Reading Anne Lamott

"Later...I remembered the seasonal showers in the desert, how potholes in the rocks fill up with rain. When you look later, there are already frogs in the water, and brine shrimp reproducing, like commas doing the macarena; and it seems, but only seems, that you went from parched to overflow in the blink of an eye."


"You've got to love this in a God--consistently assembling the motleyest people to bring, into the lonely and frightening world, a commitment to caring and community. It's a centuries-long reality show--Moses the stutterer, Rahab the hooker, David the adulterer, Mary the homeless teenager. Not to mention all the mealy-mouthed disciples. Not to mention a raging insecure narcissist like me."

A good morning

The sun has returned from its week long vacation in Barbados.

We're eating warm biscuits with honey.
Cradling big mugs of hot coffee with cream.
And listening to folksy life is beautiful music.

Did I mention the sun?

And for this there is no treatment

I've spent the whole day studying neurology. The net effect being a pain in my head (could be a ruptured aneurysm, could be a tumor) and some numbness in my left ass cheek (may be chronic inflammatory demyelinating polyneuropathy, may be neurosyphilis).

The point is...I don't know. Much of anything.

Tomorrow, they will present us with cases, and then the clerkship director will ask, So...where is the lesion? You'd think that uh...nerve would be a safe bet (because neurology is, after all, the ology of nerves), but most of the time that's not actually correct.

Who knew?
Tomorrow, the answer may well be, Um...not Terroni.

Still recovering

I meant to write something here last week. Something more than, "I was pulling for Melissa Leo." (See last night's twittering during the Oscars. Or don't. You didn't miss much.) Frankly, though, I didn't have much to say. It would have been a lot of, "Still rounding. Attending is still touching people. Oh look, he just pried a woman's eyes open and said, Heya. How you doin' in there little lady? Now, he's bopping her on the nose with his finger."

Who the hell wants to read about that for seven days?

By the way, that woman woke up when the new attending came on service this week, lending credence to my theory that some of these people are choosing coma over talking to Patch Adams. If I thought it would work, I would have tried it myself on Wednesday.

The weekend was a little more exciting. My sisters came on Friday night and brought Logyn for my birthday. Last year, she slept on my chest the whole time they were here. This year, not so much. Logyn woke up at 6:00 on Saturday morning, and she was in a constant state of motion until her afternoon nap. You know how when you're really tired, you can sleep for hours but wake up to the feeling that you've only had your eyes closed for minutes? That's what her nap was like. She slept for two hours and, to me, it felt like ten minutes.

And, you know how when you go out to a restaurant without any kids, you wonder why the hell parents let their toddlers riddle the floor underneath the table with soggy bits of food? (Or is that just me?) Well...we went out to lunch on Saturday afternoon, and when we got up to leave the restaurant, I realized that they were going to have to rip up the carpet where we sat. Apparently, most of those crackers hadn't actually been going into Logyn's mouth. But, she sat quietly in that booster seat for two hours while we talked. Two whole hours. Just playing with her crackers and talking to her place mat. We had a great lunch. And honestly, I probably would have let her light the place on fire if she promised not to make too much noise while she did it.

So, now it seems as though I'm going to have to give up my righteous indignation at every parent who seems content to let their kid pepper the floor with cheerios at TGI Fridays. It's always a little sad when I have to let that go. Righteous indignation, I'll miss you.

It was a lot of fun to have the girls here, but the whole thing wore me out. They left at 6:30 on Saturday night, and I went to bed at 7:30. Went to bed for the night. I should say that I went to bed with a whole new respect for my sister, but I was too tired to respect anything but the inside of my eyelids. I did, however, wake up with a whole new respect for my sister.

Note to self...
Re: Parenting
Not enough coffee in the world to keep me upright for that.

On Sunday morning, I found little smudges on my computer and one of my younger sister's bobby pins on the kitchen counter. Logyn dancing and pointing at the singing cucumber on the screen. My younger sister coming to visit me for the first time since I moved away to college. When I do finally recover, this is what I will remember.

Tiny fingerprints.
A bobby pin.

Happy Birthday to me.

Roll over and play dead

Just as I was getting ready to hit PUBLISH POST on a sweet little ditty about the mother who forgot my birthday, she called and left a voice mail. Damn it. I was so enjoying that mockery. 9:37 pm. Better late than never. Except not in this case, as it has interfered with deliciously snarky blogging.

