You Kids Today and your Newfangled Contraptions

Being the news junkie that I am, I usually look forward to Tuesdays because that's when the New York Times does its Science and Health sections. Today was kind of a bust, but I did notice one piece about adopting electronic medical records systems. The basic gist of the piece is that the government is trying to push hospitals and doctor's offices to modernize and start using electronic medical records, in hopes of improving record-keeping and also record-sharing between professionals.

Predictably, there has been a lot of resistance to this, for a variety of reasons. Many medical professionals work in areas where there isn't a major hospital to connect with, or in areas where there aren't a ton of specialists. (Meanwhile, you can't swing a dead cat around the New York City area without hitting a specialist.) And frankly, switching over is expensive, which is frustrating when you have worked with EMRs and have realized that it's not very complicated code.

But that being said, a part of me wonders if all this controversy is really about a much more simple truth - old people don't like change. I've seen a lot of older doctors really struggle to figure out basic stuff like how to save their work, or how to look up labs. And I'm not saying it's easy, because EMR systems are user-unfriendly to say the least. But rather than taking a course to familiarize themselves, or just diving in to get used to it, they just write off the whole thing as useless and kvetch (while brandishing their canes?) about the good old days where you didn't have to document everything and the doctor's word was TRUSTED.

Now, it might just be me. But I'm really not the brightest crayon in the box, and I honestly can't remember what I've been told 10 minutes later, especially if I am tired or distracted. In an EMR system, you can continuously save and modify what you've written, and copy and paste data so that there's less human error. And considering how many cooks are messing with an individual patient's soup, I think it's helpful to have one program that everyone is using, which keeps track of who put what in the record. It creates a certain amount of accountability, because everyone's checking everyone else. I never really thought what I wrote as a 3rd year medical student mattered, but I've had nurses and residents come up to me a week later to ask about my plan of action for a given patient. (Usually they were scolding me, but looking back, it was nice knowing that I mattered a tiny bit.) It also makes it easier to figure out what a patient's story is in the broader sense, whether this is a patient who follows up on care and recommendations or not, or whether this is a patient with a history of drug-seeking behavior, or whether this is a patient whose care is so complex that he / she deserves to be specially discussed with your attending.

I can understand that the isolated doctor's office in Wichita, KS won't see the benefit of switching over for a long time, and it's not a terrific economy at the moment so this stuff will sting when you pay for it. And I'm not sure that EVERY hospital should be mandated to adopt the systems either. But I think the way to handle this is a little bit of carrot and stick. If I were the president (sounds like a 3rd grade essay...), I would mandate that all hospital systems with X number of patients or higher must adopt an EMR system that meets ABC criteria. This part could be a tiered system, such that every few years a new mandate kicks in for a slightly smaller hospital system, and smaller after that. This would give smaller systems time to save up for adopting an EMR, and also get to see them in action at larger institutions. In the meantime, entice the doctors local to those systems and give them a small bonus for also adopting. In this way, it would be good business for a doctor to use the same EMR, because it facilitates communication and referrals with the hospital system. Eventually you'd get a trickle-down effect, and increasingly rural areas would adopt the practice in keeping with standard of care.

On the other hand, I'm thinking of replacing my Palm Centro with a new HTC Incredible. And I'm pretty sure that when my battery dies after 30 min of use, I will be throwing it out the window and shaking my cane at it, too. Damn kids and their crazy apps.

Idle Hands

Most specialties like to ask why you're interested in ________ specifically, as in "What is it that draws you to Obstetrics and Gynecology?" and you're supposed to answer from the heart, such as "Well, I enjoy cottage cheese and the smell of rancid fish." My stock answer for surgery was that I liked the thought process, the challenge of growing my bank of knowledge (a carefully chosen phrase) and also the problem-solving that it required.

We're now on Week 5 Of Vacation, though, and I'm realizing that perhaps the real answer is something a lot simpler - I hate idle hands. This isn't to say that I don't absolutely love being a couch potato, zoning out or being otherwise slovenly. But after awhile, I stop being able to sit still, mentally and physically. My boyfriend often comments on how I constantly fidget, or create distractions for myself when the task is mental (like studying). It's really common for me to pull out my phone to check the news, only to not even read it, just click through sites. (Although I am a thorough news fiend. It's just that after 2 pm, there's rarely anything new to report, and I still check anyways.)

