It's okay, Shelby, women are havin' babies every day!

I'm having a ball on this rotation. Like I said, I'm working at a little clinic that is close to home, with a family doc that I've known of for what seems like forever. She is truly a selfless person, and just works tirelessly for that little community, and they all love her. In my trek through the different departments, I've encountered lots of M.D.s (and D.O.s) - there are two distinct ends of the spectrum. Some are "physicians", commanding respect and admiration for all that they've accomplished. And some are "docs", who are following a calling outside of themselves, and who meant it when they said in their admissions interview that they wanted to "help people". The "docs" get the respect and admiration anyway, but they'd never go looking for it. My preceptor this semester is the epitome of a Doc.

Family Medicine doctors are trained in OBGYN as well as some surgery, and you can do some, all, or none of those in your practice. My preceptor does OB (which is my next rotation, by the way, so I'm getting a jump start on some things. The Lord takes such good care of me - He's trying to build my confidence so that I won't totally panic before starting the OB rotation. I'm getting a chance to know the OB residents, attendings, and nurses as well, which is good.) On Wednesdays she's on call at the hospitals, so I spend all day with her, rounding on postpartum moms and pregnant women with other medical problems, and being around whenever one of her patients decides to deliver. (Those deliveries, by the way, are so awesome and I love them. They put me on this great natural high, because I love watching God's handiwork enter the world, and the interaction between the mom & dad and the rest of the family always brings a tear or two.)

Last Wednesday, none of the students on the OB rotation were around, because they hadn't started "Night Float" yet - and that's when the students get to be on Labor & Delivery. This week, two students in my class were there doing night float, and they were each assigned to our two laboring moms. When I heard that, my heart just sank - I didn't think they'd let two students in the room.

I went with my preceptor (I'll call her Dr. L) to check the mom's progress, and she was dilated to 10 and fully effaced, so that's when we all gown up. Plus there were some head compressions on the fetal monitor (not as scary as they sound - it just means that the baby is getting into the birth canal) and that's what sent us in there in the first place. I asked the mom if she minded if a student observed, and she said no, and I asked how many she'd be comfortable with, and she said one. My heart was recovering from the earlier sinkage, and had risen to somewhere around my pyloric sphincter, but that made it sink again, because I knew it would be the OB student and not me. I didn't say anything, though, and I chatted with mom & dad for a few minutes about the baby and names and other kids and such, and then started to leave. Mom said, "The student will be you, right?" I said no, and Dad said, "How many students would have to be in here for you to be in here?" I held up two fingers. Mom said that was fine. I asked her approximately 17 more times, and told her it was all about her and that I didn't want her to regret a thing about the experience, and she said that she wanted me there. Yay! So I got to watch that birth, and I actually made Mom, Dad and other family members in the room laugh in those awkward pauses between pushes.

At one point, Mom said that her hair must be a mess. I told her that she was beautiful, and Dad agreed. By this time we could see the top of the baby's head, and a shock of dark hair. So I said, "The baby's hair, on the other hand, is looking a little rough." Then I added, "I think he just has too much product in it." Hardy har har. That made everybody laugh. Obviously, you have to get a feel for the personality of the parents and the family (and your attending doc and resident) before you say something like that, but I am a big fan of humor. If I didn't laugh, I'd cry.

Which brings me to my next point - I was talking to the other two students that are on OB (incidentally, since a class just graduated, the rest of my class are officially fourth-year students. Yay for them!) One of the students asked if I was going to take the Step 2 review course, and I asked when it was. And the other student said, "She's not a 4th year." Which brought tears behind my eyes, because I feel like I don't belong anywhere anymore since I took some time off. One of the things that helped me through the first two hellacious years of medical school was the fact that my class and I were going through it together - I saw it as a kind of "band of brothers" thing, although everybody else in the class may think I'm crazy and I may be the only one who felt that way. But now, my class is in their last year, and I still have this rotation and three more to do. I feel like they've all moved above me and are looking down on me now, so I don't belong with them. But I don't belong in the class below me either, because I barely know them (with a few exceptions). So the camaraderie is gone, and I feel like I don't have any peers that I can talk to. It makes me really sad, actually. I even feel that I can't really talk to close friends in my class in the same way - it's kind of like they're freshmen in college and I'm still in lowly high school, and I just feel stupid. You know, typing this, I realized that I don't even feel right calling the class of 2009 "my class" anymore. So, I've been kind of keeping to myself as much as possible, but it makes me sad. Oh well. Nothing can be done about it now, and everything works out in the end. The Lord has me in the palm of His hand and carries me through my difficult days. I just can't praise Him enough. So I know I'm never truly alone.

And finally, I had a patient today who tried to quote a Bible verse to me to prove that Jesus smoked weed. I'm totally NOT convinced. I do love patients, though - they are so great. That is all.

A Good Week! Yay!

I've seen the best
I've seen the worst
I wouldn't change what I've been through
I've touched the sky
I've hit the wall
But I did what I had to

On my way here
Where I am now
I've learned to fly, I have to want to leave the ground
I've fallen hard
But I've been loved
And in the end it all works out
My faith has conquered fear
On my way here
Clay Aiken, On My Way Here

Part of the lyrics from the first single on his new album that was released Tuesday (May 6th) - I love it. It makes me cry, and it's almost like he's been living my life for the past few years (although I realize he didn't write the song.) Anyway, the whole album is good - his best yet by far, in my opinion. Of course, I will always love that voice, and the production quality and the songs seem better this time around.

