In Honor of Ob-Gyn

Every time I see our beloved friend Amy I swear she's going to pop.

Free at last!

Finally finished my internal medicine sub-internship today. Its been pretty rough at times, and at others? Thoroughly satisfying. Will I jettison my potential psychiatry careers for internal medicine? Not a chance, but its not so bad. Its nice to know you love something.

Little Miss Sunshine

Hands down my favorite film of the year.

So, given that I had my first day off in twelve days, I had the luxury of seeing a movie that I viewed with great anticipation. So, Kevin, RoMo and myself all headed to the opening day at the possibly endangered River Oaks Theater. Fortunately, they've not destroyed the place yet for new condos or a Barnes & Noble.

In any case, there are just some films the capture the essence of the modern American family. American Beauty attempted this and succeeded quite well, but the characters were cultural outliers. In other words, though seen in oodles of daytime television, its not actually that common for a father to have sexual relations with his daughter's high school best friend. Just going to put that out there, Qatar.

What this film does is capture the essence of flawed, dysfunctional, and ultimately hopeful and resilient American families through literally the vehicle of a trip across the Southwest for a prepubescent beauty contest. I LOVE all the characters, each goes through personal loss and the matter and which they deal with it and each other touches the heart. This is without being sappy and with a healthy dose of humor.

Hilarious.

All that being said, this movie is solidly and without question my favorite film this year; its quite possibly my wonderful film experience in 2-3. It comes with my highest of recommendations.

Who me? Couldn't be.

Okay, okay. So I've been a little crabby recently about my torture, er, sub-internship in internal medicine. While my team is hilarious, and easy going, I just can't find enough time for my beloved sleep. Coming home and being absolutely exhausted, and then having, "Did I get the right order? What happens if the patient spikes fever again? I hope homeboy doesn't piss on the floor...again" disturb what precious hours of respite remaining.

But none to worry. On some level, buried under a guise of fatigue, its actually very interesting. And not in the euphemistic, 3rd grader's elbow macaroni art work sort of way. Its nice to have the integration of basic science knowledge with practical use. Plus, the desire not to kill anyone is excellent enough impetus for anyone to be motivated.

On that note, I've got a HIV+ patient with a CD4 count of 12. Hardly enough for his blood infection and dual lung infection, and hardly enough for his devoted partner's composure. Motivation indeed. So, despite my tiredness and missed Houston cultural events (2 in a week), I'm not sure I'd have it any other way...for now at least.

Ask me tomorrow. I'm on call.

Renal Penal

So, alas, my sub-internship in internal medicine continues...continues to reaffirm my desire to do psychiatry. While pathophysiology is fascinating, and differential diagnoses are wonderfully challenging, I can say whole heartedly, "Thanks but, hell no."

This line of thinking was further exacerbated by our new attending. This guy is apparently a world renown kidney expert. The sort that breaks down complex electrolytes with a wave of his index and slight raise of his eyebrow. He is sharp, impatient, a bit sarcastic, Armenian, and prototypically old (imposingly opinionated without much censorship).

After difficulty attaining an inpatient psychiatry consult on one of our obviously depressed and attention-seeking patients, our attending pauses, glances flippantly over his shoulder than speaks.

"I have had providence. My son went into psychiatry after medical school. I will say nothing about psychiatry." This of course said everything. After a meeting with my international health mentor, a psychiatrist, my attending inquired seemingly benignly, "How was your meeting?" After my initial cordial response, he all but asserted psychiatry was a think of the past, and couldn't see why anyone, much less his psychiatrist son, would waste their time on...that.

I know enough old folk to know that I'm not going to change his opinion, and that probably has more to do with his past experiences than with me personally. Plus, how can one describe vermillion to the blind, or universal passion to Republicans. Some things can never be changed.

Speaking of crazy, I'm on night call tonight...Friday night! Aye. It was particularly poignant when I visited the psychiatry department and was sent off with a 'have a great weekend.' Ouch. Just a little more and I'll be free.

21 days and 11 hours until its over.

Sub-human Sub-internship

So, I've started my sub-internship (read, doubly the public hospital system's paying slave) and there are several things I've learned thus far.

1. 'Day call' is a misnomer, as it can last into the next day.
2. Take any 'interesting' case and take the time necessary to work up a relatively normal patient complaint and multiply by 1.5. If after 9 pm, multiply by further by frustration.
3. Hold on to patient empathy at all costs.

In anycase, not too bad, but I left FAR too late, 1am. Especially since I've got an 'interesting' polycystic kidney case to pique the interest of our new world renown kidney specialist. Sigh. Brighter days will come. In the meantime, 24 days, 10 hours, and 22 minutes until its over!