The one and only way I can stay focused on a task is when it is a physical, mindless, fine skill thing like typing or sewing, OR it is to take up a new obsession. And this time, it's watching back episodes of Lost. And analyzing. And re-analyzing. This is a pattern I have maintained so many times over the years, and usually it ends up with me suddenly dropping the show. Before Lost, it was Cesar Milan, then Buffy, then Bones, then A&E Intervention. You can see from this pattern that I tend towards shows that either give me the "EEEE!!!" feeling (ex: Spike the vampire) or the "ugggghhhh" feeling (ex: dead bodies for autopsy / crime-solving on Bones). And so, I make a plea to Hulu: please put up the rest of Season 6. I will be eternally grateful. Also, any gratuitous Daniel Dae Kim clips would be much appreciated.



Mmmmmmmmmmmm.

(Note for my own Asian: He makes me miss you!! I promise!! =*)

Mad Skool Gradumacation

I never really consider myself to be superstitious, but I am one of those people who tends to view bad events in a particular way. I tend to have famously bad and good luck, by which I mean that a bad event will happen in a spectacularly melodramatic way, and then resolve itself in a similarly spectacular way that nobody else could reasonably expect. (Examples include $500 cash stolen from me at the Citibank and then retrieved and returned by NYPD in less than 48 hours, as well as losing all my keys on Wall Street in a giant crowd, and then having a Planet Fitness Jamaica employee message me on Facebook to say he'd found them.) This sort of reliable cycle of bad luck has now forced me into believing that sometimes, you have to make a little sacrifice to the gods to let things go smoothly. Thus, I am ok when I get into a car accident on the way to an exam and still get my 2 highest Shelf Exam scores. Or when I get rear-ended on the Belt Parkway, on the way to Graduation Weekend.

Yeah, that happened. Fortunately nobody was hurt, but now there's a ton of hassle that goes with it, which starts with my trunk door no longer opening. And graduation went without a hitch, no last minute notices from administration stating that I had failed Band-Aid Class and therefore would not be graduating. So, I am officially, a DOCTOR.

~commence applause~

Otherwise, the 2 day event was surprisingly pleasant. There were no major hitches on behalf of my school, and the event was overall well organized and meaningful to my parents, and followed by a nice brunch afterwards. I'd like to pretend that it wasn't meaningful to stout old me, but in reality, I definitely got teary-eyed more than a few times. The kicker for me was when several of my classmates were hooded by their physician parents, and I realized how much this meant to all the parents out in the audience who had supported their kids all the way. (Ok, I'm getting teary now just thinking about it.) I mentally contrasted things a little bit to the dinner dance our school held for the graduates a few nights before, in which they closed the open bar at 10:15 pm and then kicked us out at 11:15 pm (invitation said 7 - 12), a shenanigan they had also pulled at our Match Party a few months earlier. But nevermind that, it was still nice.

For some reason, I didn't really think that much about gifts for this graduation, and yet people really pulled out all the stops. In addition to the bobble-head doll, I also got quite a bit of money, some Indian dresses, and Operation.



As it turns out, Operation has been upgraded since yester-year and now there are multiple games to be played with increasing levels of difficulty. (I opened mine up yesterday to play with 2 girls I was babysitting, and they accused me of cheating because I'M A SURGEON. Ha.) My aunt, a nephrologist with a doctor husband and md-phd son, wrote a super nice note about how I was the first doctor in the family for my generation. And it was all so meaningful to have my family friends and boyfriend around with me for the ceremony. They made us announce our own names on the stage, and apparently everyone lost it when I said my full name, because my middle name honors my deceased grandmother, and they all felt how excited she would have been for me. My dad hugged me for like an hour and I had to hint at him that we needed to get moving or we'd be trampled in the aisles. And my mom kept telling people over the phone how nice the ceremony was, and I could hear in her voice how proud she felt.

~sniff~

So here I am, a doctor. Bit odd, really. And scary, because now I can't say the phrase "I don't know, I'm just the student". Wow.

