Monday, January 19, 2015

What's in a Resident Doctor's Work Bag

Hey all.

Back in March 2014 I wrote this post chronicling of all the stuff in my work bag.

Today I decided to sit down, have a chatty little bag clean out, and talk you through all the stuff (old and new) that I'm still hauling around.


Also featuring Luna.

Thanks for watching, see you soon.

Friday, January 16, 2015

Friday Faves 1/16/15

It's that time again. It doesn't feel like it's been a week already, but there you go.

1. Things My Sisters Say
While I was on nights the past couple weeks it seemed like all my sisters were keeping a nocturnal schedule too. Some by choice, some not.


2. Music
Sam Tsui and Kurt Hugo Schneider: Take Me to Church cover. These guys make original music, but also some of my favorite covers over the past several years.



3. Snack or Meal
Sauteed brussels sprouts and Trader Joe's vegan chicken. So good.


4. Lifestyle. Usually in this section I put a makeup product or something I've been wearing, but with gas prices like this it's travel time. Let's drive somewhere. Anywhere. My 16 gallon tank costs $25. Apparently it's some of the lowest prices in the country.


5. Recipe
I'm just going to share this great post from Chocolate Covered Katie with several of her best breakfast recipes, because coming off of nights has particularly made me feel like breakfast at all times of day.

12 Recipes That Prove Breakfast is the Best Meal of the Day

[Photo is hers]

Happy weekend!

Thanks for reading, see you soon.

Wednesday, January 14, 2015

The Price of Residency

I started this post because in mid-December I was on cross-cover nights on the wards over the weekend.

I was invited to 3 Christmas parties on the same night, and I could not go to any of them because I was working on a Saturday night, because that's the job.

I feel like I should put a disclaimer at the beginning of this post; I should be clear that I'm grateful for my job and having had the opportunity to become a doctor - I think I keep it pretty positive over here. A lot of people have this dream and don't have the privilege of seeing it through, so I don't want this post to seem ungrateful. I'm also absolutely certain that it used to be much worse for residents, as we're now restricted to an average 80 hour workweek.

That said, I think it's important to give both sides of this life.

So the following are just some real life times when I had to remind myself that I wanted to do this.

My first year my parents came to visit in early December because I couldn't travel for the holidays. I didn't see any of my family at Christmas.

On Christmas morning last year I got home at 7:30 AM from my shift, said hello to my husband, and fell asleep until it was time to get up and go back to work.

My sister graduates from college this spring and I'm working straight through - I'm trying to figure it out but it's just about impossible for me to go.

Two of my best friends from college each had weddings this summer that I couldn't go to, because I was working right through the weekend. There are already more I will miss this spring.

There are no sick days in residency. When I have a cold I always go to work. You just wear a mask over the cough. If I did get sick enough that I actually couldn't work, I'd usually have to work an extra weekend or something to cover for the person that fills in for me.

On any given inpatient rotation I spend half the time on days and half the time on nights. I'm never rested, but I am often confused.

There is an expectation, a professional expectation, beyond just showing up for work, that we will do research, apply for grants, participate in quality improvement. It's a different type, but essentially there's still homework even in the practice of medicine. It is also vitally important that we do, in fact, learn the medicine we're there the practice, and reading outside of work is an expected and important reality of the job. The hours don't end when we go home.

I grieve the loss of my hobbies. Our typical schedule is 1 day off per week. We do have electives sometimes, but for most of the rotations with 11-13 hour days, not including our sign out and commute, it is hard to keep up with things I used to love. That one day off usually includes laundry and buying some vegetables.

Some weeks I get to spend most evenings with my husband. Some weeks I see him for 20 minutes a day.

Before residency, I used to exercise. Most days usually. Now I mostly do not. Some residents do, and I admire them. I think I was happier when I did.

Sometimes I find myself choosing between sleeping and eating at the end of the day. Last night, for example, I fell asleep at 630 and woke up starving at 3 AM.

This hasn't happened to me, because I have a cheerful work face, but there is also an expectation of a positive attitude. It's not that there's no support, or we can't have bad days, but if we're really hating a rotation, it may show up in the evaluation if we don't keep that to ourselves.

Several of my colleagues are always well put-together. I, on the other hand, typically go for a "well, my clothes don't have stains on them" aesthetic. Today I painted my nails for the first time in a month. My last haircut was over a year ago. I do brush my teeth, so at least there's that.

I have $245,000 dollars in debt. The majority of it to the government, some of it to family. That's just medical school; I was blessed enough not to have undergraduate debt thanks to my parents. I make enough to live on, but it will take me 20+ years to pay back the cost of this education. And interest accrues all the time.

