, Hot Dogs... Done better here than in Ireland. Guinness... totally not drinkable here. I feel that this is a balanced trade.
E) 4th of July - a national holiday where we grill burgers, drink beer (my family plays "extreme" croquette and boccie on our very hilly front lawn) and then we light shit on fire! "Celebrate the freedom of your country by blowing up a small piece of it!" Canada has a similar celebration on the 1st. But I'm not totally sure what they're celebrating. The 4th is about throwing off the oppressive shackles of the British (especially their obsession with Tea... seriously... wtf). Now, since Canada never actually distanced themselves from England, I suppose it's a celebration of... being not quite British, not quite American, but just all-around nice buggers.
F) Red Sox Baseball... that is all.

Ok. Random picture time. Here's the my cousin and her new husband in their first dance. She looks amazing! This is what I want in my wedding, cause let's face it, I won't get married until I'm in my 30s either. But it was one of those great, elegant events. And the black and whit just adds an excellent touch.

I had a really fun 4th of July. It's rare that all 6 of us are together for anything, but we did our annual Extreme Games on the front lawn. There a little bit of casual competition involved, but it's "Extreme"
because the lawn generally isn't cut for the week leading up to the 4th (it gets rather long and rough... and it's impossible to see the Boccie jack when it's tossed), plus the steepness of the slopes makes the croquette a bit of a challenge. And as always, the games are complicated or made better by what my brother refers to as "Talent Juice" which comes in a wide variety of flavors. Anyway. 2 hours of games then off to ICC for dinner and fireworks. The fireworks this year were expressly impressive with the addition of a rotating firework turret. Bill was quite brave to join us, but it made the teams fair... even though I apparently suck at croquette.

Marathon Week #2: 6/30-7/6
This week went well. I covered 25 of the 27 miles I was supposed to, running 5 days, resting one, and xtraining the other. It's pretty much all on schedule. The weather was perfect for running, except for today (hence the 2mile deficit). There was no way I could run the 11 miles. It was nearly 95 degrees when I left the house, but I'm sure the heat index was much higher. It was humid and perfectly still with absolutely no cloud cover. I don't want to say how long it took me to cover the 9 miles, but it was a brutal with a bunch of walking involved. One week of running and I've already gotten all my freckles back (I have yet to rid myself of the stupid biking tan-line though).

I mentioned a hill last week that I thought was evil... well I have one here that I'm going to call Brenda. Brenda is a bitch. She's demanding and inconvenient and in the middle of every run. Eyeballing it, she's about 250 yards at a 45-50 degree incline, and appears around the corner of a gradual 300 yard uphill. I hate Brenda. And this week, she has been in every run. That'll change next week, but my overall goal is to make it up without stopping. The tough part is that it's up hill on my way back, so always about a mile before the end of my run. I'm sure my hatred for Brenda will grow over the course of the summer.

I suppose I should mention that I'm training with Hal Higdon's Intermediate II program (if you're curious you can find it at www.halhigdon.com ). He's of the philosophy that you need to clock the miles to finish the marathon. I like that policy. I don't like struggling with times and strange workouts. Plus, it helps me prove to myself that I can do the distance... and after 18 weeks of running, you can be damn sure I'll finish that marathon (more because I've been running so much to do it than because I'm prepared).

Week #2: Good week. Not a 5-star performance but I hit all the runs, and the distance will come with time. Goals for Week #3 = cover all the miles (even though I'm traveling).

USMLE Update:
I've set my test date for August 29th. I sortof started to study this week... like, I opened a book a few times, but I was still stressed over the OSCE (which I passed). Now that I can safely assume I'm headed for Senior Cycle 1, the USMLE is the only thing on my plate. Study starts tomorrow with some biochemistry for about 3-4 days. I'm going to need some time with that one, Micro, and Pharm most of all. Then I'll hit up the systems. I'll keep you in the loop as I go.