It is interesting to note, though, that my youngest brother--the sibling I talk to the least often--was actually the first to contact me today. And here I thought he just used that blackberry to schedule booty calls. Apparently, Text T was sandwiched in between Go to the gym and Get some in his day planner. I am honored to have earned that coveted time slot.

Otherwise, the day was pretty uneventful. I'm on service with an attending physician who thinks he's Patch Adams. As he asked a 25 year old patient about his leg pain during rounds today, he tenderly rubbed the guy's stomach. The dude might have enjoyed that if, say, he had been a Labrador retriever; but, in this case, it did not have the desired calming effect.

As someone who prefers her own personal space, I spent the whole day trying not to scream, BOUNDARIES. People have BOUNDARIES.

Two students on my team knew that it was my birthday. I told them both, "If you say so much as a word in front of Patch over there, I'll kill you. Both of you. Slowly. The last thing I want here is to kick off my 28th year with a belly rub."

Snow, poop, love

I was watching a movie with Graci an hour ago when I noticed the snow falling on the balcony, the warm light creeping out from above the stove in the kitchen. I was slowly swirling a glass of red wine in my hands, thinking about how I would write about all of this later. I would write about how this gray, boring day of studying turned out so...well, beautifully.

Understated beauty.
The best kind.

When the movie ended, Graci and I laid on the floor next to the sliding glass door and watched the snow fall. We laughed about the fact that the whole scene would have seemed a bit more poignant if it had been the first snow of the season, rather the umpteenth, and if the balcony hadn't earlier been peppered with the bird feces that were now staining the white flakes brown.

We talked about how much we were going to miss this--watching the snow fall and analyzing bird poop together--next year. There were a few silent tears. And then we each yelled at the other for carrying on with this sentimental shit, both of us claiming the other one started it.

We hugged and returned to watching the snow, laughed at the way the cat looks when she watches the snow, wondered aloud if all of that crap really came from one bird.

I can't remember when I've had a better February 14th.
Thank you for being my valentine, friend.

Under the influence

Holy shit.
I don't know what was in that wine, but I think it might have be laced with crack, or wild mushrooms, or that shit people lick off the back of toads.

I watch Dateline.
I know all about those toads.

What kind of liquor?

I seem to be somewhat obsessed with having something to say before I blog. When the hell did that happen? You might think that would lead to less frequent, but more substantive writing. If so, you might be someone who hasn't been reading. My regular visitors know that the actual effect has been that I still say nothing of real importance. I just say it less often.

Is that better? I'm not sure.

In truth, there's just a lot going on that I'm not writing about. Interviewing and traveling for interviews, while interesting, left me exhausted. I don't feel like writing when I'm exhausted. Unless, of course, I'm exhausted and inebriated.

Exhausted + Inebriated = Inspired

The times when I wasn't exhausted, I found myself sifting through the pile of things that had happened to me during my interview traveling, left with little to say. I decided that I wouldn't talk about specific places where I interviewed or to say too much about the people who I ran into out on the trail. That just seemed like a recipe for trouble. Or, to be more specific, a recipe for not getting a job. (Although, I have to say, I was tempted to devote a little space here to The Loud Talker. If we end up in the same training program, I am certain that I won't be able to resist that temptation all four years.)

All that said... there are a few stories from my interviewing days that I meant to write about and just never got around to (see above notes re: exhausted). For example, this was sort of amusing...


We were standing in the lobby of an apartment building during a tour of the residency housing. We had just finished a tour of the resident tour guide's own apartment, and one of the applicants asked the resident how he got such a great place. He darted his eyes around like someone looking for hidden cameras and bugs. Unable to definitively rule out the presence of secret monitoring devices, he said, "We'll talk outside, across the street. I don't want to lose my apartment."

By the time we got across the street, we were all salivating for a good story. What they don't tell you when you set out to do all of these interviews is that once you've heard three residencies present their programs, you've heard it all. That's not to say that the programs are all the same. But rather, that they all sound the same. By the time you're on #10, you're so fucking bored with the sales pitch that you're ready to take off your own high heel and stick it in your left eye. Just to mix it up a bit. So, by the time we crossed that street, we were eager for something we hadn't heard in the last dozen power points we'd smiled and nodded our way through.