So! I finished my first week back at school and I have lots to say, but I just wanted to let y'all know that I have had a GREAT week, and I am loving life right now, and I'm all-over-the-place thankful to my Lord, from whom all good things come. He is so good to me. I'll write more later about what I've been up to this week, for those of you who are interested! But for now, I'm a sleepy girl and I need a nap. :-)

Before I went back to school, I got my hair cut and my hair guy (Ron Wilson from Ron Wilson Hair Gallery, he is fantastic) talked me into highlights:

I decided after awhile that they were too red and were making me look a little washed out (and I'm translucent anyway) so I bought some Perfect 10 at Walmart and darkened the red a little. The red still shows through, but not so much, which is exactly what I wanted. I was scared as I was washing out my Walmart dye, though, because the suds? Were purple. Lavender, actually. So I was terrifed that I'd end up like one of those little ladies with violet hair. To ease your troubled mind - I didn't.

More later.

Doctors are funny!

That is, except the tactless ones that ruin the Internal Medicine clerkship for 3rd year medical students. Anyway, I found this article online from The Journal of Family Practice (Howard J. Bennett, April 1995) and it amused me. It's about humor in the medical practice, and has wit throughout. Here's a couple of my favorites:

A surgeon, an internist, and a family physician go duck hunting.

The surgeon sees a duck, shouts "Duck!" and shoots it down.

The internist sees a duck, shouts "Duck! Rule out quail! Rule out pheasant!" and shoots it down.

The family physician sees a duck and blasts it out of the sky with a burst of machine-gun fire. As the tattered carcass falls to the ground, he remarks, "I don't know what the hell it was, but I sure got it!"

Rule out quail! Rule out pheasant! Hee. It's funny because it's true. I also like this:

To the Editor:

Last year, my husband, a pulmonary fellow, sent me a valentine; he thought that the cardiac system was receiving far too much attention on that day. I thought that your readers would enjoy the valentine.

A Pulmonologist's Valentine
Roses are red
Violets are blue
Without your lungs
Your blood would be too.

Here's the whole thing, if you're interested: Humor in the Medical Literature - Editorial

Look at me, I'm funny

Well, not really. But this seemed to amuse the people in the room, so I thought I'd share. Today I was sitting in the conference room in Family Practice (obviously, because that's my rotation right now - why would I be anywhere else?) and one of the doctors there was perusing a website, which I didn't pay close extreme attention to, because that would be weird.

That's not the whole story.

Other doc in the room DID pay attention, and said something like, "Oh, are you thinking of another specialty in physiatry?" (Or something similar - I was writing a SOAP note on someone with a problem list numbering eleventy billion, and I wasn't really listening.) The other guy said something like, "You can't pull a Rich Rodriguez and leave us!"

And I said, "If you do, make sure you leave when there's only ONE PATIENT left to see!" Hardy har har.

If you don't know who Rich Rodriguez is, he was the West Virginia University football coach until recently, when he left abruptly (for the money, obviously) to coach at Michigan. He didn't leave when the team had finished their season, though (well, I guess they had finished their season, but they still had a bowl game about two weeks after he left.) The ESPN article linked above has quotes like this that make Rodriguez look like a real skeeze:

"The players are upset because he said he's going to leave before the bowl game," James Dykes, the father of West Virginia defensive tackle Keilen Dykes told ESPN's Joe Schad. "At least coach them in the bowl game. James just called to tell us and I know he is very upset about this."

Assistant head coach Bill Stewart and Magee ran West Virginia's one-hour practice on Sunday. Rodriguez was not present. "We tried to be excited," Keilen Dykes said. "We're all hurting right now, but we can't cry."

But WVU went on to win the Fiesta Bowl on January 2nd anyway. Boo-yah.

Geeeeeeeeez! I've been gone for awhile.

I have no excuse - just holidays, my birthday, and sickness. Did you know I've been sick on about 26 of the last 29 birthdays? It's kind of my trademark. You should see some of the pictures that I have from my birthdays when I was a wee tot - standing in front of a flickering Snoopy cake, looking unsure whether to blow on it or barf on it. Actually, in this day and age, you COULD see that picture. I'm at the apartment, though, and the picture's at home - I'll scan and add it later. I was so darn cute when I was a kid, I'd hate to deprive you of my cherubian face and my dark curls. (I'm not being vain - because while I was a cute kid, I'm not so cute anymore. So.)

What have I been doing, you ask? Let's see. I ushered in Christmas Eve. Then I ushered it out and ushered in Christmas. Then I ushered it out and ushered in my birthday (my 29th birthday - this is the one that I just keep celebrating the anniversary of, right?) and my pancreas reared it's ugly head even higher than normal. And then I got some sort of virus that came complete with lots of barfage, weird leg pain and twitching. That stayed around until New Year's Eve. Scott was very sweet through that whole viral crap - he came up to see me almost every day and was all attentive and stuff. Awww.

Then I started back to school on January 7th - I'm on my Family Practice rotation. So far, I really like it. It's soooooooo much better than my foray into Internal Medicine (I blame a lot of that debacle, though, on the fact that I was so sick and everyone was all, "How dare you be human!!!") This time, a whole different me showed up to the first day of the rotation. I am a lot more interested, responsible, and attentive when I don't feel like someone is stabbing me in the gut.

And I've watched Reign Over Me, Juno, and Enchanted. I'd recommend them all - especially Juno. I adore Michael Cera (is he too young to join my Geek Love Fake Boyfriend Brigade? I'll have to check.) And Ellen Page makes a great debut. It's funny, heartwarming, and just very darn good.

Oh, and I saw a toenail fungus yesterday. I itched the whole rest of the day. I know that Trichophyton (Trichophytons?) don't have legs and couldn't have jumped on me, but still. The mind is a powerful thing. Also, did you know that adults most commonly get toenail infestations by dermatophytes, which invade normal keratin? And that older adults (i.e., geriatric adults) most commonly get toenails infected with mold, which invade irregular keratin? I didn't either.