Summer Soundtrack:

Life in a Nutshell - Barenaked Ladies
Girlfriend - Avril Lavigne (This had popped up on my shuffle almost everyday this week, and I've had it in my head during all of my runs... it has a good beat, right? I'm sure it won't be the most shameful thing that ends up on this list)

Home Sweet Home

2008-07-02T13:26:00.002+01:00

And I'm Home.

After a rather uneventful two weeks on Respiratory medicine (uneventful not due to my team, the team was awesome, but because the hospital is slowing down for the summer and the DANGER-Intern flip day), I had my big OSCE during which I was given a personal demonstration of proper DRE technique. Let's not talk about that. I drank on Friday, almost missed my alarm on Saturday morning, flew to NYC, drove to Greenwich, and watched my cousin get married.

The wedding, which my mom referred to as a "mature" wedding (I guess unlike the weddings I have been attending of late? True my cousin is about 10 years my senior) was lovely. We sat the Irish on one side of the church, the Dutch on the other and had a lovely little ceremony. The reception was in the Greenwich country club (beautiful location), and I started to drop sharply just after the entrée arrived. I did last through the speeches, which seemed aimed at taking pot shots at Beck (but in a nice friendly way), and through the first dance and parent dances. But I didn't stay to boogie on the floor with the fam. Quite a night though. We wrapped up with brunch at the yacht club the next morning (I was a little more awake for this, though a few people were a little green around the gills). Kate arrived to applause, only to leave again, seemingly having forgotten Beck and needing to retrieve him. I'm sure she told him to get in the car, he must have wandered off :) The brunch was really family time, and the Larkin cousins are planning a trip or something... Danger. But we had more time to catch up and chat, time to wish the newly married couple well (they're off to Bali! So Jealous!), and time for more hugs all around.

After brunch, it was back to the hotel to pack up, to the Westchester Airport (which was a pleasant change from JFK), and flight back to MN. The flight was a bit delayed coming into NY, then we were delayed sitting on the tarmac because of lightning, so we didn't get home until 9ish... and I was among the walking dead at that point.

So, I've been home and "alive" since Monday. It feels good. I'm just hanging with the fam and taking it easy. Hard core studying starts next Monday (woot) and I'll be keeping a bit of a running commentary on the USMLE (or the u-smelly according to Tom) here in the blog. Also, to keep me honest, I'll be keeping track of my marathon training here as well (see below). And the final thing, I'll be keeping track of my summer soundtrack here. Basically, there'll be a song every week that somehow has become my anthem for the few days. There'll be a running list of that.

Marathon Week #1: 6/23-6/29
Ok, I don't want to say that this week was a total bust, but it kinda was. I didn't do any running (like any at all) until Sunday... which was a lovely 4 mile (6am) run around Old Greenwich. I had found a "route" on mapmyrun.com (which I highly recommend using when you travel... or when you're at home) and proceeded to miss one of my turns. I didn't get lost, I'm pretty good at finding my way, but it did provide some lovely scenery. It's nice to be back running where there are tons of other runners around... rather than people walking and giving you strange looks. It was hot and humid (something I haven't had the pleasure of running in in quite some time) and I felt a little like Jello, but I'm blaming the jet-lag.

But Liz, why didn't you run till Sunday? Well, I thought it would be a good idea to spend my time biking in and out of school. It's a little over 8 miles each way (up hill in, down hill back). The mornings were lovely, sunny, no traffic (because I'd leave around half 6), and even though they were up hill, they were bearable. Plus, there is something nice about getting to Blanch, showering, and being fresh (the bus always leaves me with that less than fresh feeling). The afternoons... well... I didn't like them as much. The Quays were always traffic heavy, and there's nothing like feeling as though you're about to die to keep you from wanting to do something. The second day, I was absolutely drowned in Phoenix Park. The downpour was so bad that I had to stop and wait for it to let up, because I couldn't actually see anything. On Thursday, Ed rode with me, God bless him. I'm slow on a bike (especially a bike that isn't mine and is far too big for me). But he patiently waited for me at the stoplights and went slowly through the park. He even introduced me to a better way home (better except for one hill which I will henceforth call evil hill of death). Friday was the OSCE... I wasn't going to ride in, because that would merit a drunken bike home and would certainly lead to bodily injury.