The resident started, "Okay. So, if you get in here, the first thing you want to do is email a bunch of residents and ask them how they got their apartments. If you're single, they'll stick you in some shitty studio. If you're married, you get a one bedroom, like mine. And if you are married with a kid, you get a two bedroom."

One of the applicants interrupted, "But wait...you're living in a one bedroom with your girlfriend. So, as long as you have a partner, you can get a one bedroom?"

"No. See...that's the thing. When I got here, people told me, 'Look, if you want a good apartment, you've got to lie to the apartment lady.' And I was like, I'm not doing that. It's shady, and it's wrong. So for my first year, I lived in some shitty ass studio while everyone else was getting these great apartments. The women in my class were taking these fake ultrasound pictures to the lady, and they were all getting two bedrooms. The funny thing about that is, they were using some ultrasound they found online one night, and it was a picture of an animal or something. Then, when one of them actually did get pregnant and took in her real ultrasound, the lady was like, 'Uh...this doesn't look right.'"

The applicant pool was suddenly sharply divided into two groups: the group shaking their heads in stunned disapproval, and the one digging through their purses and pockets for a pen so that we could write down that farm animal ultrasound link.

Returning to his story, the resident said, "Anyway, I decided I was going to do what I had to do to get a better apartment. First, I went in and told the lady that I was gay and that my boyfriend was moving in with me. I asked if I could have a one bedroom. She looked at me and just said, 'No.' I said, 'So what you're saying is that gay people can't get a one bedroom here like straight married people can.' She said, 'You heard me.'

That sort of pissed me off. I mean, I'm not gay or anything, but come on. I told some of my friends what happened, and they were like, 'Look dude, it takes a lot more than that to get a good place. You have to show her some kind of proof of your life change. And you have to bribe her. She likes cash, gift cards to Macy's, and booze.'

So the next week, I went in prepared. I had a fake engagement ring receipt I made on my computer, a fake wedding invitation I paid someone to make for me, a fifty dollar gift card, and a bottle of liquor."

I stopped him here to ask, "What kind of liquor?" I was honestly thinking, when I blog about this later, it would be good to know that.

Johnny Walker Black. Two people wrote it down.

Then, another applicant asked, "Hadn't you just told her that you were gay?"

He said, "I told her that I found Jesus and repented. People love that shit. Plus, you have to remember, she's mostly interested in the liquor. You'll see...when you go in there, she's all wide eyed and shaky. Lady loves her some whiskey.

Anyway, I went in, handed her the receipt and the invitation and then said, 'Oh, and just to thank you for taking care of this...' and I sat a brown paper bag on her desk with the bottle in it. Her boss was standing right behind her. She got all nervous and fidgety and said, 'You know I can't accept this kind of thing.' And I said, 'Look, it's just a thank you gift. Just to say I appreciate you.'"

As he told us, he reenacted the scene, putting his hands in the air and backing up like he was gingerly walking away from a bomb he'd just dropped.

"A week later, I had that sweet ass apartment."


We walked back across the street and into the hospital. The tour continued, "Those are the ORs. I'm sure you've seen a million of them. They all look the same. Moving on..."

Notes from a Sunday morning

Crack and beans

Do me a favor. (Please.) Even if you don't read the rest of this, leave me a comment letting me know what kind of coffee you drink. Specifically, I'm interested in the kind of brew you make in your home coffee pot. Thank you.

I'm asking because we are having coffee trouble at my house. Last year, before Graci and I were sharing an apartment, we both bought our coffee every morning, often in the hospital. This year, we decided that we would buy a coffee pot and make our own. Saving money, waking up to caffeine. It sounded like a good idea at the time.

The first coffee that Graci bought was called Ugly Mug. It was on sale. We tried it. We liked it. We have tried several other kinds of coffee since. We haven't really liked them. So, last night, we were at the store picking up chips and salsa for a Saturday night margaritas and a movie get together when we wandered into the coffee aisle to pick up some more Ugly Mug. No longer on sale, it was TWELVE DOLLARS for a single bag. TWELVE DOLLARS.

It reminds me of the way dealers get you to buy crack. They give you the first hit for free, and then...wham, you're hooked. And you have to start paying TWELVE DOLLARS a bag for the stuff. Nice try, Ugly Mug pushers, but my roommate and I aren't falling for this shit.