Tennessee, otherwise known as The Weekend of Amazing Luck

Ahhhh, what a trip.

Let me start off by saying, TN is a terrific state and I really do recommend everyone giving it a chance. The people are so kind, and their state is just beautiful. Everyone should visit, especially Nashville to support them as they rebuild after the flood. But more on that later...

My boyfriend and I decided at the last minute to hit TN, because he had once driven through Knoxville and thought I might enjoy a proper weekend there. We spent 2 days in Memphis and one in Nashville. It just was NOT enough time! We got there early Friday morning, and tried our hand at Cockadoo for breakfast (so new, they don't even show up on Googlemaps yet). We had somewhat slow service followed by an incredible barbeque pulled pork omelet, catfish and grits , and sweet potato with marshmallows. Incredible food. The price to us, for our wait? Free. (Hope I didn't just sink Cockadoo with that, but I mean it as a proper rave review.)

We followed up by wandering into the annual BBQ festival, where teams compete from around the world, and display their pig paraphernalia along with names like "Butt-oh-dacious" and "Ribbed For Your Pleasure". And my god, the food was good, and confirmed when we later visited the award-winning Pig's on Beale ("Natural Born Grillers"). We also checked out Neely's (Down Home With The Neelys) for extraordinary wings and pulled pork, and even went back for more before our flight. On a detour from bbq, we enjoyed fried burgers and twinkies at Dyer's on Beale St.

Mind, not everything in Memphis is food (although even if it was, it would still be worthwhile). On a whim, we followed signs to the Civil Rights museum, only to discover that it is the actual site where MLK Jr was shot and killed, on the balcony of the Loretta Motel. It was so worthwhile to see, we went back a second day to spend time in the building where the shot was fired from (now used to showcase the forensic evidence and following criminal case). We also got to see "The Witness", the oscar-nominated documentary, and the guy that it's based on was even there that day! We also checked out Stax Museum for the history of Memphis blues music. All I can say is, if you love gold-plated pimp-mobiles or anything Isaac Hayes, this is a MUST VISIT.

We scooted our way into Nashville, which sadly does not have nearly as good food, but makes up for it in sheer talent. Nashville was recently flooded due to bad rains, and is now cleaning up the mess. To help, several crazy-famous country stars came to do a benefit concert, which we managed to sneak into at the last minute, and land terrific seats. My god, I did not know that country music could be so good. The lineup included Lady Antebellum (I nearly cried), Brad Paisley, Keith Urban (I WILL marry him, Nicole Kidman be damned), Martina McBride, CeCe Winans, Sheryl Crow, Kellie Pickler and several others. It was just so good, and meaningful. It was also kind of fun to see how a live televised event is organized, since I had never been to one. And now, I am a converted hick.

More to come, as I am completing this post the day after graduating and want to write about that experience as a separate thing. But basically, Tennessee was a hit and I recommend it to all!

Queens Command

I'm not sure if I'm the only one who feels this way, but I hate searching for apartments. I mean, HATE. HAAAAATE. (hate.) It's such a hassle, and I can never understand why people posting their apartments don't include basic details of space, features or even photos. It's 2010, people. Everyone has either a digital camera or a cell phone, or knows someone who has either.

It wouldn't be so bad except that my parents have their spoons in the soup, too, and their idea of a decent apartment often conflicts with my own. This is often complicated by the fact that they used to live in NYC, and my dad commonly makes proclamations about how well he knows the area. (Mind, the last time they lived there, it was the late 1970's.) They have ideas on convenience and comfort, I have ideas on proximity to civilization (aka Manhattan), and unfortunately the market just is not cooperating.

On top of it all, I have been doing the apartment scramble for a long time now. 4th year for me meant moving almost every month to a different location and hospital, and I pretty much lived off of Craigslist and the sublet listings. For the most part, things worked out really well. I generally had proximity to hospital, proximity to life (or something like it), and proximity to home. For my hospital, it seems like Queens is the best option, and I had a number of good tips on neighborhoods that are slightly less chic but still do the job.

