when ducks fly

I always find it such a privilege to find out what really matters to someone, especially when I’ve only known them for…say 15 minutes? 

A secondhand bookseller has collected books for 60 years, sold for 40, and camped out as a vendor at the French Market for the last 26. He says the Market used to be more fun with the other vendors because business was slow. Thanks to him, I also now have a beautiful edition of Steinbeck’s East of Eden :D

While time isn’t the only measure of commitment, it’s a darn good one.

Visit our trip blog! awbnola2012.blogspot.com

like @happyducktape (just going to pretend i can tag people), i also played tennis this morning, though i’m probably not very good. when we were resting, i had a heart-to-heart with my good lil’ bro, who refused to share his tennis skills with me. i retorted by saying my boyfriend would teach me, to which he said that only a banana would ever “admire” me. timmy: 1, ya: 0. still, admire is a good word.

yesterday it rained again, so we only spent three hours at the beach, during which my dad lost his glasses in the ocean (apparently no one told him not to) and i was part of the biggest digging commission ever. there was a digging competition: three boys vs. one girl so of course i had to help her out. we came back for lunch and i took a nap while the parents played cards. after dinner, the parents shared their testimonies, which was a blessing to be part of, and i got to hear a more complete story of the goings-on when my parents were saved. good stuff. really humbling to hear what they all went through in the States with their unique struggles both spiritually and physically.

I SLEPT ON THE COMFIEST COUCH last night. slept like a baby compared to the previous night.

i think it’s supposed to rain again soon, so we’re probably off to the second outlet, and as my super smart friends say, spend the rest of my jelly benjamin. though…why is it called a jelly benjamin?   

ewrargsgwer really not a big fan of family vacations. especially when family includes one obnoxious brother, one youngest sister who fights often with said brother, and one mother who packs our house into the minivan and fits us into the crevices last minute. but despite not being a fan, this may be one of the last family vacations that will look the way it is now. so i will really really try to be grateful for each moment and refrain from watching netflix movies. (fail on one count already for “secretariat”.) we’re vacationing with a couple other families from my parents’ cell group. actually, i don’t even think that’s true. we met a new family that is related to another family that’s also with us, and then there are families that are staying for just one night.

anyway, the families are fairly young so there are lots of little kids, mostly girls from ages 6-10. can someone say dramaaaa? the aforementioned youngest sister is the primary instigator, and i’ve already had to ref several rounds in the boxing ring, keeping two crying girls from attacking each other. i’m half jesting, but i’m really learning a lot about raw human emotion from them. i think as we grow older, we learn to filter, sanction, portion out our emotions according to what we believe is appropriate or useful in a particular social context. but little girls aren’t too good at that. they experience jealousy, exclusion, injustice so real-ly that they spew their anger, sadness right back out (though i have still have to work on distinguishing screaming from speaking). once it comes out, they can let go and forgive. have you noticed? young children don’t often hold grudges, maybe because it’s their short attention span, but i think it’s because they trust easily. even after someone wrongs them, they find it easier than most adults to re-trust. oh to have the heart and innocent mind of a child. ugh i just love them haha. 

yep so we chose a bad week to come to rehoboth. d2 consisted of 2 hrs beach and 4 hrs shopping and 6 hrs of eating/snacking/chatting because it rained for most of the day. not to say that i complained; my mum slipped me a spanking new hundred dollar bill ;)

i have been working, but a combo of laziness and busyness has kept me from tumblr. though i must admit, it’s sometimes too easy to mistaken one for the other. the inspiration for this blog began several weeks ago in the ED when one of the PAs talked about how he took his wife to see Wicked and then i started going on about how i was afraid the touring cast wouldn’t be as good as the original but i was still wowed and they all looked at me like i was crazy… haha i’ll miss the ER’s awkward moments. anyway, so one of the songs in Wicked is “Defying Gravity”, which if you haven’t heard it yet go listen on youtube. its epicness is not solely due to its composer’s expert musicality (much love to mr. schwartz), but it comes at the climax of the story, when elphie realizes she can fly on a broomstick among other things. her good friend glinda tells her she’s having delusions of grandeur, but elphie laughs it off and…well, defies gravity. 

