Grandma

My family is German/Swiss. There's no hugs. No "I love you's". Grandma didn't even smile for a picture. Well... you really had to pry it out of her. But we, her three granddaughters, could do just that.

The past couple of days, I was given a huge gift from my co-workers. My current team at St. Vinny's literally kicked me out of the hospital last Saturday (February 18, 2017) when learning of my grandmother's passing. Told me to just leave, and spend the time with my family. They gave me no other option than to accept and take the next ticket to Illinois. I owe them all so much for treating my family like their family.

And as instructed, I didn't do anything while in Illinois, but stay with family. There was a lot of nephew time. There were a couple of trips to Grandma's house. Some cleaning. Some looking through old pictures. And then of course, Grandma's funeral.

That swing is still there. The shed behind it replaced, no longer white. Those "Fourth-of-July Lilies", not blooming in February, but there every summer just like in the picture. When big enough to rock ourselves on that swing, we'd push it higher till the back would knock against the shed, and we'd try to grab leaves as they brushed against the bottom of the swing. If I tried to sit on that swing now... it would most likely crumble.

Grandma's piano. The same one she taught mom how to play on without ever having a lesson herself. That line of camels, all in a row, ever-present and and following after each other on their way to who knows where. The bell, not really a bell at all, but just one of grandma's many music boxes. It was horribly out of tune, Grandma's piano, irreparably so, and more than a few keys would stick leaving a fourth of your chords empty as you played. But when all the dishes were washed and the dinner cleaned up, she'd come and sit  next to the piano and want to sing along no matter how poorly it was played. And when she no longer could sing, she hummed.

Grandma collected red glass. It complimented her pink towels and rose-colored furniture. She added to her pieces slowly over the years and ultimately had quite an impressive collection. There was not a room in her home that wasn't touched by red glass.

The corner windows in Grandma's kitchen where curtains were closed every evening to "keep the night out" and opened again the following morning. She could sit at the kitchen table there doing her township paperwork or stand at the ironing board with her stack of ironing and through the green leaves of her plants, keep an eye on the goings-on across the street. What used to be the Forrest AC Church and now the town's public library and community center provided a fountain of endless entertainment.

The three paneled mirror in Grandma's bathroom, on the other hand, provided endless entertainment for us girls. All Grandma was trying to do was put her hair up, and she managed, somehow, with little girl's bouncing around opening and closing her mirrors. Then sitting with our feet in the sink to better see. Open and close. Giggle. Open and close. Giggle. Repeat.

She taught us to sew. She taught us to quilt. She taught us to cook, to bake. To can corn, strawberries and pickles. As for myself, I'm not sure I will ever can pickles again in my life. But it wasn't ever about canning pickles anyways. I was just having fun with Grandma. Sewing on the other hand, now that I do every day! ;)

Grandma's blanket, made with old left-over dress scraps. It's like one of those background props. As I looked back through pictures, it was always there, hanging over the back of the davenport. Maybe I was sitting there focusing on getting homework done, or Carrie and I were trying to tandem hula-hoop, whatever the picture was, you didn't notice it at the time, but it was always there.

Grandma and Grandpa went with us on a family vacation every summer for about 6 years straight. Grandpa sat in the middle bench of the van with Chelli so his leg could extend up between the front two pilot seats, and Grandma would sit in  the back bench in between Carrie and myself. She had very bony shoulders, but that didn't stop us from using her as our pillow. I like this picture of Grandma sitting up straight and proper, like a lady, on a bench somewhere in Gettysburg. Us three girls obviously lacking in "like a lady". She held the standard high for herself, and for us, but loved us despite our slouched posturing and wrinkled up faces. This carried over into every aspect of life. She was smart, and fair, and proper yet never made you feel inferior for not being so.

After quickly scanning our family photo albums for pictures of Grandma, I had to conclude, "Thank goodness for birthdays." Without a yearly picture of grandma for her birthday, we'd be left with very few. A fact which she would not have had an issue with, and honestly probably have supported. So, I say again, "Thank goodness for birthdays!"

I love you Grandma.

My sheep know my voice,
And the path that I take,
They follow wherever I go;
My sheep know my voice
And come at my call,
But a stranger's voice do they not know.

My sheep know my voice,
And the pastures of green,
Where I lead them so often to feed;
My sheep know my voice
And the cool sparkling stream
Where beside its still waters I lead.

My sheep know my voice,
And the valley of death
Thro' which I shall lead them some day;
But no danger nor harm
Can touch one of them,
For I will be with them alway.

My sheep know my voice,
And day by day,
They abide in the fold
And go not astray,
They love me because
I have made them my choice,
And they follow my call,
For my sheep know my voice.

Estoy parte de la misma relación.

It's a dislike-dislike relationship. It is really rather unfortunate, but Surgery and Emergency Medicine often have poor opinions of each other. That's not to say there aren't excellent Surgeons.  Same as there are many many excellent ED docs, but there are a select few that create a bad name for the entire collective group and that's it. Stereotype made.

Walk a few miles in an other's shoes. For the most part it's easy to understand the ED's annoyance with Surgery, so I do my best not to fit the stereotype and for the most part we get along just fine. As for Surgery's distaste of a certain approach exhibited by those select few in the ED, I get to stay in my own shoes to experience that one.