Overall: Biking=Good IF you have a bike that's built for you. As Richie said, "Sure you wouldn't do surgery with a sausage... I mean, you need the right equipment, that's all."

Week #1 = Meh... Not good by any stretch of the imagination, but it wasn't a total bust. I'll catch up on the miles I owe. Goals for Week #2 = Actually run.

Summer Soundtrack:

Life in a Nutshell - Barenaked Ladies

Awkward

2008-06-14T11:50:00.002+01:00

Reason #792 for putting screens in windows:

Coming home to find a very scared and mildly retarded sparrow flying around your room and shitting all over your books.

Seriously... the window wasn't open very much. But the little bugger found his way in, then couldn't find his way back out. I opened ALL of my windows quite wide and left the room. But no. He didn't think to leave the perch on my bookshelf until I "ushered" him out. Now I have to do more laundry to wash the bird poop off of my chair cover. And let's not mention the number of bugs I'll now have to collect around the room because I left the windows open so long to get that bird out. Why don't they believe in screens here?

What I get for being stupid

2008-06-13T13:35:00.005+01:00

So... I haven't fainted in 9 years. And much to my shame, I managed to put myself in a position to drop while working in theatre (OR) during my surgical rotation. It's entirely my own fault, and what I'll say is this:
+ Mucho stress for about a month straight
+ Less than 3 hour sleep
+ Tequila shots
+ Very early morning
+ Unhappy stomach (re: Tequila)
+ Not eating breakfast
+ Dehydration
+ Standing on feet for 3 hours
+ Scrubbing in for a long surgery and being under the lights and retracting stuff and sweating and not moving..
______
= Fainting...
Yeah, Liz of the impervious stomach managed to bite it during surgery. Thankfully, I recognised the impending faint and got out of the gown and gloves, out of the actual OR and into a chair. I was busy putting my head between my knees and sending a friend to get me a glass of water when I hit the floor. I broke my fall with my face and my knee... Go me. So I have a nice bruise on my chin (see pict below). The impressive stat was my BP about a minute after the faint was a whopping 94/45 (normal BP = 120/80 and while I have low-normal BP, it's normally around 110/65).

If there's something very wrong with you, the Operating suite of a hospital is a great place to faint. I was on a gurney in the recovery room within 2 minutes, one of the anesthetists put an IV line into an impossible vein on the side of my wrist (he was the only one that could even find a vein at the time) and I was on fluids and glucose and O2 (totally unnecessary). However, if there's nothing really wrong with you, you're just going to embarrass yourself over and over again as you explain that you were an idiot, there's nothing wrong with you, and it wasn't the surgery that made you faint. I had to fill out an incident report and was processed through the A&E, given an ECG (all normal), and sent home early. They were all very lovely... And I think my dignity is bruised worse than anything else.

I suppose you're wondering why I was out so late drinking such things that I refuse to drink... Other than my idiocy, it's because our exam results came out. Everyone in my class passed all three exams! We are super happy! So atleast I have good reason for being an idiot, right? Yeah... maybe.

You should see the other guy...

~LLL

Back on the Grid!

2008-06-07T23:11:00.000+01:00

Hey Friends!

I’ve resurfaced and am back on the grid. Woohoo. This round of exams was particularly rough and I studied until I couldn’t see straight (literally), then tried to balance the stress of sitting the exams with the much more tempting fun of having a bunch of ND alums in town for the ND-Ireland Reunion. So let’s start there, hm? First of all, the people who were in town were wonderful. I haven’t seen a few of my classmates in 4 years, and it was great to catch up on everyone’s lives. PS: two newly engaged couples and one recently married couple… Awesome! It was great to see everyone who was in town!