I actually had narrowed things down to a few decent apartments, and my dad and I drove out yesterday to check out a few. The one I liked the best was one that was newly renovated in a nice neighborhood, but was a bit far and lacking in street parking for my dad's taste. Nevertheless, I insisted that he see it because it was miles better than any of the apartments I had been able to schedule in the closer neighborhoods. Also, I had seen this apartment and another similar one and gotten a shady vibe from the second place's owners, and so felt confident that this place was The One True Place. Alas, it was not meant to be, as the owner turned out to be EVEN MORE SHADY, trying to nickel and dime us even to the last second, and questioning all of my credentials while offering none of her own. (For example, I showed her a copy of my hospital contract, my driver's license, my passport and my impeccable credit report. She still insisted that she couldn't be sure that I was reliable, or that I had verified employment, and asked my dad to sign a document ensuring he'd financially back me.)

The long and short of it was that it did NOT work out, and we wound up making a hasty exit with some tastefully chosen words for her lack of professional demeanor. Of course, it's better that I found this out now than later, etc etc, but I was just so disappointed that the whole business was THISCLOSE to being done and now I had to start from scratch. Of course, I do still have lots of time before July and blah blah blah, but I have to say that I am just so tired of living with uncertainty. I should be able to handle not yet knowing where I will be living 6 weeks in advance, but after moving all the time and worrying about the match all year long, I just need a break.

.... anybody know of a nice apt in a house in Queens I could stay in?? I don't do drugs!!

mad knife skills

Aaaaaand, I'm spent.

I made it back from a lovely trip yesterday, much of which was spent lying on a quiet beach with my med school girls (and guy) and eating as much seafood as possible. I tried out crab-eating for the second time, and I have discovered the key - it is THE KNIFE!! The Crab Deck gives you these lovely sharp knives with which to pick apart the crab and avoid injuries, which my friends sadly were unable to do. But having more comfort with a knife than most people who know me are ok with (my boyfriend usually keeps one eye on me at all times while I dice a tomato), I actually found that using the knife to both pry open the crab as well as scoop out and eat the meat while dexterously avoiding "the mustard" was the best way to go. Ha ha! I eat off of sharp knives! And build cabins with my left pinky! I am CHUCK NORRIS!!

~a collective round of sighs emanates from everyone who actually knows me~

As usual, I tanned quite a bit and now I think my hands are starting to age from the lack of year-round sunblock protection. (For some reason, I religiously wear sunblock on my face in winter, but not on my hands. And so, my hands are 80.) But I anticipate that in a few days, I will have settled into a healthy glow. Just in time to hit MEMPHIS, BABY!!

The thing is, I'm finding that this extended vacation time actually makes me a bit uneasy. Following The Match (which for me was in February of this year), each rotation got easier and easier, until I was barely there. And now I have about 3 weeks before graduation, then another 4 after. I love being able to finally travel the way I wanted to, but it's actually oddly frustrating to have so much free time.

(Yes, I recognize this doesn't make sense to most people. Or anyone.)

I don't know, I guess that I'm often happier and more productive when I'm too busy. I get more organized, I have a schedule, I don't spend insane amounts of time thinking about non-existent slights from other people. Sad as it is to say, sometimes having real work to do makes me feel like I have a life, because I make time for that life. Whereas now I am 100% in that life and it feels kind of empty. My med school friends think I'm nuts, but a big part of me is really looking forward to starting internship and learning stuff and being busy and working hard. I'm getting emails from my program about lab coat sizes and health forms and orientation, and it's just a little exciting. Like when I was a kid and looked forward to the third grade all summer long. It will be exciting.

(Yes, I know that in 3 months, the word "exciting" will be more appropriately reworded as "torturous". But I'm ok with the delusion.)

vay cay

As evidenced by the lack of posting, I have been on vacation. YEAAA for the end of medical school!! I had previously planned on writing a profound and deeply moving piece regarding this momentous occasion, but I got lazy and didn't feel like motivating my lazy ass out of lazydom.

And so, I am on vacation in Maryland, to be followed by vacation in The Deep South, and hopefully more vacation to come. Sweet =)

On a separate but related note, my program contacted me to ask about dates for vacation for the coming year. I feel like no matter what dates I pick, I will either not get what I want OR I will get what I want and still not feel that it is enough. *sigh*