I've been on a roll lately with choosing my books. It's justified my commitment to read more than just dramatic fluff, and increased my desire to have some sort of book club in which to discuss my good finds. Instead, I'll just tell you about them.
Major Pettigrew's Last Stand (not to be confused with Mrs. Pettigrew Lives For a Day)--reminiscent of Jane Austen's commentary on manners, class, and interferring in matters of the heart. A retired British major and widower finds a kindred spirit in the widowed Pakistani shop keeper, and together they work through family drama, racial misunderstandings, and Kipling's poetry. Believable characters I wanted to root for, with human flaws and perseverance.
Divergent--a dystopian drama bordering on fluff, considering that I read it in a single 5-hour sitting, but also an interesting discussion of what society values, the tension between one's tendencies and one's choices, and how loyalties are formed and changed. I found myself unable to keep from turning the pages, but also wanting to slow down and savor the deeper themes. Already reserved the sequel at the library.
Frankenstein--how did I get this far in life without this ever crossing my bookshelf? Nothing like Mel Brooks' interpretation--which nonetheless deserves its place amidst the cultural icons--it is a fantastic true horror story, dreamed up--quite literally--as part of a contest between Mary Shelley, her soon-to-be-husband, and Lord Byron. The original story is far more believable than Hollywood's green monster spin-offs--the frenzied obsession as Dr. Frankenstein pursued the secret of life, the repulsion he felt when he succeeded, and the fear and dread that haunted him the rest of his life, running from his creature's vengeance. Definitely a classic for a reason.
Not sure what's up next--I've got a small stack on my bookshelf--but as always, I'm up for suggestions.
Wednesday, August 28, 2013
Tuesday, August 20, 2013
...and follow Me
Yesterday in the Gospel, Jesus encountered the rich young man, who went away sad, unable to detach himself from the things of this world to gain the next. It's easy for me to simply think of material possessions that I could give up, and consider myself good to go. I have all of two purses, still sleep in a twin bed, and Michelle is embarrassed by the paucity of my DVD collection. But to me it's all just stuff.
However, as I reflected, I realized that it's easy for me to be detached from things when I am financially secure. If someone wrecks my car, I have insurance, and the ability to buy a new one. I am not living paycheck to paycheck, and can afford splurges like a trip to Ireland or an extra dinner out. I tithe, yes, but it has never been a matter of deciding whether that money goes in the collection plate or to pay my electrical bill. Would it be as easy for me to be detached if I had no way to replace the things I owned?
Furthermore, what of attachments to things besides possessions. If Jesus asked me to give up my job, would I follow Him? What about my health and ability to be active? My eyesight or one of my limbs? My family? The opportunity to worship freely, or to live in a land of relative peace? My ability to call my free time my own? Would I, too, be walking away sad?
And yet, all of these things are gifts from God, not things I've earned. Why should I not be willing to give them back to be with Him?
However, as I reflected, I realized that it's easy for me to be detached from things when I am financially secure. If someone wrecks my car, I have insurance, and the ability to buy a new one. I am not living paycheck to paycheck, and can afford splurges like a trip to Ireland or an extra dinner out. I tithe, yes, but it has never been a matter of deciding whether that money goes in the collection plate or to pay my electrical bill. Would it be as easy for me to be detached if I had no way to replace the things I owned?
Furthermore, what of attachments to things besides possessions. If Jesus asked me to give up my job, would I follow Him? What about my health and ability to be active? My eyesight or one of my limbs? My family? The opportunity to worship freely, or to live in a land of relative peace? My ability to call my free time my own? Would I, too, be walking away sad?
And yet, all of these things are gifts from God, not things I've earned. Why should I not be willing to give them back to be with Him?
Monday, August 19, 2013
Medically clear doesn't mean okay
I mentioned in my last post that one of the jobs of the third (non-emergency-medicine) attending at the main ED is medically clearing the psychiatric patients. Denver is one of the few cities with an inpatient pediatric psych unit (we referred to them from KC) and has a lot of resources and a lot of patients. Many of the families of patients in the Medical Day (psych) program-or who have recently gone home from inpatient-are instructed to bring their kids to the ED if they are having behavior issues. Here there is 24-hour psychiatric coverage and the ability to be monitored or admitted to the psych unit if necessary. These behavior issues can be anything from a patient saying "I want to die" to being handcuffed by the police for violent behavior. And all of them need medical clearance before they can be appropriately placed.
I suppose one could easily walk in and out within a minute and a half, make sure the kid's heart is beating and then order the urine tox screen. But that feels like a dismissal of someone who has spent their whole life being dismissed. And though they put up a tough front-acting like they don't care about the scars on their arms or the fact that they are living in a group home-you can easily hear the cry for help, and I want to show them that I see them as a person and care about them, even in that briefest of encounters. It's one of the hardest parts of my job so far, knowing that I can easily say "medically clear" and walk away, but that they are likely in for a lifetime of conflict, heartache, and ER trips just like this. I wish we did a better job with pediatric mental health from the beginning, teaching parents how to discipline and set boundaries, but also how to show affection and listen. Teaching kids how to express their frustrations in appropriate ways and to treat others with kindness. Screening for family history of mental health or risky social situations so we could watch for it.
