There are no sick days in residency

Of the numerous sucker punches residency has to offer, I think the most baffling is the way we deal with falling ill. As in, the residents themselves being under the weather.

I know! That happens? Bunch of pansies...

It's okay for our patients to get sick, I mean, they kind of have to in order to eek a living out of this popsicle stand, but we, as care providers, can not. 

Our daily zigging and zagging of snot is irrelevant. Our very job description of promoting health, wellness, and recovery, doesn't apply to us. We must defy the principles of communicative disease, be the commander of our own physiology, make ways to rest/hydrate/exercise within our 80hr work week, and not get sick.

Okay. Let's be fair. That might be a bit extreme. There is a contingency plan in place if you are delirious or in a coma. 

Or, if you are a weakling who doesn't want to bring your virus laden wet rag of a self to the oncology ward because you're "concerned" about the "vulnerability" of patients "without an immune system," then you can fall back on the a fore mentioned contingency. It's called Jeopardy.

Jeopardy. Sure it may refer to the Alex Trebeck themed monologue running through your head -  "You chose this career you nincompoop for 100", "Nut jobs in charge of scheduling for 200," or, today's daily double, "Schadenfreude," - but in reality it refers to the word's dictionary definition:

Jeopardy [jep-er-dee] noun 

1. harzard or risk of or exposure to, loss, harm, death or injury

2. peril or danger

3. the danger or hazard of being found guilty, and of consequent punishment, undergone by criminal defendants on trial

Synonyms: See Danger; menace, threat

Antonyms: Security

So, see? You're totally covered! 

Vomiting, immobility, fevers, explosive uprisings of rebel recruits in your sinuses? Nope! Doesn't sound like death to me! Walk if off you whiner.

If you really are in peril, you can call in a jeopardy person. Go ahead. See what happens.

Who is the jeopardy person, you ask? One from a shiny cavalry of good hearted souls on call to be our back-up? Close... it's a fellow resident.

365 days a year there is a resident on jeopardy call. Actually, three. One for each year -- there's an intern jepo person, a 2nd year jepo person, and a senior jepo person. If you can't come in on a given day -- your grandmother died, you're in a car accident you can't leave the scene of, you've just found out you have two months to live -- then you call the jepo person in to cover whatever shift you're going to miss. 

Am I the only one who finds this sketchy? Cause, I mean... yeah you get a break, but you're screwing over your counterparts by succumbing to your body or circumstance, you lame-o.

It gets lamer.

If you DO call somebody in to cover your shift because you're dying, what do you get in return? Sympathy? Chicken soup? Nah, how about a healthy serving of guilt and immediate e-mails asking when you're going to PAY THAT PERSON BACK.

If you're sick, and someone has to cover for you, even though you're miserable and are making what is probably a considerate decision for anyone working with you who might pick up what you've got, you need to pay whoever covers you back.

Not with money, mind you. With another, comparable, shift. 

Last February I was hypoxic (low oxygen in my blood) and dyspneic (short of breath) and physically unable to walk from my couch to the kitchen (sooooo sick). I'd worked four 12hr ED shifts in as many days with a waning voice and a progressively looser grip on reality, taking care of angsty teenagers and snotty kids who weren't half as sick as I was, and finally said, ENOUGH. 

Well, my husband did. He said enough. He thought I was dying and forced me to stay home.

I had to jepo someone for the first time in 22 months of residency. Because GOD FORBID the ED would be down one resident for 12 hours (when there are always at least 3 residents in addition to 2 mid-level providers and 2-3 attendings)(plus med students).  

While it was great not having to go in that day, and probably best for the health of everyone involved, I then had to work with the covering person to find a time when I could cover a 12 hour shift that they had in the future. So I ended up covering the PICU, NICU, and peds ward at the city hospital overnight on Thanksgiving, because that's the only time we could find that jived.

Be ye warned. There are no sick days in residency. And in fact, you get insult to injury by having to cover another shift for that person in the future.

While I get that the payback expectation is largely to discourage people from abusing the system, why on Earth isn't there a better way? A medical diploma didn't make us superhuman. Why does the system expect us to be? 

A firm decision to do or not do something.

My resolutions for 2013 are straightforward:

1) Take better care of my teeth.
2) If I wear make-up during the day, I must wash it off before going to sleep.

And by "straightforward" I evidently mean "peepholes into my true life as a slob and possible redneck."

I forget how messy I was am. Throughout college, my roommate, Disturbingly Potent, was meticulous and very upstanding when it came to home making. Think pastel hued gingham with navy madras accents carrying a book on manners whilst wielding an acerbic wit and you have the jist of her persona. So of course she was tidier than a 1950s housewife.

In an effort to make up for the fact that I was am incapable of getting up when my alarm goes off and therefore ruined the majority of her mornings with my snooze hitting, I tried to keep my areas in check. No clothes on the floor. No dirty dishes.

At least, no dishes dirty enough to grow things.

As soon as I got to med school and had a room of my own again, the clutter came screaming back, albeit a little reigned in because Manhattan isn't a place too conducive of hoarding, at least not on the amateur level. I certainly rivaled the pros in terms of incapacitation due to mental illness, but even though I couldn't get out of bed in the morning, by God I could still aim and throw things in the trash.

Having said all that I don't think my hygiene has ever been out of check, save for the few years in elementary school when I was the smelly kid.

It had to have been around fifth grade after we moved 3 hours away from the only home I'd known and I implemented a bathing strike to make my displeasure known. Malodorously.