We see a lot of senseless loss and sadness. Horrible accidents, child abuse, neglect, chronic diseases that leave kids spending months or years in the hospital, cancer, premature babies, parents that care a lot but are dying of terminal illnesses and also parents that can't overcome their own addictions in order to care for their kids. While I think this is one of the most rewarding specialties in the big picture, it's true that it's hard.

I have a lot of nightmares, especially when I've been taking care of really sick kids.

So what's the point of airing all of this?

This is what I always say to people who ask me about getting into medicine now: It's worth it if it's the only thing you could imagine doing. On the other hand, if there's another career that would make you equally happy you should do that instead, because this is life with a cost.

Thanks for reading, see you soon.

WIAW: Snow and Switch Day


What I Ate Wednesday!
Thanks as always to Jenn for hosting.

It snowed yesterday morning and my walk with Luna was both gorgeous and cold.



It was switch day, meaning I'm done with NICU and I switch to an elective, CART, our Child Abuse Response Team. It's something I'm definitely interested in, our department here is great, and I also have a lot of projects going on right now so I'm also grateful for normal hours instead of those 12 hour shifts.

Breakfast: Cereal and Banana. I thought this shredded wheat cereal would be just another of the same old thing, but for some reason it's better. I can't put my finger on why, something about the texture.


Lunch: Tofu Stirfry with Vegetables. I was on campus, so I got it from the cafeteria. I forgot to take a picture, but it's beige and ugly anyway. They usually have this on Tuesdays and it's the one cafeteria meal I get excited about. 

Dinner: Hot Cereal with Banana. I fell asleep at 630 and sort of missed dinner. At 2:30 I woke up and was starving, so this is sort of breakfast but also sort of dinner. I used to eat oats every day, but it's been months, and this mix is really good with cranberries, almonds and lots of texture variety. I got it in my December Vegan Cuts box. 




I hope you're having a good week.

Thanks for reading, see you soon.


Friday, January 9, 2015

Friday Faves 1/9/15

We took a break for the holidays, but we are now back and though I'm pretty busy with night shifts right now, here's a few faves for the week.

1. Things My Sisters Say

Since I was home for Christmas, I got to have some real life conversations with my sisters. The following is an exemplary moment of us teasing Shannon, who is a good sport.

Me: Nicola are your friends having a good break?
Nicola: Oh, pretty normal - you know it's good to see family but you kinda want to kill them.
Shannon: I never feel that way.
Emma: That's because you're the most annoying one.

2. Music: It doesn't matter at all which version you listen to, but Into the Woods has always been one of my favorite musicals and the new movie adaptation does the songs and score well. So whether you prefer original Broadway or not, you're going to like this.


  
3. Snack or Meal


This little gem from my December vegan cuts box was so good. Like a macaroon.

4. Style and Beauty

This Lemon Lip Cream from C.O. Bigelow [bought at Bath and Body Works] has been really perking up my parched lips. They're always dry here in New Mexico, but winter is especially bad, and with this one a tiny amount goes a long way. It also has a delicious wake-me-up lemony smell.

5. Recipe: Tempeh Bacon grilled cheese. As I mentioned on Wednesday I eat significantly less well on night shifts. This is a combination that satisfies my comfort food cravings.

Ingredients
Whole grain bread - 2 slices 
Ketchup
Vegenaise
Tempeh bacon - I use the More Peas, Thank You recipe and make it myself but you can buy it already flavored too. This recipe does not flavor the tempeh and heats but doesn't cook it, so raw tempeh will not work as a substitute.
Earth balance
Daiya mozzarella or other cheese. Hummus may also work but I would then omit the Vegenaise and ketchup.
Veggies: I like peppers, tomatoes, olives etc.

Method
Heat a pan over medium heat, no need to spray it.
Place a small amount of ketchup and Vegenaise on the inside of each slice of bread and spread thinly.
Spread a thin layer of earth balance on the outside of each slice of bread.
Place one slice of bread butter side down in the pan.
Sprinkle with a thin layer of vegan cheese.
Top with slices of tempeh bacon, then veggies and another tiny sprinkling of cheese.
Add the remaining slice of bread and squish it down a little.
Cook about 5-10 mins, then flip and cook another 5-10 mins on the other side. When the cheese is a little melts and the outside of the bread is crispy, you're done.

 

Happy weekend!

Thanks for reading, see you soon.

Wednesday, January 7, 2015

WIAW: Night Schedule

   

What I Ate Wednesday!
Thanks as always to Jenn for hosting.