The ND 10-year Ireland Spectacular was done to the nines. And while I could not attend all of the events (studying and taking exams sadly takes precedence), the ones I did attend were put together in traditional Notre Dame pomp and class. I went to the first big dinner on Friday night that was hosted at the Mansion House just off of St. Stephen’s green. It was the “Big” dinner with the most non-ND people in attendance, and was kicked off with a bobble-head U2 band welcoming people from the street. Both of the major ND-Ireland supporters, Charles Naughton and Don Keough were in attendance with their wives and gave lovely speeches to welcome and reflect. Provost Burish also had some wonderful remarks before Fr. Scully blessed the meal with an unusual but pleasant grace. After dinner there was a performance by an a cappella Irish music group with voices that gave me chills, totally amazing.

The next night was the ND Alum Dinner in Dublin Castle. I had never actually been in the castle before that. We received a tour to begin the night, followed by a wine reception with a string quartet. The meal was in the banquet hall, and absolutely delightful. But the night actually continued with a party at the top of the Guinness Storehouse complete with a live band and free flowing pints. I perhaps stayed out a little later than I should have on both nights, but it was well worth it.

On Sunday, there was a Folk Choir Mass (they stopped by on the European tour to bless us with their voices) hosted in Trinity’s Chapel. I have to say, I was struck by the clergy in attendance. President Jenkins (on a brief touch down in Ireland) presided over the mass, flanked by both recognisable Notre Dame priests and representatives of local Irish priest (all of whom I’ve met numerous time before in my time here in Ireland). Most notably, the recently elevated Cardinal, Sean Brady, drove down from Armagh to attend and receive an honorary degree (along with Seamus Heaney). I wish I could have been a part of the other daily activities, but… school comes first.

I had four exams this term: REGUB (standing for Renal-Endocrine-GenitoUrinary-Breast), which was a hodge podge of just about any pathology you can think of; CNSLM (Central Nervous System and Locomotor) which was relatively well confined and taught; the dreaded HLTM (Hemopoietic/Lymphatic and Tropical Medicine); and then the TOSCE (team objective structured clinical assessment) which is a nice way of saying, go play doctor while this guy with a clipboard hovers and grades you. I can’t say that any of the exams went stellarly (though I’m still awaiting the results), and REGUB was just about the most difficult exam I have ever taken. I’m just crossing my fingers that I don’t have to re-sit any of them.

Once exams were finished, eighteen of us packed up and shipped off to the Aran Islands. Mark graciously invited us to crash in his cottage (and crash is a good term for it). I won’t lie, at night there were bodies everywhere (it’s not a large cottage). But it was a wonderful break. I needed to get out of Dublin, and the Islands are the perfect example of the beauty that drew me back to Ireland. We could not have asked for better weather either. I (again) left the Islands sunburned. I think it’s a curse or something, but a curse I can live with. I think the highlight of the long weekend was the bike ride we took around the Island (that manage to be 20 plus miles by the end) that included the round tower, Dun Aengus, and the beach. It was rough going at times, and I (shamefully) had to walk my bike parts of the way. But it was a glorious day. We grilled each night, went to the local pubs, and bought out the Island supply of Corona. Again, God bless Mark for letting all of stay at his place. I’m not sure I’d have the courage to do so.

I’m in the middle of a two-week rotation on General Surgery, which is a lot of fun. I love surgery (telling, I think). And have been in theatre a bit and doing a lot of patient work-ups. After this, I move on to two-weeks of Respiratory Medicine, a big OSCE (solo this time) that determines whether or not I can go on to the senior cycle of medicine in Sept. I haven’t managed to become stressed out about this one, I think I’ve used up all my stress for the year. But I’m on the wards in the hospital every day now, so I’m getting plenty of practice.

The day after I finish with the OSCE, I’m on a plane for NYC to attend my cousin’s wedding. I’m extremely excited about that. I’ll get to see some of my extended family that I haven’t seen in ages, and it’s a wedding! Happy Family Time.

My plans for the summer aren’t entirely exciting. I’m in MN for the majority of the summer studying like it’s my job, because well, it is my job. I’ll be sitting the Step 1 USMLE (medical boards) at the end of August (the 29th… at the moment). It’s an 8-hour test, and carries a good deal of weight when I apply to Residency programs in the States. So… I may be just a little stressed out about it. The last few weeks of my summer look to include an ND game (yay!) In July, I’m hoping to get up to Detroit to spend a few days with the lil’bro and to celebrate Emilie’s wedding with a second reception in her new husband’s neck of the woods. Since I wasn’t able to be at the wedding (fell right in the middle of exams, much like the 10-year), I’m so excited to be able to celebrate with them.

