today was the last day of the first month of internship. for once i was able to sign out early. i started off the month painfully, my service ballooning to about 10 patients at one time (3 of them intubated/ventilated, 1 dead).. today out of 4 patients left, i discharged 3. i handed the intern who is taking my place a very empty board, much to his delight. and i was able to sign out early today! plus, i was fortunate yesterday - had a nightmare of a patient (she was faking seizures - that's a whole different story) who was drug seeking, i had a loooong list of shit i needed to do to get her out of the hospital, and she got so pissed off by our lack of action (which means, we weren't giving her 50mg of morphine when she wanted it), she walked out of the hospital and left (that's called eloping).

so now let's talk about signing out AMA. that means signing out against medical advice. sometimes perfectly competent, intelligent, reasonable patients will sign out AMA. i had one lady who signed out AMA from an ER in connecticut, even though she was pretty anemic, because she wanted to come back home to the bronx and receive her care here (we transfused her here). and there was the guy who came in with whole-body itchiness and dark urine, elevated liver transaminases, who signed out AMA because he had to take care of his kids when his wife went to work (he came back the next day after arrangements had been made). those are perfectly understandable reasons to sign out AMA. however, the "best" AMA signouts are from the crazy crazies who come in demanding pain medications and scream and yell and accuse you of being bad doctors or whatever, who bounce from hospital to hospital with drug seeking behavior, and finally bounce to you, and when you tell them that "no, i can't give you 8mg of dilaudid every 4 hours for your ovarian cancer which has never been biopsed in the 5 years that you claim to have had it, and for which all our imaging has been negative" they get upset and sometimes, SOMETIMES, if you're lucky, they'll be so pissed off they'll sign out AMA. saves you a lot of work

jesus i am cynical. i blame my job

tomorrow i start on radiology. 9am start. unbelievable. i can't even imagine the amount of sleep i'll be getting. plus i get this full weekend off. and it actually looks like i might be getting ALL my weekends completely off this month. i'm seriously having some difficulty wrapping my head around that idea. i mean, wowsers.

i have received my ikea shipment o' scandinavian el-cheapo furniture. now i have two bookcases (more like stilts with shelving), a small table and two chairs. i've been able to unpack a few more boxes, which now actually makes my place look worse than it did before. i have a lot more cleaning to do. and a lot more stuff i need to get. like a bathrug. and maybe a lamp (there's a corner of my apt that has no lighting.. kind of becomes unusable during the evenings.

not sure why i got cable. i've watched about 2 hours of tv this past month. i may cancel this soon.

saw may or may not and co. last weekend, and it was a very fun and reunificatory weekend. i felt like a normal person for about 36 hours there. and those MOMNers get better and better every time i see them. and new guy on the drums is gonna kill someone with those snare hits i swear to god.

and while i'm talking about my friendses bandses, this sleep out cd is really great. my favorite songs are still "it wasn't darkness" and "your voice"

p+k have now departed this fair city, so that makes 2 less friends to see once a week. but i know they're coming back, so i'll see them again as long as the bronx doesnt eat me

new music! the new psalm one album is pretty good, seriously. as an aside, i love jean grae and all but i always kinda felt that her production lacked a little sumfin sumfin. well psalm one does not have that problem. pretty ridiculous album. i listened to it twice in a row last night while building some ikea furniture.

new music 2! the justice "waters of nazareth" ep is pretty good as well. not sure how i feel about the title track, but the other tracks on there are quite outstanding. i think they're french. it's like industrial-tech-disco-dance-punk-lite. that was a total cop-out description. feel it.

what else, the new dr octagon is still good and still burning out my itunes. the new lady sov singles are also fucking great. i know a lot of people hate on her, and i must admit that like jean grae, i thought her first singles were amusing but a bit flat in the production department. these new tracks bump pretty hard. loving it.

you know, i STILL haven't gotten around to listening to the new junior boys, despite all the wonderful things i've heard. i'm going to put it on RIGHT NOW.

i have to get a digital camera soon. i miss taking pictures. i feel like i've missed out on a lot of great opportunities. what fucking horrible timing, break your camera right before moving to new york. god i am a knuckleheadbrain.