Had a particularly bad spoonful of it last night. Got called for a surgical consult on a patient in the ED, at that point the patient had already been in the ED for 5 hours. Within the first 5 minutes of interviewing the patient together with my Attending, it was obvious that the patient's issue was not surgical, and appropriate work-up was severely lacking. When we presented this to the ED Attending taking responsibility for the patient, he hmmms and hawwws about it for a bit and then turns to me and says, "well, just order whatever you want." Caught me off guard, passing the buck on his patient like that. Handing management of a non-surgical patient in the ED over to a surgical resident. Inappropriate, but whatever. I ordered the work-up for the patient. Even had to compromise with the CT techs to get the exact studies we want, but we finally got it ordered and everybody happy.

An hour or so later, I'm leaving the ED after a trauma and cross paths with this same attending. I'm heading down a hallway about to exit through a pair of double doors and he calls after me. "Hey! So what's going on? Why isn't that guy's CT scan done yet?" I froze, my hand on the doors to exit. I turned and stared at him. This ED doc is much taller than me. I probably come up to his shoulder. But I stepped right up to him, head back, staring him straight in the face, and flat out scolded him! I told him what was going on with his patient too, but definitely scolded. Was that inappropriate of me to speak to an Attending that way... can we just not answer that? Because honestly, either way, his general lack of caring is so thorough that he didn't even flinch, completely zero interest in taking ownership of care of his own patient. It's upsetting, so very upsetting to me!

To punctuate the whole situation, because I had been the one to order the work-up, it was I that the radiologist paged to communicate finding of a pulmonary embolism on the CT scan of the chest. It was the ED that were the ones that needed to know that information, not a random surgical resident, yet I was the one they called. So I thanked the radiologist, and then called the ED myself and relayed the message on.

There are many amazing ED docs. And whenever I come across a medical student who wants to do emergency medicine, I emphatically encourage him/her to be the best ED doc ever! And maybe one day... the stereotype will no longer hold true. But until then, it is still very much alive.

Much Love.

Estoy adentro y la nieve está afuera.

Snow in the Northeast,and a couple of my co-residents at St. Vinny's this month joined me over at the house instead of suffering the commute back and forth from Westchester.

 

L to R: Monica, Rachel (one of the ortho interns), Me

Snow up thigh-high to get to the house.

 Q: When are you too old to have a sleep-over even on a work night?

A: Never

Biggest difference between us and most others... by 09:30pm we can't believe how late it is and collectively decide it's time for bed!

Greeted by the sun the following morning!

Much Love.

Estoy comiendo mentos.

Last year our program started Mock Orals for our senior residents. This is a very good thing. For myself personally, I am already terrified of even the idea of Oral Boards. But time does not stop, and one day it will be me standing before a panel of stoic well-seasoned surgeons who will throw every complication at me to see how I react and make decisions quickly. So all the practice I can get will be welcome.

Unfortunately, they schedule these mandatory mock orals on the same day, and the same time, for every senior resident. Not horrible back at Westchester as everyone will still be there if needed. However for our little hospital up in Bridgeport, it's a completely different story. This past Tuesday were mock orals. It left one 2nd year and two interns in charge of the entire surgical service. That includes all cases in the OR. All traumas coming in, no matter what level. As well as all patient's on the floor. Then to top it off our one second year was taken away to give a presentation at a Medical/Surgical Conference. Leaving the two interns alone.

This could have gone Very. Very. Bad. Many were nervous... most were nervous. I was almost hurt at what could be interpreted as a lack of confidence. Every resident has those bad days/calls. Completely bombarded with traumas, the consults never ending all with a full day in the OR and patient's decompensating on the floors. And I will admit, that could have happened. Very well could have happened. But at the same time, I will also say we could have handled it. Lived through the storm before and can definitely do it again... will do it again. This particular Tuesday, it was not required of us. We split the work, and by the time the seniors got back in the afternoon all but one OR case was done, floor was pretty tied up and traumas had stayed at bay.

Much Love.

Estoy planeando mis vacaciones.

The rest of the month of January was more of the same. Our TICU nurses were joking that we had to run into a few people on our commutes home, you know, to fill up the TICU again. Our census got so low that pretty much every nurse was being floated to other units. My last night in the unit I was scheduled with one other resident and we started the night off with two patients. We of course accumulated a few more as the night went on, and I would walk over to the Surgical ICU and help there throughout the night as well, so at the end was maybe even more busy that usual.

Despite a generally low level of critically ill patients this past month, we still had our handful of deaths. From time to time, we were faced with having to step into that role of explaining reality to a family in denial, or bringing the family back to the hospital after a change for the worse. And when bad things happen to good people, and a daughter pleads with you, tears streaming down, "doctor, fix him please! please! please fix him", sometimes you think you'd pay $1000 to know what the right words would be.

From nights in the TICU, it's been an easy transition to nights at St. Vinny's in Bridgeport. February is the first of three months in a row I am scheduled at St. Vinny's. Why as a junior resident I'm scheduled three months in a row... not even the chief who made the schedule could tell me why. But either way these three months mark the end of my 15 straight months without a break. Surprisingly, it hasn't been as bad as I was thinking it would be. Mom & Dad came to visit me once. I went to visit them once. I had my good share of golden weekends. Of course, Vinny's isn't exactly easy for the junior resident, which is why we don't do all of our months strung together. But I guess I'll just finish these 15 months running uphill to the finish line. It'll just make vacation time in May that much more welcome!

Much Love!