Other random stuff:
• Meg and Tom, my little though no longer little cousins, are in town next week! Fun!

• I may be breaking up my studies with running, perhaps to the tune of marathon training. I’m toying with the idea of running Dublin in the fall. But the idea of another marathon is a little daunting… But aren’t marathons always daunting?

• My parents will be closing on the new town house sometime in June or July! It means changing all of my permanent mailing information and everyone else changing the place they mail me at my parent’s house. Don’t worry, I’ll get that address out when I have it.

• I’ll be spending next year in my second term as the Sec/Treas of the Surgical Society at RCSI. I had promised myself I wouldn’t do it again, and I caved and agreed to run again. Oh well… c’est la vie. I do get to meet a good number of Consultant Surgeons throughout the year, and the committee this year looks to be solid. Fingers crossed, eh?

• Even though my season ended with two broken ribs this year (they’re all healed up now, I promise), I’m going to be playing basketball for UCD again next year. My coach (Sean) won his dream wedding, and we’re all so excited for him! Plus, I just can’t stay away from the courts.

That’s about all I’ve got for right now. It has been a long time since I’ve caught up with a good number of you, and I’m going to try to take time to call people over the summer when I’m back home and it’s financially feasible to do so. I miss you guys! There are times when I kick myself for going so far away for medical school. And there are frequent times when I long for a good chat with people who know me as something other than Liz the (sometimes crazy) north-american medical student. I’m looking forward to being home for so many reasons, but most of them involve being closer to people I love.

Peace,
~Liz

That Time

2008-05-11T08:50:00.002+01:00

It's that time of year again... sadly. I'm going to drop off the face of the world for about 2 weeks so I can study. I hate it, but I have to do it. Stupid exams. Stupid internal motivation that makes me want to do really well. Stupid profession that puts lives in my hands... Yeah. Study time.

Things that Suck

2008-03-13T09:50:00.005Z

For this next post, I'm going to have a running list of things that suck when you have broken ribs. (I realize that having broken ribs sucks a good deal on its own, but I'm going for the in addition to category here).

So...

Things that you never knew could be so painful:
* Sleeping
* Breathing
* Laughing
* Coughing
* Pooping
* Sitting up
* Pushing yourself up
* Shampooing your hair
* Trying to walk to the front of the bus when it stops suddenly
* Burping
* Closing your bra when you get dressed
* Hiccuping
* Singing

I'll keep adding as I discover new things.

xo
~LLL

PS: This is awesome. Go Rev Jenkins.

Vantage Point

2008-03-10T11:43:00.003Z

So, the highlight of my week was seeing Vantage Point last night (my Sunday night movie). I have two comments about the viewing experience.
1 - I was struck by the number of people in the theater that seemed taken aback by the way the story was told. One such person (who may or may not have been a rude, teenage male sitting next to me) commented, "Why does it have to be noon again? Why can't it be one?"

Um... I thought it was clear from the previews that the story was going to be told in a series of flashbacks from different points of view. As a narrative tool, I thought it was done quite well, slowly adding new pieces every time, moving faster through the parts that were already clear and focusing on what was new. It really wasn't a surprise. And there wasn't too much repetition. It was far from boring, maybe frustrating to add to the suspense, but not boring. Boring is sitting in a micro lecture.

2 - The movie worked. I thought it was really well done. I liked all of the characters. I felt they tied up the loose ends that needed resolution but kept from resolving everything. Life doesn't always wrap up in a neat little bow, why should the movie. They never give full motivation for certain actions, and I left wondering why people did what they did. The movie was great.

