Archive for the 'piss and moan' Category

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!


Welcome to my pity party

My bloggless month of April crescendoed with the acquisition of a rather fastidious GI virus that then resulted in an impressive fecal meltdown and, subsequently, one work day spent conducting the business of surgical residency with an IV in my right upper arm, IV fluid running through me, followed by several more nauseated, bloated work days wishing someone would follow their “you don’t look so good” with a “you should maybe go home and get some rest.” It was a shitty way to end a predominantly shitty month spent working entirely too much.1

Spoiler Alert: May’s not turning out much better. (Albeit significantly less “literally” shitty.)

May has found me in Reno where I’m rotating at an affiliate hospital for this month and next. I’ve come to the conclusion that Reno isn’t so much “The Biggest Little City in the World” as it is the Littlest Little City in the World with the Most Stripmalls. I’ve polled the Reno locals (n=4) on what there is to do in this town and have been met with just as many blank stares and one silent nudge in the general direction of Harrah’s. So I’ve revitalized my relationship with my surgical textbooks and renewed my Blockbuster membership. Note: Surprisingly, many patients who’ve suffered TIA’s have CT evidence of stroke and Pineapple Express has its funny bits but is generally shit.

Which leads me to something else that’s shit. Cancer. If last year was The Year of The Wedding2 this year is certainly The Year of Cancer. I’ve already mentioned The Love Muscle’s stomach cancer but The Brit’s aunt was diagnosed with colon cancer, I just got word the other day that one of my aunt’s brother’s has a pancreatic mass, one of the nicest patients I’ve ever treated just got diagnosed with throat cancer, and, also, a wonderful couple The Brit and I know are getting a divorce which isn’t so much literally cancer as it is figuratively Stage IV Marriage Cancer so I’m throwing it in there anyway. It’s my blog.

Things with TLM’s stomach cancer have taken a turn for the worse…its spread throughout his abdomen. This has left us all simultaneously paralyzed and racing against a timer whose countdown is indecipherable. Daily, I find myself trapped in a variation of the same scenario: scrubbing into this case or that, fake smile plastered across my face while pretending to listen to my attending’s monologue about this, that, or how fantastic the back yard will be once the hideously expensive 40 ft pool is finished and the imported palm trees have been planted…all the while resisting the temptation to make a run for the Reno airport and hop on the next plane to Portland (but not before pelleting my attending with my chlorhexidine soaked scrub brush and telling him/her what they can do with their imported fucking palm trees). (Hypothetically, of course.)

I warned you.

1. The pun wasn’t intended but it did work out rather nicely.
2.  Not only did The Brit and I get married but so did, like, a billion of our friends.

Not that I condone torture or anything

What would you say might be appropriate punishment for an accountant who, what’s the word he used, miscalculated what you owed in federal and state taxes?  Because I’m thinking that I might dip said accountant in honey, spray him with bird seed, and then hang him from his scrotum in the yellow bellied sap sucker bird exhibit at the Academy of Sciences Museum during peak business hours for precisely 12,000 seconds.  And then mention to him, say, around second 11, 999, that I really only meant to hang him there for 1,500 seconds. 

Oops!  Minor miscalculation!

Pass me the searing hot accupuncture needle

Checking voicemail rates highly up there on the list of things I’d gladly trade for the chance to have hot accupuncture needles jabbed into my eyeballs.  It’s right up there with euthanizing lab rats, running uphill, and listening to any song (rap, opera, yodeling or otherwise) that violates the rules of syntax and grammar for the sake of having the lyrics rhyme.   (I’m going to go ahead and call you out on this one, Juvenile, the words “ass” and “bad” cannot be made to rhyme by just adding “yeah” to the end of them.)  So, anyway, what I’m sayin’ is, I don’t enjoy checking voicemail messages.  Don’t ask me to rationalize it, there’s no explanation for it.  Just…no me gusta. 

The only reason I mention this is because the other day,  I unexpectedly got out of work early enough to go to the SF municipal transport office (to see about getting a residential street parking permit) before it closed.  I took a number and the only remaining empty seat in the room only to realize moments later that I’d wedged myself  between a guy who was checking his voice mail ON SPEAKER PHONE and another guy who was listening to his headphones loud enough for the entire waiting room to hear the atrocities being perpetrated against grammar in the particular song he was (we were)  listening to. 

I’m about to strip and I want it quick
Can you handle me the way I are?

You have SEVEN!! new messages!!  Message number…one from… four…one…five…three…three…nine…two…four…seven…seven on Monday…March twenty…third at…four…fifteen…pee…emmm:  Hi Doug!  DUDE!!!  Are you coming out tonight or WHAT???…[DELETE] Message number…two from…four…one…five…

Somewhere, out in space, the planets and the stars were aligning against me.  Surely a litter of innocent lab rats minding their own business was being brutally murdered somewhere while Celine Dion* was signing to the tune of something Kenny G* was playing on sax…ALL AT THE SAME TIME.