i can’t help but ask myself if that’s also what a lot of pre-meds, med students, and even residents envision when (or if) they reach their goal of being a full-fledged, independent doctor. do they expect to defy gravity because they’ve worked their hearts off for this, having spent their youth in school and listening to others congratulate them for their dedication to saving lives? something must drive you to be a doctor, be it wealth, glory, acceptance, heart—because it’s not an easy road (and you need to tell your interviewer something convincing :P). but what if whatever you were searching for isn’t at the end of the road? i can’t tell you the number of doctors who regret choosing medicine. it’s sad and scary. regretful doctors can make bitter people who’ve invested so much only to be disappointed. 

i feel like these delusions of grandeur have exploded in our generation, though i’m not quite sure why. maybe it’s all those over-dramatized t.v. shows; all i know is i want to be a dancer after watching an episode of SYTYCD. don’t picture it. a colleague scolded me the other day for saying that my parents have a lot to do with my career choice, saying that he hated it when people listen to their parents when it comes to jobs, because after all, shouldn’t they be aspiring for something greater? i resented his words to my bones. by no means am i exemplary daughter when it comes to obedience, but when did it become shameful to be obedient? especially when one man’s obedience to his Father became salvation for all? that. is way more than enough grandeur i’ll ever need.

what set me off to finally write was reading this article: http://www.crossway.org/blog/2011/08/the-bored-life-isn%E2%80%99t-worth-living/ no reason to be bored… reasons plenty to be grateful and excited for God’s creation! only two more days of work yeeeeiiiiiiaaaa don’t know how to feel.  

Got home from work, showered, and drove straight to ocean city where I am currently typing this on my phone :) I had made it just before the sunrise when I got here at 5:10; it’s still lovely here minus the seagulls. I’m actually scared enough of seagulls that I’ll run away from them. A secret.

Something mortifying happened last night: I managed to lose two t-sheets in one night, two more than the total number I’ve ever lost. But it’s more than embarrassing because those sheets had enough medical history to be incriminating. On top of that it was a fairly steady night, so it was hard to comb through the patient rooms to find my sheets. Late into the night, one of the other docs found it mixed into their cubbyhole!

Another one of my embarrassing secrets: I am secretly a slacker, known well only by those who have lived with me (my family and Arlene and Karen). I hide it well under the pretext of efficiency. At work, I’m probably one of the most likely people to be twiddling my thumbs, and I am done with my work!! But there is always something that could be done. Always. In the past I used to fall asleep on my elbows for 10 seconds, but now more than not I’m open to conversation. And now I know many details about other people’s lives. It’s great. Also when I first started working, I was pretty zealous and didn’t eat or use the restroom. Now I’m getting old old and lazy. The slacking is probably due to losing steam, which is pretty inevitable when it comes to earthly things including ourselves. It’s the logic of biology.

The sun is higher now, and I must go take a nap before everyone wakes up for breakfast. Blessed Saturday mes cheris.

first night back in too long, almost didn’t survive. especially because patient volume lagged for most of the night. though a couple of us did take a jaunt outside at 3am. beautiful beautiful morning. 

i noticed that the SMS software in the ED (system for putting in orders for labs, x-rays, etc.) hadn’t been updated in 21 years. it’s a wonder it even works on the newer computers. it’s kind of shocking and ironic how technology cannot imagine catching up to the medical advances in this particular hospital. wouldn’t be surprised if it were a chronic problem in other hospitals. recently, we switched over to an electronic charting software that uses a special camera-pen to track what is written down for each patient. the purpose is to keep an electronic database of all the patient charts, which was previously kept solely in reams upon reams of paperwork. great idea, really. pretty fail practically speaking. as you can imagine, the new technology slows down the ED servers considerably, so everything just started crashing constantly for weeks. finally, yesterday, we went a temporary eChart “strike” that will likely last several weeks. we need a serious IT person here stat. 