BUT the last 2 minutes were the worst pile of crap I've ever seen. I mean, cut out the last two minutes and it would have been fantastic. I felt as though the writer was like, I really want a bit of dialog in there, and vomited out a script. The snickers in the theater were aimed at the ridiculously Amero-centric resolution, and the pure cheese on the screen that could only be made worse with a series of American flags flapping in a gentle breeze.

On the walk home though, I had a rather interesting conversation. And this is in no way meant to insult or offend anyone, I apologize if I do. I don't think there is anything I believe in strong enough to blow myself up for it. I actually really started thinking about it, and I can't really think of something that I could see myself strapping on a bomb and detonating myself for. Now, that's not to say I don't have convictions. I do. I remember that during Confirmation we were asked, "if it were illegal to be Catholic, would there be enough evidence to convict you?" I would be rotting in jail for my association with the church. But at the same time, I wouldn't blow myself up if the Pope told me to... Granted, that would be against Church Dogma (amongst other problems), but still...

So I pose this question:

Do you have convictions strong enough that you might end up a suicide bomber?

You don't have to answer me, but think about it... It's interesting.

Peace,
~LLL

In like a Lion

2008-03-05T08:26:00.002Z

Sometimes there are these days that remind me to be human. It sounds weird, I know. But let's see if I can make sense of this. Sunday, I did a good deal of studying. I'm still behind from all the chaos I was working in the past few weeks, but we're starting a new module (Neuro/Musculoskeletal Pathology) and so far, I'm feeling like I'm in a zone. Granted, the 4 years at ND studying Psych from a physiological/cognitive standpoint should give me a leg up.

But before I got to studying, I walked into town, taking my time to arrive at the designated study cafe. I find it hard to take my time, to move through a city without appearing to have some place to be. It's obviously not healthy to have to rush everywhere, and yet I seem to find reason to do this ALL THE TIME! I won't go so far as to say I'm going to give up rushing for Lent, but let's just say I'm adding it to my to-do list. I was reasonably productive in spite of taking the half hour walk into town and the nice long chat with my mom in the middle of the study session.

I was hoping to get out to Zurich for the beginning of my March break, but it doesn't look like it's going to happen this time around. I was looking forward to rocking out with Drew for a bit, but now I'm looking to see if May might be a possibility. In the mean time, it's Edinburgh with my mom at the end of March. And that will be great.

Just a nod to the crazy march weather we've got out here in Dublin. On Monday, on my way home, I experienced about every form of precipitation. And by experienced, I mean I was hit on the head with rain, snow, sleet, freezing rain, hail, "wintry mix." It was only a 5 minute walk... bizarre!

Peace,
~Liz

Irony

2008-02-23T18:02:00.008Z

Define 'Irony'... two homeless alcoholics sitting on the steps of the RCSI main building, drinking from bottles in paper bags at 8pm on a Sunday night. I stood at the LUAS stop waiting to go home and thought to myself, "Hey, I'm sure I'll be treating them soon."

The past two weeks have been bonkers. I've been running around doing just about anything other than what I feel a second-year medical student should be doing. I've had basketball games, helped the orchestration of an intercollegiate case competition, I've conducted photo shoots, I've pieced together promo reels and prize reels, run audio and video for events, and sat on a counter and sold lollipops. I was at a mall yesterday, sitting in a starbucks, talking about my former life as a teacher and my head nearly exploded. It was a "hey, wait, where am I?" moment.

Anyway, the four videos I put together are available on youtube. I'll post the promo reel at the end of this post, and the other 3 can be found through my youtube profile. I'm taking Saturday to decompress, clean my room, do laundry, put together a grocery list, send out long overdue emails, sign up for the USMLE, upload photos to facebook, organise my notes, and generally get my life in order.

Tomorrow begins the massive study necessary for me to actually pass the quiz coming up on Wednesday. I actually breathed a sigh of relief when I put together my calendar for next week. I have a game on Monday, mass on Tuesday, and Ballad Sessions on Friday... that's nothing. It's like a big, wide open week of free time. Then I wonder how the hell I get myself into so much stuff. Study, study, study! AHHH! Ok, I'm going to bake some cookies, because that seems like the best thing to do right now.

