Archive for June, 2010

I won’t start getting panicky until I hit my early late 30’s

I distinctly recall being eight and thinking that people in their 20’s were old.1  People in their 30’s were washed up has-beens.  And actual old, wrinkled people?  They were already dead, just hanging out until there was an open slot in purgatory.  Or outer space. 

Then again, when I was eight, I also thought that I had my finger on the pulse of the 1980’s fashion movement.  There was this one outfit that I put together all by myself.  It combined an aqua tie-dyed Minnie mouse t-shirt that came to my belly button with a pink tank top underneath (I wasn’t allowed to show my belly button because only sluts showed their belly buttons.) with a white floral-print denim knee-length skirt (I wasn’t allowed to wear above-the-knee skirts because only sluts wore mini-skirts.  Only sluts watched Dirty Dancing too.  Pearls of wisdom from Mamacusa.) with three pairs of tube socks (pink, blue, yellow…to match the flowers on the denim skirt) scrunched down to look like tri-colored leg warmers and white reebok high-top Velcro sneakers.   Man, I rocked that shit.  I had to beat the boys away with my enormous, blue, plastic/metal combo framed grandma glasses. 

If I had a time machine, I’d travel back to my eight year old self, counsel her on the future photographic ramifications of that outfit, and then I’d sit down and watch Dirty Dancing with her.  (I was eight in 1985 and the movie wouldn’t even come out for another two years but, fuck it, nobody puts Baby in the corner!)  Then, I’d give her a post-movie talk about how 20 is not old…and, you know what?  Neither is 30.  In fact, in the future, this is how we will regard one’s 30’s:

The Thirties: 
30 –late, late, late 20’s
31 – early early 30’s
32 – mid early 30’s
33 – late early 30’s
34 – early mid 30’s
35 – mid 30’s
36 – late mid 30’s
37 – early late 30’s
38 – mid late 30’s
39 – late late 30’s
40 – late late late 30’s

So, see!  I’m only in my late early 30’s…I’ve still got AGES before I should start carelessly spending my retirement money and telling people what I REALLY think of them!

1.  This may have something to do with the fact that when I was 8, my Mamacusa was 27.  God, she was a loose woman!  one might think.  Perhaps, yes, but more importantly, she was a MARRIED loose woman.

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Add that to the list of things that med school was good for

Days left in residency: 18

The other day I was seeing patients in clinic with one of the colorectal surgeons. Lots of run-of-the-mill problems of the colorectal variety, you know: colon cancer, hemorrhoids, rectal prolapse, gerbils, that sort of thing. Much of this clinic is spent performing anoscopy – the fancy term for inserting a cold, sterile, six-inch metal tube up a person’s poop shoot and poking around while trying not to laugh.

Given that this minor procedure requires a rather compromising body position, we like to preserve what’s left of a person’s dignity by providing them with a cloth drape that allows them to cover all but the area of interest.

It looks like this:

And is meant to be worn like this:

Apparently some patients are so nervous about the impending medically approved sodomy that they don’t hear the nurse’s instructions for how to put it on. I can only assume that is the explanation for why one particular patient was found in his exam room with his drape fashioned as such:

It’s a good thing I can tell the difference between the oral and anal cavities1 otherwise he might have gotten a mouth full of lube and a referral to the orthodontist to have some braces installed on his malaligned and curiously calcified hemorrhoids.

    1. Those who didn’t go to med school might confuse the two on the basis that both have the potential for producing nonsensical diarrhea and both, depending on manscaping and hygiene, can be hairy and malodorous.

Yeah, I can amputate that for you

Rule number one of being a doctor?  Don’t tell anyone outside the hospital that you’re a doctor.  Trust me.  It always starts with an innocent medical question.  And ends in a dark, dank alleyway with a dubiously indicated excision of some fleshy appendage using nothing but a plastic butter knife for an instrument and The Steve Miller Band’s Greatest Hits album for anesthesia.  Abracadabra does surprisingly little to settle the hearts and minds of patients looking for free medical advice. 

I was sitting at the BART station the other day, waiting for a train, when a young girl sat down next to me on the bench.   Lots of eyeliner, cut-off jean shorts, strategically torn tights…Miley Cyrus + Ke$ha hold the Britney.  Old enough to know about the late Michael Jackson, but not old enough to know he used to be black.