So...if you have a minute, tell me a bit about your morning brew.


Massive transfusion protocol (courtesy of not yet a doctor, not quite an economist)

Watching the national news coverage this week and Meet the Press this morning, I have decided that our Congress men and women need to spend a Saturday night in a trauma bay. Not as the trauma... although, I must admit, I have occasionally been tempted to swing blunt objects in their general direction.

No, I'm actually suggesting that we build them some kind of observation booth (heaven forbid they should get bodily fluids on their shoes) so that they can watch a trauma team deal with massive blood loss. Because right now, while our economy hemorrhages, our elected officials are fighting about fighting. And, they are saying things like "we need to slow down here" and "let's have a series of procedural votes."

Tell you what, people, next time you find yourself in that trauma bay as a patient, we'll have a series of procedural votes. Literally. We'll vote about each and every procedure before we do it--everything from the rectal exam to the chest compressions. We'll slow down and put it to a vote.

Because, as you said, that's what the American people would want us to do.

On the policy end, let me just say, giving working families more of their dollars sounds great. But, fewer families are working right now. Those people don't need an income tax cut, they need an INCOME. Spending on infrastructure not only shores up our shitty, shitty infrastructure (if you'd like a tour of said shittyness, spend a few months traveling around the country, using only public transportation), but it also creates jobs.

Loosely returning to the above trauma analogy: If you lose blood, we can temporarily restore your blood pressure with IV fluids; but, in order to save your life, we have to give you blood. Tax cuts are like IV fluids. Spending on infrastructure is blood.

And, fighting about fighting is a good way to lose the patient.


All the weird love that's fit to print

On Sunday mornings, I flip through The New York Times online. I pretend that I'm interested in the national news. Honestly, I am there for the wedding announcements. I know, I know. It doesn't get much more stereotypically desperate, single woman than that. But, although I am certainly not looking to get married again, I have not sworn off relationships forever.

I'm cynical, but I'm not bitter.

There is always one couple in The Times that reinforces my optimistic suspicion that there may, in fact, be someone for everyone. This week, that couple is Rachel and Seth. They are the first people featured in a video about half way down the page--a video that starts and ends with a small dog obsessively licking a bald man's cranium. They fell for each other in an anti-Oprah succession book club. (And really, who hasn't met the love of their life at one of those?) But, my favorite part is when they show you the picture of the two of them trying to reenact the famous lift from Dirty Dancing.

Something about it makes me laugh. With them, not at them. Like I said, I may be cynical, but I'm not bitter.

Certainly it must be 5 o'clock somewhere

It feels like it's been a month since I posted last. That is to say, it's been a long week. I was in New York at the beginning of the week for a second look at one program and an interview--my LAST interview--at another.

The second look went very well. I had a lovely chat with the chair and program director. The chair of the department asked if it might be okay if he just asked me to be his chief resident now. I said, "Oh, come on now...you probably say that to all the girls."

The program director, whose mouth fell open when the chair asked, said, "No. No, he really doesn't." So, that was nice.

This program is not my first choice. But, it did move up several spots on my list after that visit. My mom called me later that day and asked me about it. I said, "It's not the best program I've interviewed with, but I would be well-loved here. And that's not nothing."

The interview the next day did not go so well. I should rephrase that... The interview was fine. They seemed to like me. I think that if I really wanted a spot there, I could probably have one. But, I wasn't impressed. They spent all day reminding me where I was interviewing.

This is IVY LEAGUE PROGRAM.

It was there answer to everything from Do you see much trauma? to Where's the bathroom?

Honestly, I think that they missed their true calling... We should hand them a bunch of red markers and let them write YOU ARE HERE on subway maps and mall directories.

This is IVY LEAGUE PROGRAM was quickly followed by We're the best. They started to sound like those people who think that the dinner portion of a date is an opportunity to talk about how good they are in bed. I have learned that this actually code for Prepare to be disappointed. And, extrapolating from said dating experiences, I suspect that I would leave the residency exhausted and annoyed.

Since returning from New York, I have been back at work, rounding on nephrology patients in the ICU. I have spent most of my time trying to keep from screaming LISTEN TO ME, DAMN IT at the residents.

