Saturday, January 2, 2010

Christmas bubbles

We had a wonderful Christmas! Family on both sides came to join us, and we feasted and laughed more in a few days than is strictly possible.

I don't have time for a proper Christmas picture post, but these shots are too sweet to keep to myself. For Christmas, Brian bought Sam an automatic bubble machine. Needless to say, it was a hit.




Saturday, December 19, 2009

Family wedding

Last weekend my brother Andrew got married. The wedding was really gorgeous and I'm so thrilled to have a new sister. In other news, it was Sam's second wedding, but his first as a dancer and he wowed us all with his moves.












Monday, December 7, 2009

Part-time residency

Now that I'm out of the Q5 frying pan and into the Q4 fire, it seems like the right time to write about part-time residency.

One or two years ago, part-time residency wasn't even a glimmer in my imagination. Never occurred to me that it might be possible. Then I received my UCSF residency interview invitation and discovered !they offer part-time residency! I interviewed there -- and was so impressed with the program -- but ultimately decided that adding an hour long commute to my life was the opposite of family-friendly. But the seed was planted and I matched at Stanford with the expectation, misguided maybe, that part-time residency was going to work for me. Hey, if they can do it at UCSF, why not at Stanford?

As it turns out, they *can* do it at Stanford. At least, I can. After some careful negotiating, I am the proud owner of a shiny new part-time residency, starting next year. I'll spread my remaining two years over three years total, doing two months on, followed by one month off for 36 months. Even better, the call schedule quiets down considerably starting next year. As an R2, I anticipate five or six call months; I'll have four or five call months as an R3. In other words, stanting in July, my life will go like this: call month, followed by elective month, followed by month off. Rinse, repeat.

To say that I am overjoyed about this development is a severe understatement.

There are some downsides here. For one, I won't be paid during my months off and neither will I be eligible for benefits. Happily, Brian earns a salary and receives benefits, so this isn't a crisis. Also, I'll have to keep up my continuity clinic during the off months, at least for the first 24 months. On the one hand, drag. On the other, it's probably for the best that I'll keep the clinical side of my brain engaged during those months off.

While the major motivation here is simple -- more time to mother my small son -- I do anticipate doing some research during my off months and I've begun to talk with my research advisor about possible projects. Even so, he's encouraged me to enjoy these months off for what they are: pulses of diastole amid the systole of residency.

Oh, I am happy about this.

Tuesday, November 24, 2009

Postcard from internship

So the other night, I'm interviewing this vet with no legs. At some point, it seemed reasonable to ask about it.

Me: Sir, I notice that both your legs have been amputated above the knees. What happened to your legs?

Him: <flinging the sheet aside, inspecting his well-healed stumps with some surprise> I don't know, Doc. Couldn't really tell you. I don't remember.

You can't make this stuff up.

Tuesday, November 17, 2009

Excuses

Last month, one of my ICU patients called the police from his hospital bed and told them I was trying to kill him. The police showed up at 2 AM -- I suppose they have to -- to take the patient's story and to question me. As it happened, that night was one of the busiest nights in the ICU that entire month; we admitted four or five patients over the course of as many hours, several of them desperately sick. I stopped briefly to talk with the officers as I moved from disaster to catastrophe. Of course I'm not trying to kill my patient, I told the cops. Although now that you mention it, the idea does have merit. I'm not sure what's happened since then with the investigation; I certainly haven't heard anything more from the police. And the incident did yield a dash of surreal humor to what would have otherwise been an entirely humorless night.

As luck would have it, I readmitted this delightful patient to the hospital on Sunday night.

Un-freaking-believable.

So far, he hasn't called the police again to report me (so far as I know), but every encounter with him is intensely unpleasant. This man may be the most miserable human being I have ever met. He is nasty and hostile. He is racist and sexist. I can't so much as greet him without being subject to a stream of profanity and disdain, sarcasm, rage, hate. Because he's been sick more or less continuously since July, he has been cared for, at one time or another, by many of my resident colleagues. So far as I can tell, he is universally despised. Post-call yesterday, I was briefing the dayfloat resident (DFR) who covered for me in the afternoon. As it turned out, DFR also had cared for my patient, a couple of months before, and he knew more about this man's history. Apparently, a few years ago, my patient's college-aged daughter was raped and murdered. And that's why he's so miserable and mean, DFR said.

Wait a minute, there. I certainly don't diminish the tragedy my patient has experienced. But does a tragedy -- even a horrific one -- entitle him to be hateful to strangers? Maybe I'm heartless, but I don't think it does.

Monday, November 9, 2009

California Academy of Sciences

Yesterday we took Sam to the California Academy of Sciences. He pretty much made this face all afternoon:













Tuesday, November 3, 2009