She looked at me.  Looked at my scrubs.   “Are you a nurse?”

I hesitated.   On the one hand, if I told her the truth, she might ask me about her unusual skin rash.  On the other, if I told her the truth, she might feel all empowered and shit.  A doctor with a vagina?1  Holy fuck, right!?  Then she’d straighten out her ways, stop listening to that obnoxious (albeit totally catchy) Ke$ha music, start wearing impalement-resistant tights and bottoms with proper hems…and maybe go to med school.  All because she CAN…something that never occurred to her before that fateful and inspired conversation with that haggard appearing, pear shaped lady in scrubs on BART. 

In a spasm of feminism, I decided to tell her the truth.  I waited for the empowerment (and shit) expecting that it would look something like The Rapture.  Whatever that looks like.  You know it when you see it, right?

She proceeded to ask me about her unusual skin rash.  “Oh, cool.  Because I have this funny thing on my thumb.” 

She gingerly gave me the thumbs up. About six inches away from my face.  (Perhaps she didn’t understand that my glasses had prescription lenses in them?)  And I swear a yeast spore jumped out from the scaley patch of skin on her thumb onto my face.  I considered, briefly and earnestly, offering her a thumb amputation.  But ended up telling her, instead, to get some cream for that shit.  And to maybe go see a dermatologist.  In the meantime, though, she should probably suck on it.

Bottom line is that people shouldn’t ask me about their medical ailments unless they want an operative intervention of my obnoxious choosing.  I understand that strangers might not pigeon-hole me as a surgeon at first glance (I do, afterall, have a vagina2) but family…they should know better than to ask me about their problemas. 

One of my relatives of the male, freeloading variety called me up one day after a 2 year lull in conversation.  After some awkward small talk in which I determined, with relief, that he didn’t seem to want money, he got to the point and told me he had a medical issue he needed to ask me about.  I could hear the italics in his voice.  I braced myself.  Italics are never good. 

“So I have this painful swollen area next to one of my testicles…almost like an extra nut.  What should I do about that?”

Wait.  Is there a do-over button somewhere?  Ask me for money instead!

Thankful that there were 3000+ miles between me and his sweaty, tender tri-balls, I recommended that he get that checked out and warned him that he might need a third nut amputation.  I mean, everyone knows a third nut could go one of two ways…cool party trick versus malignancy.3 

Don’t get me wrong.  It’s not that I don’t want to help family and friends and random BART passengers.  I do!  I became a doctor in the first place to help people.  (And to be able to write myself prescription drugs.4)  Perhaps I should just preempt every potential curbside consult with the following public service announcement: 

Please kindly keep your herpetic epidermis

and your purulent gonads to yourself.  

(Thanks in advance.) 

 
 
 

  1. Rarely seen in the wild, not unlike the nurse with a penis.
  2. And LORD knows surgeons don’t have vaginas!  I only say this because I’ve spent the last seven years conducting a rigorous research study examining the number of times a woman in scrubs gets called “Doctor” vs “Nurse.”   Hypothesis:  Women in scrubs never get called “Doctor.”  Methods:  Be in possession of a vagina and walk around various hospitals in scrubs +/- a long white coat.  Results:  Women in scrubs get called “Nurse” 100% of the time (p < 0.00000001).
  3. Disclaimer:  a “third nut” can be way more than just two things.  You’ll be relieved to know, I’m sure, that his was just a follicular abscess.  Don’t shave your balls, gents!
  4. Just kidding, Medical Board!  Tee hee!

 

Aaaaaand, she’s back. Again. Now with new and improved lemonade.

So.  You know how sometimes life hands you lemons?  And chirpy, shiny, happy, annoying people tell you that you’re supposed to make lemonade?  And, under normal circumstances, you would (because you love lemonade, it’s full of vitamin C and brings you back to happy childhood memories of when your Abuelita used to make it for you from scratch when you were young, carefree, skinny and you had no fucking clue how many calories were in all the sugar in there, am I right?)…but this particular time, all you have is lemons.  No water.  No sugar.  No spoon to stir with.  No friggin’ pitcher.  Just you.  Lemons.  And that annoying chirpy person.  In the middle of the desert.  No camels.  No shade.  No sunscreen. [Aaaaaand SCENE!] 