Peace,
~LLL

SHAG Week Dating Game - Promo Reel

Galwegians!

2008-02-06T20:47:00.000Z

It was my roommate's birthday on Monday, so I took her to Galway as a mini-celebration. I didn't tell her where we were going until the night before we left (and then it was only because the random and crazy snowfall across Ireland sortof changed the packing list and I didn't want her to end up cold).

It was a fun weekend. We got in Friday and dropped our stuff at the hostel (Kinlay House Hostel... I totally recommend it if you're looking for a nice place to stay and can't afford a hotel) and headed out for food. We ate a crap load at Fat Freddy's, mostly because we hadn't eaten all day then went to find some drinks. Martine's is a lovely cafe/wine bar that had the feel of the local, classy watering hole. The woman serving wine seemed to know every person (save the two of us) that walked in the door.

We bounced from there to a trad session at Taaffe's that was quite the fun time. I'm not going to lie, I managed to get a little tipsy while we waited for the two boys to arrive, and we kept busy buy making bets on who would get there first and what you call someone from Galway. We had a nice list going before Mark settled it for us... Turns out, someone from Galway is a Galwegian. Who knew? After Taaffe's (which I also recommend for a weekend visit) we hit up Tigh Neachtain's, then called it a night.

On Saturday, we braved the weather and took a tour of the Burren, stopping in Doolin for lunch (of course) and the main point of which was to see the Cliffs of Moher. Thankfully, the weather held long enough for us to bum around in the ridiculous wind and get a few silly photos before a downpour sent us into the Hobbits-meet-Teletubbies burrow of a tourist centre for cocoa. We moved on to the Ailwee caves for a little venture underground. Overall, it was a good tour, the weather didn't damper our spirits, but it did dampen my clothes.

We went to the Skeff for dinner and met out for drinks again at Tigh Neachtain's, but perhaps a little too much fresh air during the day had tired us out a bit and we called it an early night. Sunday was coffee and a newspaper and then some chill wandering around the city before catching the train back to Dublin (it was Superbowl Sunday and I did want to watch the game). And so I don't neglect it, my roomie saw a lot of baby sheep (or lambs for those who want to be technical).

I have to say I was a little bummed with the result of the Superbowl, but Tom Brady is still gorgeous and brilliant, and I'd totally have his babies :) The game ran from 11pm-3:15am here and I stayed up to watch all of it. It was a rough way to start lectures off on less than 3 hours sleep, and perhaps ill-advised to go to basketball practice that night, but hey, I'm still kicking.

Here's to another week of lectures: Diabetes, Hyperthyroidism, and DKA.

Sláinte agus táinte.
~LLL

CTD

2008-01-26T14:55:00.000Z

First and foremost, my apologies for the extended absence. Things like exams, Christmas, travel, stomach flu, and a slow attachment have prevented my updates... though, I'd really like to blame it on the Writer's Strike. Unfortunately, all the bad writing is mine and mine alone, can't pin this crap on anyone else.

So, I'm back on attachment in the hospitals, and I've had an interesting go of it. First, it sucks being sick. Everyone knows that it sucks to be sick, but let me tell you that it sucks to be trying to make other people healthy when you yourself are unwell. Boo on that. It's even more difficult when you're a student. If you're employed and sick, you take a sick day, you're docked pay, and such is life. If you're a student, you take a sick day, miss lectures, fall behind your learning, get chewed out by your instructors, miss more lectures to make a doctor's appointment, argue with people who don't realise you're a soon-to-be-doctor and think you're just a hypochondriac, struggle to stop by the store to get some crackers and soda before you drop or start vomiting again. Thank God for my roommate.