just got a wedding invitation in the mail from my long lost friends chris sample and his bride to be kelly, both of jason's freshman year fame. it's on saturday september 23rd, in plymouth michigan. i'm pretty sure it's going to be tough to score that weekend off, but i will do my best. everybody's getting married, i just hope i can go to these weddings. I HATE IT WHEN LIFE PASSES ME BY

wow, this opening track on the new junior boys IS really good. shit.

more cleaning and general organization of my apartment awaits. keep your ear to the ground.

this educational lesson brought to you by dr. j around 4:24 PM |

jesus h, this new dr octagon album is the whoooooooooooweeeeeeeedoobiedoobiedooo
intern year make me ccrrrraaaaaazy

this educational lesson brought to you by dr. j around 6:28 PM |

more bullets

working 100 hours a week will not kill you. working 100 hours a week makes you wish that it would kill you.

having no furniture in the apartment is kind of tricky. i have one chair. and a bed. i eat on my bed. i read on my bed. sometimes i sit in the chair. makes it difficult to do anything. ikea will be delivering me a lot of cheap furniture soon.

intern year, contrary to what they may tell you, has nothing to do with education or learning or anything like that. i ain't learneded shit no how. seriously. no time for reading or learning or anything. just work, work work. my medical student knows a lot of esoteric knowledge which makes me feel stupid. my resident is a superbrain, but thats ok because he's senior. and my co-intern is much smarter than i am, but thats ok because he's categorical. i'm just a knucklehead that's trying to survive so i can go live the good life in anesthesia next year.

i've been real lucky with my team. my co-intern, mark, is a real cool guy who definitely knows his way around internal medicine. the med student is a bit goofy at times (goofy like awkward - ok, one of his eyes doesn't point the same way as the other one), but also a chill dude who is totally not a gunner. and my resident is the coolest dude, like, ever - basically knows everything and hates medicine. like me, except for the knows everything part. he's actually thinking about going into anesthesia once he finishes his residency this year. we may end up as CA-1s in the same program, how cuuute.

spending as much time in the city as i can when i have free time, which at best translates to about 1.5 days per week, at worst, about one afternoon. done quite a bit of shopping. all of a sudden i have a craving for denim. and shoes, but thats not really a new thing.

the grilled chicken and the turkey burger are really the best things to get in the cafeteria. the best value is whatever the hot entree is, which can be fairly good (the paella) to nauseatingly terrible (vegetable lo mein). the lunchlady (dinnerlady, whatever) already knows me and piles on like 2 pounds of food onto my styrofoam tray thing when she sees me, because i gotta "thicken up" a lil bit.

i think i'm losing weight.

also its nice to stockpile the little bags of chips and yogurts and such and save them for later. that's a nice "perk."

project runway just started last week. i found two PGY-2's who are into the show. we have lively discussions about this.

i'm making friends in my intern class (awww). and i'm already deciding who i don't like. one intern basically talked shit about anesthesiology, so i was like "psssht whatever bitch please" and shit. and another one constantly gives me terrible signouts, and then constantly complains about how shitty other people sign out to her. oh and theres this guy who's a pretty good guy but his voice is uncomfortably loud and he sounds like his nose is congested all the time, he's the guy that you can't just say "how's it going" and keep walking - you ask him that, and he will give you a long answer. i've definitely had to do the walk away backwards, slowly, thing with him.

it is painfully hot up in the bx, but my apartment is nice because i have central air. however, the hospital does not. sucks dick.

matt and tamar came up to the bx the other day. we explored the neighborhood, that took like 20 minutes. then we ate at a weird kinda-nice, kinda-not place called caridad, which served us fried chicken chunks and rice and beans and an avocado salad and a cuban sandwich and we only got charged for like half of it and nobody else in the restaurant was korean or jewish or you know. it was pretty good though. bit of a weird vibe.

not having a microwave means that when you put your leftover chinese food in the fridge, the next morning it will not taste very good. sooo i need a microwave.

i am afraid to start my ICU rotation in september.

you know what i can't figure out? how to deposit a check into a chase atm. i have like 4 i need to deposit. one of them is from may. i mean cripes.

i subscribed to the new yorker. and also new york magazine. we'll see how much i read.

crap! reading! i'm supposed to read this article about pneumonia for journal club tomorrow. snoooooooozzee

ice cream is soooo good

the WWB turns 5 years old this year. i turn 27. i think i told someone i'm 27 the other day. i forgot how old i was. intern year make-a me stupid.

i'm on call tomorrow.

this educational lesson brought to you by dr. j around 6:33 PM |

Ok. It works.