Yeah, so that’s been my 2010 thus far.  We’re up to our tits in lemons over here.  The nutshell version?  My stepdad, TLM, died this past March at the young age of 51.  And a little more than a month later, I miscarried a baby boy 15 weeks into pregnancy. 

Don’t think for a second I haven’t had words with God, Mother Earth, and The Cosmos because I have.  And they weren’t pretty, dainty, lady-like words.  But I’m fairly certain I got my point across and I get the distinct feeling that the remaining necessary ingredients for lemonade should be arriving shortly.  I’m just about ready for a little sugar is all I’m sayin’.  (And, for the moment, that’s all I’m willing to say about either of those two delicate subjects.)

Until things start turning around here, I’m just hunkering down…counting down my last days as a surgical resident.  For the record, I have 3 days left until I should be done and 24 until I’ll actually be done (when one takes into consideration the 3 weeks that I have to make up for the time I took off to be with my family in March).  I’ve been at this for seven years…48 weeks out of every year…80+ hours every week…so it’s safe to say that when it comes to performing surgery, I’ve established a way of doing things that is my own.  And that’s partly what residency is about…you watch how everyone else does an appendectomy and then you decide which way you like best and you do it that way.  (For instance, I learned early on in residency that using your bare hands to extract the appendix Mortal Kombat Style wasn’t the most effective.  Nor did it adhere to the strict sterile procedure code followed in the OR.  Whoopsies!)  After participating in so many different operations with so many different surgeons, your own personal style is born out of picking and choosing the techniques you like and abandoning the ones you don’t.  And sometimes, your style is born from watching how they do it on Grey’s Anatomy.1

So there I am.  In my seventh year of residency.  Performing a laparascopic cholecystectomy.  With an attending surgeon who I suspect (based on the fact that she shrinks annually and now measures roughly nine inches tall and weighs about as much as my left thigh) is older than the practice of surgery itself and who, while operating, refers to organs as if they were likable puppet characters in Mr. Rodger’s back yard (ex: Ooh, let’s not mess with Mr. Liver, We don’t want to upset Ms. Pancreas, Miss Jejunum likes to be handled gently!) which, for the record, is annoying.  (Seriously.  Did I want to be Mr. Rogers’ neighbor in the 80’s?  No.  Do I want to be my attending’s now?  Hell.  No.)  So there I am, grasping Mr. Gallbladder while gingerly dissecting out Ms. Cystic Duct, taking special care not to damage Mr. Common Bile Duct or accidentally avulse Miss Cystic Artery when I get frustrated that the dissecting instrument I’m working with isn’t the kind that rotates, thus forcing me to awkwardly rotate my right wrist (one that I injured a few years ago and, since, try to avoid re-injuring).  So I ask the scrub nurse for a rotating instrument.  And my attending says, “I feel awkward having to point this out to you at this stage in your training, but that’s what you have wrists for.” 

Oh. No. She. Didn’t.  Yes she did.  So, slowly and calmly, I removed the non-rotating instrument from the laparascopic port and, with the power and precision of a samurai swordsman that’s been training for roughly 80+ hours a week, 48 weeks out of the year for, say…SEVEN YEARS, I inserted it under direct visualization (an important principle in laparoscopy!) up into my attending’s Mr. Rectum, lifting all 82 lbs of her up onto the instrument, and spun her around by rotating my wrist..all the while, thanking her for reacquainting me with that joint that I never TRULY appreciated between my forearm and my hand.  All in the span of a few seconds.  In my mind. 

Is my lemonade ready yet?  Let’s throw some vodka in there…my wrist hurts.

1. Just fucking with you.  It’s the show ER that taught me all my best surgical techniques…Grey’s Anatomy just taught me how to bag & bang a good looking attending.2
2. Just kidding, Husband!


Hark!

The madness featured here is mine and mine alone. It does not, in any way, reflect the madness of my employers, colleagues, patients, nutty family, or my colorful friends. The privacy of my employers, colleagues, patients, nutty family and colorful friends is sacred & deeply respected, so no names. All words Copyright © la cubana gringa, no method, just madness 2006-2010. All comments © their authors. Don't steal; it's not nice. (And my Grandfather knows people.)

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