* Also on the list.

That and some pretty spectacular snot!

January is routinely a giant pain in my giant behind. Seriously. Every morning of every January we go through this whole routine where I have to muster up the will to scrape myself out of bed and go out into the big, grey, blustery outside to do Things.1 I normally like doing Things. Honestly…me and Things? We’re tight. But in January, Things just seem like a big, steaming load of Not Fun wrapped in a winter coat and scarf. And don’t forget the umbrella, otherwise it would all be a big, WET, steaming load of Not Fun. Which, for the record, is considerably less fun.

It’s not just the weather that colors everything so many shades of poopie2 for me, it’s also that every year, on the last Saturday of January, I (along with all the other general surgical residents in the US) have to take a surgical board prep exam. A little sum-m sum-m the American Board of Surgery dreamed up to simulate the experience of sitting for four hours in a room and having your fingernails ripped out of their nail beds with pliers…by an extremely technically gifted surgeon, of course. An exaggeration, perhaps, but it’s about that much fun. So, yay, about that.

Adding insult to injury is the fact that apparently, quite a few decades ago, the maternal and paternal sides of my family held a conference with my stepfamily as well as with the family of The Brit. And in this conference, they came to the consensus that everyone should hump their friggin’ brains out in, say, April…so that EVERYONE would have January babies. Maybe they all liked Garnet as a birthstone, I don’t know. But the end result is that my grandfather, stepfather, father, brother and The Brit all have birthdays in January. I hope they all like handouts of surgical board prep test questions, cuz THAT’S ALL I’M GOOD FOR RIGHT NOW!

  1. Things like Work. And Stuff.
  2. Shades like Blahhh. And Urghhh.

Yeah, so…so far, 2008 is TOTALLY going my way

In the last couple days I have devolved into a semi-gelatinous glob of mucousy viral contagions which, I guess, is the cosmos trying to tell me that breathing through one’s nose is a privilege, not a right. Dually noted, Cosmos!! DUALLY NOTED!!

Considering my time of late has become vastly consumed by sneezing and obligate mouth breathing, the last thing I’ve been in the mood for is writing two medical journal manuscripts for a Jan 4th deadline. And yet that’s what I’ve been doing. So, needless to say, there hasn’t been a whole lot of recreational fun going on around here…and, in turn, there’ve been considerably fewer cocktails than I was hoping for as well. Happy New Year to me! Wheeeee!! (Achoo!) He Who Established Such A Ridiculous Circa-Holiday Deadline should be happy that he is not within my breathing range. There would be carnage. (Or at least the passing on of a pretty unpleasant cold.)

And. Just a side note. This morning, I thought that a cute outfit might cheer me up, so I decided to don these cute little wide-legged, dark brown sailor pants with a GAZILLION buttons in the front. Note to self: Do not wait til the last moment to go pee when wearing these, for the unbuttoning process is noticeably more lengthy than that which is required of the usual zipper contraption. I’m glad I had the bathroom to myself to do the Snotty-Nosed Pee Pee Unbuttoning The Pants Dance earlier today at work because I know for sure it wasn’t my best choreography ever. Not even top 5, let’s be honest.

To top it all off, I’ve got a righteous zit in the center of my forehead and my winter coat (which I’m still wearing because it’s sub-arctic in our house at the moment…YOU HEAR THAT, HEATER? WTF?) seems to have increased it’s affinity for my shedding hair. Perhaps I’m turning into a unicorn, after all! It’s about damn time…I made that wish, like, DECADES AGO!

On the upside: Not brain dead. (Which is good.)

Diving did not go quite as expected this weekend. For two reasons:

Because of the recent storms, the visibility was so bad I could barely see two feet in front of me much less see Little B or the two other divers we were with. We all spent more time searching for each other out there than actually enjoying the dive. It was a bit like playing hide and go seek…only wetter, with a lot fewer clever hiding spots, and not nearly as much fun. Booo.

On the third and final attempt to make something of our dive, we descended a bit too fast for me to equalize the pressure in my ears. When my right ear popped and a cold rush of water entered my middle ear, I essentially got a free cold caloric test.1 Judging by the vertigo I experienced underwater (Hey, would you look at that!! Everyone’s spinning!! Yay!), my vestibulo-ocular reflex is in tact. My right tympanic membrane, however, is not. So, that put an end to any further plans for diving this weekend.2 Or for hearing properly out of my right ear for the next few hours. On the plus side, though, I now have the ability to spew sandy water and/or air out of my right ear! Fun party trick!

So, the weekend, to put it mildly, sucked sandy butt crack.

  1. A test often done to assess a comatose patient for brain death.
  2. And for the next several weeks while the rupture heals.


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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