But I've found that when your time is crunched, like say, if you're enduring an on-the-job equivalent of water boarding and come home after an 80hr week unable to function in society, non-essential things go by the wayside. And now that you realize teeth brushing and face washing fall into the "non-essential" realm of life, you can see what dire straits we are dealing with here.

Residency: don't let it happen to you.

3am in the Peds ED:

Phone rings...

Me: Hello?

ED Resident working for the Dark Adult Side: I knew it.

Me: Knew what?

ED Resident: That it was you working over there tonight.

Me: Oh?

ED Resident: Two techs just crossed to our side, one saying "Holy shit, our doctor is knitting at night!" That pretty much narrowed it down.

This is what I heard Romney say:

1) It's silly to invest in solar and wind power.  Let's suck this planet dry and then leave it to the future citizens to figure out what the hell to do when there are no more non-renewable resources to renew.

2) I live under the illusion that individuals can "shop around" for insurance companies.

3) The only thing I care about is making jobs in this country.

4) I'm going to reduce the federal deficit by cutting federal jobs in this country.

5) I am not even remotely embarrassed that I believe health care is a privilege. In fact, though I espouse my Mormon heritage and it's Biblical truths, I have no problem living with the immorality that every citizen in this country is not guaranteed health care.

6) I have short term memory loss. I want to stop shipping jobs overseas, but yet I was the big man on campus at one of the nation's largest corporate outsourcers.

7) I would rather have people admitted to the hospital with acute, expensive, preventable illnesses and let them take on the hundreds of thousands of dollars this accrues just so I am not caught in public saying that I would support adding an average of $2,500 per year to families. I would rather them be hundreds of thousands dollars in debt.

8) I believe Obama is responsible for the two smoke and mirror wars that cost trillions of dollars in the eight years preceding his entry into the Oval Office.

9) I care about education. But Big Bird can suck it.

Opposite of Sycophant

All I've wanted to do this week was come home and send ANGER ANGER HATE HATE HATE out into the internet unknown, but I felt this was probably unproductive and would not necessarily be helpful. So, instead, I channeled my rage into writing. Thus, I give you:

The Opposite of Sycophant

By: Me. 

Forcibly spending a week with you

was like attending a lecture on Jerk

You showed off its malice, its bally-hoo

in mincing comments regarding my work

I skimmed the lecture’s whole outline

having taken this class times before

it’s clear you think you hide it with saccharine

but your charms and your tricks, I abhor

I can usually hide indignation,

and play right along with the games,

but with you I can’t hide my frustration

you’re Satan finessing his flames

I can’t stand your insincere candor,

with students and colleagues alike,

it’s clear that you want them to pander

to your ego that rivals Third Reichs’ 

You imply that I’m stupid and lazy

veiling thinly the truth of your joke

through questions irrelevant and crazy

that make my eyes seem appealing to poke.

What made your curriculum so bitter

worse than most assholes’ I’ve known

was your critique that my notes, they did fritter,

any story or use on their own

You told me to read what you wrote

about the team’s patients and plans

You asked that I pare down, not emote

you’d never seen something so rambling, so bland.

This hurt more than the barbs you had crafted

since it wasn’t intentionally mean

for you attacked all that had lasted

of the me that med school wiped clean.

You couldn’t have known that you’d done that,

but I know it’d make your short self seem tall,

to realize you won in our combat,

with an offhanded comment so small. 

Though I failed all your quizzes by guessing,

and despite all the spits and the swings, 

This week did teach me one lesson:

You’re a dick and you don’t know a thing.

Clueless

I can't tell you how many times I watched the movie Clueless growing up.  I can tell you that if we had time to kill waiting in an amusement park line I could recite you the first twenty minutes without stopping to breathe.

So, naturally, when I needed some audio accompaniment to my knitting this weekend, I chose the best movie I could enjoy without watching on Instant Netflix: Clueless.

When I was younger and the TV used to do that thing where Pay-Per-View was just a channel and it played the same movie 24/7 until it switched to a different movie, I would just watch movies over and over and over. My Dad is a local sports announcer and we got all the zillion channels for free, so, why not? 

We would also tape (on VHS)(VHS! How weird is that!?) the movies we liked so that when the 24/7 week was over we could continue to watch them again and again and again. And by we I mean me.

I did dupe some friends and family members into joining my couch potato-ness. In fact, I remember sitting next to my mother watching Clueless and feeling only marginally uncomfortable when it was the cafeteria scene where Dee asks Tai if she's ever done it in water. I remember my pre-adolescent self wondering... do what? Do what? And concluding that I must've missed something in the earlier conversation. Them talking about doing their homework or clipping coupons, and how crazy it would be to do poolside. Or something.

Needless to say, this time around the jokes made a whole lot more sense.

The portion where Amber tells the gym teacher that her plastic surgeon doesn't want her engaging in any activities where balls fly at her nose and then Dee quips, "Well, there goes your social life," was not in fact a nod to Amber's intramural dodgeball league that I assumed she competed in on the weekends. 

Nor does an "herbal refreshment" refer to an all natural breath mint. 

Though, to be fair to pre-adolescent me, Dee and Cher didn't get the reference either. "Well, we don't have any tea, but we have Coke and stuff."

"No shit, you guys got coke here?!"

Again, I thought... oh, poor Tai! She really is clueless! She doesn't know what Coke is!? Joke's on you past me. Joke's on you.

Last Week's Haiku

Adulation of vacation.

Nine days with no work.

It was bitchin': beach, books, bff.

I will miss this bliss.