Estoy pintando.

W.O.W event #2 of the year, paint and sip followed by sushi.

 Muse Paintbar, White Plains, NY

Front row L to R: Alex, Sara, Alex

Back row L to R: Michelle, Monica, me

missing in action: Clara and Maria Clara

Making art is stressful. Or attempting to make art. I guess that's why they encourage the "sip" part of paint and sip. As is typical with surgeons, that OCD part of our personality wanted to get the cloud right, and the reflection right, and the color the right shade or tint and the blend smooth. Ha! None of that was even close to achieved though we stood there and tried. If you ask me about my painting, there's a laundry list of things I would change. In the end, that's why I painted Nessie. To relieve myself from the pressure of making a pretty scene. You can look at Nessie, and we can all enjoy a laugh together.


One fact easily recognizable with art, it looks much better from a distance. Up close the individual colors standout and look out of place, and you can make a fuss trying to get one cloud look just right, or trying to blend a specific part of the sky. But taking a step back, that color in combination with the picture as a whole, makes sense. There's a well known reiterated life-lesson to take from that. ;)


1Co 13 9-10,12 For we know in part, and we prophesy in part. But when that which is perfect is come, then that which is in part shall be done away. For now we see through a glass, darkly; but then face to face: now I know in part; but then shall I know even as also I am known.

Estoy aprendiendo operaciones nuevas

Just barely made it off trauma with my sanity intact. Monday was change for the juniors... for continuity of care the chiefs change on Tuesday. Meaning, I had one more day of trauma to tough it through. As is typical, my Monday morning was spent cleaning up from the weekend. Multiple patients sitting on the floor waiting for a plan. I stopped by and said hello to each one. Promptly followed by a goodbye and take care, but please don’t come back.

 Tuesday I switched to my Head & Neck rotation. Basically I get to follow the ENT residents around and jump in on their neck dissections and thyroids. At least that’s what I am supposed to do. It’s not a real rotation, because we still get pulled back to Gen Surgery to take call and cross-cover when needed. It’s not really fair to the ENT residents, but they put up with us and act like they don’t mind. I plan to take full advantage of the rotation and scrub on everything possible. Tuesday was a bunch of ear cases which I was looking forward to. So Monday, when a chief called me asking me to take his call that night, I couldn’t do it. The idea of more trauma and missing my ear cases, I couldn’t quite stomach it, just so he could do a case he wanted the following day. I frequently stay post call for cases, even 12 hr cases, and figured if he really wanted it, could do the same. I think he’s forgiven me for saying no. But the ear cases were so awesome! One of them a prosthesis was cemented in place within the inner ear that was so tiny with the naked eye it didn’t appear any larger than a twisted ball of wire no bigger than a spec.

I’ve learned so much already, in just the first week. I’m a bit disappointed that a holiday falls in the middle of my rotation. Not disappointed for the holiday, but disappointed as they have nothing scheduled for those days. My days on head & neck are numbered.

I’m also trying to make use of the lack of responsibility I have right now. Maybe lack is not the right word, the vast reduction of responsibility I have right now. We come and operate with the ENT residents... but anything more than that is up to us. I try to stick with them and round with them. One of their patients decannulated herself today! (Took her own trach out) First time I had seen that! Her mom video’d her while she did it too! But, in general my schedule is drastically different than usual.
I am trying to take care of myself a little bit with the relaxed extra time. I am sleeping more. Drinking less coffee. Checking things off my To Do List. Studying more. And in general just trying to enjoy breathing.

Much Love.

Estoy contemplando homicidio.

One more week of trauma, almost there. I didn't think I would be so ready to be done with my block of trauma this time. The work has not been heavy. We've even had two days so far with no traumas at all, and the team is able to keep up with the work flow that we do have.

But if you were to see me in the hallway, in the store or even at church and asked me how it was going. You'd probably receive some sort of complaint surrounding M&M. (Morbidity & Mortality). (An M&M is a confidential meeting at which complications and deaths are presented for review in effort to provide feedback and opportunities for improvement). My life as trauma chief is nothing but M&M. It did not used to be like this. We presented at the monthly multidisciplinary M&M and then when our turn came up at the departmental M&M. Now they want us to present once a week, and they want Ev-Ry-Thing presented. A catheter-associated urinary tract infection is a complication. We have checks in place to prevent them already. There is no educational benefit having me prepare an entire presentation to state that patient xyz had a CAUTI. But they want it now, they want them all. So I oblige and present and then watch as they talk in circles and peacock.

Today was multidisciplinary M&M. My attending had set up a meeting with me and another co-resident last week during which he went patient by patient, pointing at each one telling us which M&Ms he wanted presented. And then again after our weekly M&M I spoke with him verifying new patients that I would include. To which he responded, "definitely, they're mortalities. They have to be presented."

So today, when I stood up and started going through the statistical analysis portion, and that same attending interrupted me to tell me I was doing it wrong.... I was soooooo. Not. amused.  I stared back at him, in my mind, trying to determine if I could successfully verbally rip his head off without anyone else noticing. I know, excessive perhaps, but it lasted a hot second. And I went on with my presentation according to my now brand new rules. My intern had snuck a picture.  Had she ment to take it at that moment of murderous contemplation, I don't think so. 

Zoom in if you dare, but I warn you. It's not a pretty picture at all. Like I said, so Not amused.
As horrified I was to see how I looked in that picture, good reminder that I need to smile more often.

(Disclaimer: I do not now, nor ever want to rip my attending's head off. I do love my attendings, can just get frustrated at their poor management and unrealistic nonbeneficial expectations from time to time.)
Much Love.