I'm on nights in the NICU for the past couple weeks so my meals are really weird right now. Not only do I typically eat a little less healthy, but I eat at totally weird times. When I'm at work for the night, it's pretzels, chips and hummus for dinner. In the morning it's 2 different kinds of fried potatoes. 

Yesterday was a day (night?) off so instead of the cafeteria food these are the things I made at home. 

Breakfast (5:30 AM, after being up all night): Pumpkin Cinnamon Rolls


These are from the More Peas, Thank You cookbook. They're ok though I think they lose something with the altitude baking, just not quite perfect. With some icing though, they're very good.

I ate these with my husband before he left for work and then fell asleep around 6:30.

I woke up about 1 because I needed to go to the post office while they were still open for passport applications. I'm travelling in a few months and my passport's the last thing I never changed over from my maiden name. 

I had to drive to another town because all the post offices here in Albuquerque require appointments for passport applications, so I took Luna with me and we stopped at a new dog park on the way back. It had a separate section for little dogs and she seemed to like it. 



Lunch I guess?: Tempeh bacon wraps. Around 6 it was John's dinner time and I guess it would be my lunch. We made tempeh bacon wraps: pita, melted Daiya mozzarella, tempeh bacon, spinach and tomato. I also had some leftover pasta. 



Dinner: Cinnamon rolls. Before falling asleep I ate a couple more of the cinnamon rolls from this morning. I'll spare you a second identical picture.  

Also tea and orange water. 

Like I said, weird food day. Way healthier than the potatoes I'd been eating from the cafeteria though - at least there was some whole wheat flour and something green.

I hope you have a great day.

Thanks for reading, see you soon.


Thursday, January 1, 2015

2015 New Year's Resolutions

It's a misleading title for this post - I'm not really making New Year's Resolutions. In  the close to 4 years I've been blogging, I've never written New Year's resolutions. I stopped making them in general because, to directly quote myself from 2012:
     "They have a lot of potential. I love the feeling of a fresh start, but never in my life have I successfully changed my life with a resolution. Too often they've made me discount my successes and blessings because I didn't succeed in some arbitrary guideline I thought I wanted from my year."

My planner. Journal J 2015.

In 2012 I wrote this post about things to look forward to instead, and in the following two years I never really wrote a New Years post at all.

I think this year I'd like to continue with setting just a couple specific monthly goals, so later I'm hoping to write a "January Goals" post.

However the main purpose of this post is to mention my New Years Resolution alternative: 28 by 28.

I made a pretty fair run at 25 by 25 several years ago, but never really continued it despite my best intentions in the subsequent years.

Since my birthday is towards the end of the year, I have almost a whole year to try to accomplish the 28 things on the list. I'll be applying the same guidelines I did before - this is meant to get me to try new things, but not be a point of stress. Things I don't get done will roll over into the following year and I'll be updating as it goes along.

There is nothing work or medical related on this list, and that is intentional. There is quite enough pressure in residency without putting it on a list like this that is designed to exercise other parts of my brain.

There is now a 28 by 28 page along the top tabs where I'll be keeping a record, and so here it is:

28 By 28

1. Read 4 books (for fun).
2. Update my "In Case I Die" letters. I wrote them in 2008.
3. Develop old disposable cameras.
4. Make another video for the blog.
5. Go to Machu Picchu.
6. Do a primarily strength-based workout for at least 2 months.
7. Do a 1000 piece puzzle.
8. Go to Yosemite.
9. Spend a whole day without any non-essential media (i.e. work email ok, cell phone games not).
10. Eat 1 raw meal a day for a week.
11. Change my gym membership to save some $.
12. Try a vegetable that's new to me.
13. Bike to Nob Hill.
14. Take Luna to a new dog park.
15. Learn to play a new song on the keyboard.
16. Try a new type of art.
17. Take the Railrunner to Santa Fe for the day just for fun.
18. Try a new type of tea.
19. Do 20 full pushups in a row.
20. Volunteer doing something that isn't medical.
21. Make a meal plan for dinners and stick to it for a week.
22. Watch at least 50% of the films nominated for a 2015 Best Picture Oscar.
23. Go to White Sands National Monument.
24. Take a non-medical class or workshop - online or in person.
25. Go to Carlsbad Caverns.
26. Grow something.
27. Try every Thai restaurant in Albuquerque [3 star or higher on Yelp]
28. Go camping.

I'm sure I'll be looking to you all for help and troubleshooting as I go along.

I hope you have a great year and fill it up with new adventures too.

Thanks for reading, see you soon.