Yesterday, it was, "T, what happened to that patient?"

"She died."

"When?"

"This morning at about 10."

"Why didn't anyone tell me?"

"I did tell you."

"When?"

"This morning at about 10:05."

"You told me?"

"Yes. Remember when I showed up five minutes late to rounds and said that I was doing chest compressions in room 75 but she didn't make it?"

"You told me that?"

"Twice. I was going to say it a third time but decided that when we got to the room and you saw the empty bed, it would sink in."

"Wait...so she died?"

The whole week has been exactly like that.

I just got a call on my cell phone from one of them...

"Where's my note?"

"What note?"

"The note on Mr. Smith."

"The last time I saw it, the fellow was carrying it in his left jacket pocket."

"He doesn't have it."

"Did you check his pocket?"

"No."

"Check his pocket. If it's not there, check his other pocket. Then, I'd look in his socks. If it's not in either of those, you should consider the fact that he's European and may carry a man bag or murse. If such an accessory exists, I would rummage through it. Beyond that, I'm not sure what to tell you, but I wish you the best of luck."

Because I sure as hell wasn't going to drive back to the hospital to strip search the fellow to find a piece of paper that the resident should have left in the chart. Where charting belongs.

Like I said...a long week.

Tomorrow, I fly to Atlanta to take the part of the boards where they videotape you examining 8 fake patients. They want to make sure that you can (a) speak and understand English, and (b) keep all of your psychotic/douche-bag tendencies on the inside. Where they belong.

Wish me luck.

To do

Blog. It's number 3 on my list. Numbers 1 and 2--Blue Moon and shower--completed, I have no choice but to soldier on. This is me. Soldiering...

I'm tragically behind in my travel stories. Some of them now seem a little bit, well, for lack of a better word...outdated. Maybe pictures will help.


But first, a word about my trip to Boston. I went. I interviewed. I had dinner with Christine! She was a wonderful hostess (and a great blogess). Unfortunately for her, I was a little fried by the time I got to her. Interviewing has a way of sucking all of the life right of you. Or rather, me. The fact that we had fun is a credit to Christine's awesomeness, which more than compensated for the fact that I had spent all of mine a few hours earlier.

After my trip to Boston, I was home for three days. I have absolutely no idea what I did during that 72 hours. Hell, I may have been kidnapped by aliens. I just don't remember. (Although, from all I've read, the alien kidnapping is typically followed, almost immediately, by some sort of alien anal probing; and I think I would have remembered that.)

Oh wait, it's sort of coming back to me... I drove around in the snow for a few hours on Saturday night. My car door froze shut. The driver's side handle broke off. I spent a few days crawling around from the back seat to open the door from the inside. During one such maneuver, I stepped on a lint roller that had fallen out of my bag onto the floor of the back seat. I rolled off said roller and planted my face in the back of the driver's seat headrest. (Thank God for the padded headrest.) I dropped my car off at a mechanic's with a note that said, Please fix the door handle before I knock out my front teeth. Thank you.

Monday morning, at 4 in the AM, I headed to the airport to fly to Atlanta to fly to San Jose to ride to Palo Alto.

I started the trip by writing in my journal a bit...


This served two purposes. First, it gave me something to do when I wasn't in the mood to read my book. Second, it pissed off the guy next to me who really just wanted me to turn off the reading light so that he could sleep. When he decided he was going to hog the arm rest between us and spread his feet into the space where mine belonged, I turned on the light and began to write about the jackass sitting next to me. The passive aggression paid off. He retracted his appendages back into his own seat, and the two of us had a lovely flight...



In Palo Alto, they call this winter...


Because they do not know any better. Those poor fools. Poor warm, tan fools. But, you know what they say. When in Rome, do as the Romans do.

Take off your socks...


And eat outside...


It is important to try to blend in. One doesn't want to appear ethnocentric.

On my interview day, one of the residents was complaining because he had to cancel his facial reconstruction case because the patient had poison oak on his cheek. I laughed. He said, "What's so funny?"

I said, "You can get poison oak here...in January?"

"Well, yeah," he said.

"Ahh," I sighed, "this truly is a magical place."


The trip home was, as previously mentioned, way too fucking long. But, Lyle was right. The lights of LA County do look like diamonds in the sky...



