Larie's Blog

Friday, May 25, 2007

ICU nights ambiance

I have had a lovely ICU nights experience thus far and only 3 more shifts to go... Feeling a bit contemplative since this is my last ICU nights block ever. We only do ICU night blocks as a second year so will just have some ICU day rotations next year. The obvious difference (or maybe not so obvious) is that on nights I am alone admitting everyone that comes into the ICU and cross-covering on all the other patients in the ICU. It can definitely get messy and busy...
This particular rotation has been all about codes... PEA, asystole, etc (basically, not good). Fortunately, or unfortunately, they were expected to have bad outcomes so it was no major trauma that neither patient survived all my valiant efforts, though still very sad.
This ICU nights rotation has had a certain ambiance all its own. I think I have finally gotten used to juggling 10,000 things at once (admissions, labs to followup, etc), getting interrupted by the nurses every five seconds (various cross cover issues)... the rotation has been nice, but the ambiance actually came from the small Gideon Bible (but with fairly large print and that stays open very nicely) that somehow appeared at the corner of my workstation halfway through my rotation... I normally don't even think about having time to read the Bible at work, especially in the ICU. But it was there... so I opened it... to Colossians "walk worthy of the Lord, fully pleasing Him..." and Phillipians "Be anxious for nothing, but in everything by prayer and supplication, with thanksgiving, let your requests be made known to God...", "not that I speak in regard to need, for I have learned in whatever state I am, to be content... (this one keeps appearing), "I can do all things through Christ who strengthens me..."
In between the busyness, having a Bible open to glance at and meditate on brought a special peace...
Is someone out there praying for me? Who is responsible for the Bible's appearance? Or was it there the whole time and someone prayed it to my attention. Thank you to whoever is praying...

By the way, I'm coming to visit June 1-3. Will see you all at AdventHOPE on Sabbath, perhaps friday night, and maybe we can eat out Saturday night or Sunday. Looking forward to it!

Saturday, May 12, 2007


Well, I suppose I should really say hello to all my long lost pals in So Cal and a few other places...

I think about you all the time but feel like I am always too deep under my pile of things to do...

Currently brewing:

1) trying to get various papers, competencies, certifications turned in before the end of the year (it helps in order to go on to 3rd year residency)

2) about to take USMLE step 3. yes, I know, I am very lazy procrastinating so long. everyone else in my residency program seems to procrastinate this test so why should I be any different...

3) lots of power point presentations. seems like we end up doing about two per month depending on the rotation. then there are other didactics that we teach.

4) just went to an area high school as part of out patient rotation and taught and A&P class on the digestive system to juniors. wow they seem young now! Of course I found out I was doing this 3 days before it was due, all of them were work days and the first two involved a 30 hour shift and postcall napping leaving little time left for preparing what I was going to say.

5) I'm really starting to freak out about having only 1 year left until I have to know it all... just kidding about the knowing it all part, since the attendings all tell me that they felt quite dumb their first year as an attending with the whole adjustment of having no one to staff with.

6) seems like everyone in my clinic group is on vacation right now including a lot of attendings so of course that means I am managing all their issues.

7) did I mention that winter is really dreary here and that I NEED SUN!!! By the way, Sunny counts for sunshine. Thanks for coming up to visit Sunny Bunny! You're a sweetheart! It was fun hanging out with Halle and Lisa as well.

8) I really need summer so that all the snow will melt off my favorite trails so that I can backpack! must backpack!!! Nothing like living in the part of town with all the bars and street noise to make me need to escape.

9) Tim, enjoy life as a medical student. That's all I am going to say. Just kidding, residency is much better, though also more exhausting.

10) What is with everyone I ever hung out with getting married this summer??? You guys have nothing better to do than be romantic! (Kidding again, great choices everyone! there is more to life than work...)

11) I'm trying to decide what to do with my life after this next year. Hospitalist? Primary care doctor? Missionary? I want to be mobile enough to do mission work, I want the job flexibility of a hospitalist and I want the doctor patient relationship of a primary care provider. Any ideas???

12) Thanks for the darlings that remember me enough to invite me to be a part of their wedding! I'm honored... and looking for plane tickets... and trying to get dresses altered and find shoes, etc. I will make appearances in June (1-3) and August (10-12).

13) while I did gain about 100 extra pounds during my intern year due to eating junk (must have energy) I have been revising my habits to include fasting when at work and eating only when at home and now only weigh 40 pounds extra. (kidding about the numbers, take off one extra zero for each.)

14) my patients are driving me crazy much of the time. while I like primary care I must say that vague dizziness, chronic back pain, narcotic seekers really make me think twice about my career choice. And I really don't like it when the chief complaint listed by my medical assistant on the progress note is "multiple issues". I'm definitely getting better about interrupting people and guiding the interview, but some interviews really are impossible!

15) trying to read something every day that I learn on my current rotation. seems like not much time is left though after going the the grocery store, paying bills, doing laudry, doing the dishes, etc. Did I mention that it seems like every night I am preparing a power point for something

16) would be nice to have a good church to go to. there are some reasonable places out here though they are definitely not AdventHOPE. But it seems hard to ever get to know anyone when I have so few Sabbaths off.(Doesn't help matters when I go backpacking for the weekend, either.) Audioverse is great!

17) Did I mention that every weekend I'm off, it rains and all week at work it is sunny weather. Arrrrrrggggggg!!!!!!!

So... most of you will now understand why I don't blog very often and why when I do blog I just put up a nice scripture verse. I generally prefer not to say anything rather than to whine like I just did. Sorry for the attitude.

So... here is the verse (I really need to work on applying it):

"Not that I speak in regard to need, for I have learned in whatever state I am, to be content... I can do all things through Christ who strengthens me." Phillipians 4:11, 13