Instead we see probably an average of 40-50 kids a week hitting the ER because there aren't a lot of other options. I'm glad we have the safety net, but sad that we need it at all, and doubtful that it's making any lasting changes. I guess I would just encourage all of you who interact with children or teenagers in any way to let them know they are loved and worthwhile every chance you get, and that they don't have to do anything alone.
I suppose one could easily walk in and out within a minute and a half, make sure the kid's heart is beating and then order the urine tox screen. But that feels like a dismissal of someone who has spent their whole life being dismissed. And though they put up a tough front-acting like they don't care about the scars on their arms or the fact that they are living in a group home-you can easily hear the cry for help, and I want to show them that I see them as a person and care about them, even in that briefest of encounters. It's one of the hardest parts of my job so far, knowing that I can easily say "medically clear" and walk away, but that they are likely in for a lifetime of conflict, heartache, and ER trips just like this. I wish we did a better job with pediatric mental health from the beginning, teaching parents how to discipline and set boundaries, but also how to show affection and listen. Teaching kids how to express their frustrations in appropriate ways and to treat others with kindness. Screening for family history of mental health or risky social situations so we could watch for it.
Instead we see probably an average of 40-50 kids a week hitting the ER because there aren't a lot of other options. I'm glad we have the safety net, but sad that we need it at all, and doubtful that it's making any lasting changes. I guess I would just encourage all of you who interact with children or teenagers in any way to let them know they are loved and worthwhile every chance you get, and that they don't have to do anything alone.
Wednesday, August 7, 2013
Working Girl
Well, I'm three shifts in to my big girl job, and I've already had to present a patient at my first Morbidity & Mortality conference (did NOT feel like a stellar start). I wish I'd appreciated the hand-holding more as a resident. Because in real life, there is no candy bowl or Mario Kart tournaments or Chief's office to escape to. There is just do your work.
And I don't mean "just" do your work. Because when it's a brand new computer and hospital system, you have super complicated kids, and you are making the final decisions for the first time, that work can seem pretty daunting. There was a very real moment of panic at the end of my first shift when there were 27 patients in the waiting room, every ED bed was full, and I had finished exactly zero of my notes--what the heck have I gotten myself into?
But Day 2 was better. And so was day three. And everyone has been super nice. And I'm not the only one that feels slightly overwhelmed. One of the other just-graduated-attendings told me today that even though she did her residency here, her first day was still a bit rough. "No one's standing behind me telling me what to do. Are you sure you don't want me to check this patient out just for kicks?"
Small successes--I did my first two sedations today, have learned a few nurses' names, and have gotten quite proficient at medically clearing the psychiatric patients (something I didn't realize was a big part of my job during my main ED shifts).
It's all just growing pains, and thankfully I've got a good support system and excellent training, and soon I will be able to look back on this trial by fire and smile.
And I don't mean "just" do your work. Because when it's a brand new computer and hospital system, you have super complicated kids, and you are making the final decisions for the first time, that work can seem pretty daunting. There was a very real moment of panic at the end of my first shift when there were 27 patients in the waiting room, every ED bed was full, and I had finished exactly zero of my notes--what the heck have I gotten myself into?
But Day 2 was better. And so was day three. And everyone has been super nice. And I'm not the only one that feels slightly overwhelmed. One of the other just-graduated-attendings told me today that even though she did her residency here, her first day was still a bit rough. "No one's standing behind me telling me what to do. Are you sure you don't want me to check this patient out just for kicks?"
Small successes--I did my first two sedations today, have learned a few nurses' names, and have gotten quite proficient at medically clearing the psychiatric patients (something I didn't realize was a big part of my job during my main ED shifts).
It's all just growing pains, and thankfully I've got a good support system and excellent training, and soon I will be able to look back on this trial by fire and smile.
Thursday, August 1, 2013
Deer in the headlights
Just finished my "shadow shift" in the ED, and have my first real shift on Saturday. Apparently, "shadow" means "see your own patients and carry your own phone" so even though I was nowhere near my usual efficient self as I tried to navigate a new system, I still was the one making the final decisions. It's weird knowing that I'm not going to run the patient by anyone who will hopefully catch anything I missed. That there isn't another, much more experienced set of eyes looking at my patients. I felt sneaky discharging the patients, like someone should still be double-checking me.
The good news is that I like the people I've met so far who are starting with me, even though because we're all new, we won't really be working "together" for a while, I finally got my access all set up, and I don't have to worry about learning a whole new city in addition to a new hospital system.
But still I'm having a lot of trepidation as I get ready to start, knowing that I'm just going to have to truck through the overwhelmingness of it and learn as I go. As one of my new co-workers said yesterday, after doing something different every month in residency, having no idea how things work and who people are should be old-hat. Hooray for us.
The good news is that I like the people I've met so far who are starting with me, even though because we're all new, we won't really be working "together" for a while, I finally got my access all set up, and I don't have to worry about learning a whole new city in addition to a new hospital system.
But still I'm having a lot of trepidation as I get ready to start, knowing that I'm just going to have to truck through the overwhelmingness of it and learn as I go. As one of my new co-workers said yesterday, after doing something different every month in residency, having no idea how things work and who people are should be old-hat. Hooray for us.
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