That, perhaps, was the one saving grace. You can't be on the wards in a hospital if you're vomiting. Roto-viruses are highly contagious, and you don't want an entire ward of patients throwing up... that's just wrong. So, now recovered from the flu and able to see patients, I'm finding myself on a Care for the Elderly attachment (aka Geriatrics). Now, it's very laid back, the consultants are brilliant and helpful, the Regs and SHO are lovely and take time to teach and explain, and the intern is so chill it's contagious. But, there isn't much for me to do. This is the disappointing thing with health care. Many of the patients under our supervision (and I purposely say supervision not care) are simply awaiting placement in Long Term Care or Nursing Home. This means that there isn't much we need do for them. There are no bloods to be taken, no X-rays, no exams, no treatment other than maintaining medication. And for a student looking to learn and understand, this is frustrating.

I titled this post "CTD" for a reason. It's a reference to former, crass abbreviations used in the medical community for things that shouldn't be said out loud. CTD stands for Circling The Drain. It's up there with FLK (funny looking kid) and DP (difficult patient) as things that are no longer written in charts, but occasionally are spoken in an exchange between doctors. CTD is one of the the things that I feel epitomizes what I'm taking away from this rotation. End of life (EoL) issues are ever present. They are not easily or happily dealt with, but they must be dealt with. The respect and compassion I've seen from the team I'm working with has made a large impression on me. You cannot teach a medical student how to handle EoL issues, just as you cannot teach a person how to come to terms with their own mortality. But modeling appropriate behaviour and practical thinking can be done. I've now seen it.

I may not want to go into Geriatric work after this attachment, but I can say I've learned from it. I've learned a lot. Most of it has been comforting.

Pax,
~LLL

Christmas!

2007-12-14T19:49:00.000Z

So I managed to survive exams with something close to sanity... but not much. So, to deal with this, I'm mocking my friends again. So here's a tribute for Bren.

Boredom

2007-11-09T11:33:00.000Z

There are good things and bad things that happen when I'm bored. I'd like to think this is a bit of both, but I suppose it depends on your point of view.

A thought on games

2007-11-07T13:32:00.000Z

At what point is a game no longer fun?

I'm asking in the wake of a basketball (club level) that has left me with a limp (I'm hoping will be gone in two or three days) and more bruises than I can count (including one to my sternum that knocked the wind from me and one on the back of my head from the gym floor).

Who do I blame? Certainly not my team. They played with dignity. There weren't cheap shots taken from our end... at least, none that reached the level of getting punched in the kidney when off ball. Add in that our coach was MIA, and I think we held our own.

I want to blame the other team. There were some pretty dirty things going down on the court. They were taller (and heavier) than we were, and there was some serious shoving. I saw one move that was intended to land our point guard on her head, and I almost lost it. But was the problem that they were attempting these blatant fouls? Or that they were getting away with them?

That's what it comes down to--The Refs. I think it's the job of the ref to make sure the game is safe. Yes, sometimes this goes to the extreme and it seems like the game is nothing but whistles. But there is a line. And when a player is shoved into a wall and there's no foul call, that line has been crossed. The other team wouldn't have continued their blatant infractions had the refs been calling the fouls.

Now, none of this changes the fact that I'm angry we lost, or angry that I'm limping and in pain. Anyone who knows me well, knows that I'm tough enough to put up with a heavy dose of abuse without flinching. This was the first game that I limped off the court at the final whistle to keep from collapsing on the floor. It is not my definition of fun. It is not my definition of a game. And frankly, it wasn't that close to my definition of basketball.

On Things That "Can't Be"

2007-10-17T17:35:00.000+01:00

True story:

A 30 year old woman reports to A&E (or the ER) complaining of abdominal pain. She is unwed, but scandalously shacking up with her boyfriend (at a time when that was highly frowned upon). The ER doc takes a history and does a brief exam before stepping back and telling her that she's pregnant.

The woman says, "Doctor, that can't be." When the doctor assures her that it can, in fact, be. She says, "No, it can't. My boyfriend has had a little surgery, it's not possible."

The doctor frowns. Feeling that it would be quite impossible for the woman to become pregnant if her boyfriend has had a vasectomy, the doctor (assuming it's the time before HIPAA) does some searching. The doctor comes back into the room laughing and tells the woman that it was QUITE possible she was pregnant... What happened?

Her boyfriend's "little surgery" wasn't a vasectomy, it was a circumcision.

Ha!

Peace.