it’s a shame though because the medical care could be so much more efficient and less wasteful. there are a good number of things that just seem so roundabout, and it may be because instead of revamping/rebuilding, we’re just adding onto outdated systems, hoping that things will be better. it’s like throwing a banana on degrading compost and expecting banana trees to sprout out of it. now the docs are talking of a root causes analysis of the eCharts. personally, i think we need to analyze our healthcare system and be serious about it. it’s a pain in the butt to rebuild, but tinkering just won’t cut it anymore.   

ahh i beg your pardon. i cheated two three nights ago and [yesterday] having failed to blog after work. and so i’ll just lump tonight’s with that those night[s], which is kind of nice because this topic is dear to my heart but is also difficult…i think. yep. this is a continuation of what i started on last night!

one of the big surprises of the ED is the substantial number of EP cases we get. i actually don’t know what it stands for, but probably something “psychiatry”. emergency psychiatry? EP cases include folks with elevated episodes of chronic psychiatric diseases such as bipolar disease, schizophrenia, and those who overdose/abuse substances (ethanol, cocaine, etc.). most of the time, these patients are physically “well” and medically cleared: heart beats, lungs move air, limbs move. i think in the ED we aren’t quite sure how to react to these patients who clearly are combating some inner demons. a lot of them, after some anti-psychosis drugs, calm down and appear normal, a word i’m using loosely. usually, we just laugh and make fun and get frustrated to have to deal with such patients when other patients have real medical issues. 

i think the reason we jeer is because we don’t really understand the psyche as well as we do the lungs or the heart, which leads to fear. honestly, some of psych eval patients scare me, especially those that are paranoid/hallucinating. their vivid accounts must be real to themselves, if not to the rest of the world. i just hope that doctors and nurses will continue to be more understanding of psych patients because i think that though they know that warfare in the mind is no less serious than physical deficits (nor are they unrelated), it’s treated as such. to the anxious patient, a physician’s patience may do more than any amount of ativan.

!! tonight was uber sloooow in the ED, so i ruminated a little on what i’ve learned and how i’ve changed since my first day. here’s what i came up with:

1. i now drink coffee with milk and sugar. coffee in the ED is blacker than tar. 
2. i go to the bathroom none-to-once every 8 hours, instead of my typical 1x/hour frequency. poor bladder…
3. i can walk really fast now. definitely a blessing haha!
4. cuteness and kindness can take you far in this business :P
5. the best insults can be found in the comments section of political op/eds 

keeping my mouth (more) shut from now on. 4:40pm, confidently i walked out the door, telling my dad how i’d be home by midnight at the latest because all the sick people were vacationing elsewhere. there were almost three simultaneous codes tonight. and it was the first time i even considered being nauseous—because you know, i can totally control that.

two of the three codes passed, and the last wasn’t even a code and woke up after some mind-clearing (gag-inducing) medication. codes actually aren’t that common at shady grove; on average i would see one every five shifts, and most are dead on arrival. the typical story is that the patient is found unresponsive with an unknown downtime (as in no one knows when the patient actually lost consciousness). i remember my first code vividly. the guy came in with an abdomen inflated to the size of one of those globes on rotating stands. he looked cold. i was more shocked than scared and, this sounds terrible, it was exciting in the sense that you could slice a considerable chunk of tension from the air and choke on it. but of course the doc and nurses were no novices. the doc that night was an above-average go-getter anyway, so the patient got shot with several doses of atropine and epi and was sent on his morbid way to where expired code patients rest.

since then, i’ve seen maybe a dozen others, and it still takes my breath away. there’s still that anticipation that the patient may survive. it’s only happened once.