I'm not sure what Mr. Lovett has to say about the ice on Lake Michigan, but it is also lovely from a couple thousand feet up...



And, finally, home again...


The clouds looked better from the top than they did from the bottom.

Clouds, a metaphor for, well...everything.

Sunday afternoon, I leave for my last interview. I suppose I don't have to say that I will be relieved to be done. But then, in a few weeks, I'll be bummed that I don't have an excuse to hop on a plane, skip out on a couple days of rounds, and meet some new people. The grass is always greener I suppose.

Grass, a metaphor for, well...everything else.

(Blue Moon not only hydrates but also makes things seem metaphorical that may otherwise, well...not.)

Home again

I went to Northern California for an interview on Monday. Flew back last night. With a couple of lay overs and a delayed plane, it was an all night extravaganza. When people say, Oh, I just love to travel, nights like that one are not what they're referring to.

I have spent August days roofing houses and gone home feeling less disgusting than I did after spending the night in that airplane. Something about greeting the morning (and its fermented breath) with 150 people separated by nothing but a bunch of tiny, grungy used pillows, all their toothbrushes buried in the overhead compartments...

Just thinking about it makes me want to take a hot shower in Listerine.

The trip was not all bitching and moaning, though. Monday afternoon found me sitting on a bench. Outside. Eating an ice cream cone. In JANUARY. I thought of you, Maria. In fact, I briefly considered calling you to tell you all about it. But, I seem to remember you kindly requesting that I no longer do that when I'm stinkin' drunk...and I was stinkin' drunk on that ice cream.

More on all of that later. Right now, I'm heading to my bed (ahh, that just sounds nice) to rest up for a long day of nephrology tomorrow. I anticipate a lot of time spent drawing the nephron on the backs of paper towels, trying to figure out where my patients' electrolytes went. And that will be almost as much fun as sitting on a bench. Outside. Eating an ice cream cone. In JANUARY.

Blowing. And also drifting.

Drove through the snow for two hours.
Didn't die, but also didn't make it to that dinner.
(Damn you, Winter.)

Graci gave me a chocolate chip cookie left over from her own dinner.
She even warmed it in the microwave.
Amazing how much better that will make a girl feel.
(Thank you, Graci.)

26 years ago today...

Graci showed up.
And the party was suddenly so much better.

Happy birthday, friend.

Love, T

In an airport

So titled because that is, in fact, where I'm writing this. A tiny little airport and the most vigilant security force I have ever met. The enemies of freedom will do little to advance their cause flying through here. The TSA agents were ready to take my carry-on bag to an undisclosed location and blow it up when an observant supervisor suggested that what they were so concerned about on x-ray may in fact just be the HANDLE OF THE BAG. That crisis narrowly averted, we moved on to other potential weapons of mass destruction, namely my shoes.

Now, I'm monopolizing the only outlet in the whole airport and playing music without using my ear buds. If you don't want to listen to Melissa Ferrick, you and your crappy taste can sit over there. (If you say it with a smile, it's almost like being courteous.)

Okay, back to where I left off...

Friday

I interviewed at a phenomenal program in New York. Phenomenal. (Wait, I said that already, didn't I?) Dead sexy. My interviewer said, "You know, I never say this, but if you want to come here, I'm sure we have a spot for you." I think I've heard something like that before. I was standing next to a used Chevy and the guy said, "I never do this, but for you, I'm going to give up my commission."

Sure you are, dude.

I'm cynical with good reason. Programs are known for lying to applicants to ensure that when it comes time to match their rank list with our own, they get everyone they wanted (and have several talented back-ups just in case). While I appreciate his apparent enthusiasm about me, I'm keeping it in perspective, matting it in a frame carved with the words, This may be total bullshit.

Friday night, after much debate about whether or not it was worth it to trek out in the cold weather again, I finally decided to head to Rockefeller Center to see the Christmas tree. It looked shorter in person. The star on top was almost too big. Like a friendly, stout old man wearing an over-sized hat. In fact, it looked like the guy sitting across from me...except that he isn't actually strung up with lights.

Three minutes after I got there, they turned the lights off and began taking down the tree. I actually felt like my timing was perfect. Frankly, it was too cold to stand around and stare at the lights, and I got to see the tree say goodbye. (Damn, that sounds lame. Screw it. I'm leaving it.)

Time to board my flight. More later.