Spending plenty of time raiding the bargain bin of denim at Barney's. Thinking about buying more shoes. Must. Resist. Urge.

this educational lesson brought to you by dr. j around 5:28 PM |

I forgot how to do the mobile posting thing. Just testing to see if I'm guessing correctly.

this educational lesson brought to you by dr. j around 5:25 PM |

so here i am in the bronx.

saturday morning i "moved in," meaning 3 duffel bags and an aerobed. i found that the apartment was not clean - paint on the floor, dust and dirt everywhere, dirty windows, dirty bathroom, dirty terrace, and the central air didn't work. what a nightmare. so i went down and talked to the super and he came right up to fix the central air, and then noticed that my room wasn't clean. so he called up his russian cleaning crew (not even joking. a little russian guy with a bad tan and worse comb-over, wearing a halfway unbuttoned black dress shirt tucked into stonewashed white jeans, complete with bronze chest hair tangled up in his bronze chains, and his crew of 3 skinny, young, pale russian girls and what looked like his wife (or mother)) and said they'd come over to clean.

i planned on showering before i began call that afternoon. well the RCC came early, around 12:30pm, and i was effectively kicked out of my apartment at that time. so i went over to the hospital and figured i'd begin my shift early (on overnight call you get up to 5 admissions (and you almost never NOT get 5)), since that would presumably mean that my early start would equal and early finish.

such was not the case. i ended up not sleeping at all. 1 of my patients died (it was a terminal extubation - the pt's family decided to remove his breathing tube), 3 of my patients were intubated and placed on mechanical ventilation (1 of them was supposed to go home today), and one of them was absolutely fucking nuts.

i stayed until 7pm. i was supposed to be done by 3pm. i had a 28hr call, 36 hrs awake. my resident said it was one of the worst call nights he's ever had. i came home and showered and pretty much passed out.

today was much better. i got in at 6am and was supposed to pick up one admission, but the MAR (medical admitting resident) felt that my board (list of patients) was so heavy that i should be spared an admission if at all possible. which it was. and which i truly appreciate.

then today i came home and discovered that i can steal internet. hooray!

this educational lesson brought to you by dr. j around 9:42 PM |

With anti-pigeon netting

this educational lesson brought to you by dr. j around 11:48 AM |

Of my 1st apt in nyc

this educational lesson brought to you by dr. j around 11:48 AM |

"living area"

this educational lesson brought to you by dr. j around 11:45 AM |

when i lose sleep over a period of nights, i tend to not sleep well when i have the opportunity. i've been sleeping about 4-5 hours the past few days, and last night i could have slept in until 9:30 or so this morning. instead i went to bed around midnight and have been up since 6am. couldn't fall back asleep. i was even trying to read a copy of forbes magazine that's laying around here (jesus that was boring) and it didn't put me to sleep. just made me bored.

in about 45 minutes i will be leaving brooklyn for the bronx. not that i really want to do such a thing, but at least my commute will go from 75 minutes to 75 seconds.

thanks to tam/bard for the aerobed and the duffel bag to help carry it. i just realized that my sheets and bedding and pillows are all in u-haul storage still (with my real bed). so i guess i'll be sleeping on a sweatshirt pillow for a week. fuck! i don't even have a blanket.

damnit.

also i highly doubt my apt is internet ready at the moment, so these posts may come to a halt soon. unless i feel so bold as to post from the hospital. which i don't.

in 6 hours i'll be on for 24 hours. ho boy.

this educational lesson brought to you by dr. j around 9:19 AM |