The Mockingbird

A few years ago I had a nature blog called "Backyard Safari," where I wrote about trying to find the beauty of nature no matter where you were. My grandfather always enjoyed watching birds, first at the house they lived in for many decades, and then on the balcony of their apartment. 

In 2010 I e-mailed my Grandpa to ask if he could tell me about watching birds, and this is what he wrote back, presented in full, to let him speak for himself:

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“As a child, I was probably only aware of and familiar with robins and sparrows.  Later on, I grew to appreciate the beauty and coloring of the cardinals and blue jays, since they are easily distinguishable.  Then when we lived [at our old house], we had a very interesting mocking bird.  He would sit on the chimney of the house across the street and sing through his whole repertoire, occasionally jumping straight up about five or six feet and returning back down to the same chimney to continue his repertoire.  This could go on for four or five minutes–and the strangest thing was he might even be doing it at 11 or 12 o’clock at night.  During that summer, he also perched on the top of our garage and I would put pieces of apple or grapes on the back kitchen window sill and he would come and get them.  After a while, if I forgot to put the fruit out, he would show up at the top of the garage and wait for his food.  That was the most fun.

I guess I never got into the other birds too much until we moved out here–although we did have a bird feeder [at the old house] which your father installed safely on the top of a pole.  So he fed not only the birds but my continued interest in them.

When we moved where we are now, your wonderful father put up the finch-food feeder and the hummingbird feeder on our deck, both of which have been feeding many birds since then.  So you can credit your dad and mom for my continued interest.  And last year your dad brought the suet holder and suet, so we have a third source for them.

I miss the mocking birds–we never seen any anymore here.  But on most every day we do have goldfinches and purple finches, hummingbirds and cat birds, black- capped chicadees, cardinals, nuthatches, downy woodpeckers and many sparrows or similar types, including the chipping sparrow.  Still a few are a mystery.  It all proves nature is beautiful and a part of God’s plan.”

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Preparing for P2

With only 10 class days left in the semester, the "next year" of our P2 clinical year is now officially more like "next month." I am terrified, but am also getting more and more excited about what it will be like. 

As you know from any post about packing from our trip, I love accumulating and being surrounded by small objects that I might need. I like to think of this as a generally human trait, keeping the wolves at bay, but if you are Subash and caught in my piles you may have a different interpretation. 

At any rate, in the tiny lull between regular exams and finals exams this weekend I put together a little P2-Emergency-Kit to keep in the car or bag or somewhere as we begin this next adventure.

It's pretty simple, and mostly stockings. Some of the places we will be rotating in have rules that you have to wear stockings, not just if you are wearing a dress or skirt but over any foot visible. In order to combat the inevitable "oh my god I forgot stockings" 5 am moment, I bought a super cheap-o set of black and "nude," and then some knee high ones as well. I also have a set of little sock things for flats to stay comfortable.

Next up is a toothbrush, toothpaste, hand sanitizer, tiny deodorant, and lint roller. I actually got 3 lint rollers and plan on having one in my bag, in the car, and with this. It is the only way I will ever make it from our house to rotations without being a walking tumbleweed of cat hair.

Pro-tip: getting a travel deodorant was stupid. A real deodorant is what, 2 inches bigger? And with probably 500% more actual product.

Next comes hair clips and ties. After spending my whole adult life with a pixie cut, this long hair is still confusing to me. I don't know exactly what to do with it but certain rotations, like surgery, it will always be back, and in the end that will probably be the case for most things--long flowing hair just means hair in someone's face when you bend to examine them, or something for people to grab if they are obtunded/a kid/a jerk. We'll see how rotations actually go to figure this one out.

Lastly, you know I have to have a book and pens. For our 4-hour Friday rotations this year I used a small flip memo pad, but I am sizing up slightly with a 5 star college ruled notebook I know will fit in my white coat pocket. 

I also have this "Perfect H&P" book I ordered off Amazon. I haven't really used it yet but it is nice as a memory jog because it has categories for all the information you should be getting from someone. We'll see how it fits into my real life, but it might be good in the beginning at least to get me through those "oh shit" moments when everything important falls out of your head. 

For pens, my go to is the Pilot G-2 0.7 mm. They run out of ink too fast but they are a pen that can keep up with your thoughts, which is especially important when you are trying to balance listening to a patient, narrowing down a differential diagnosis, and getting the relevant info all at the same time.

This weekend I also went on a bit of a shopping spree, as I suddenly realized "oh crap I have to be presentable every day." And not just the old presentable behind a desk or in a lab like I used to do, but "trust me with your health and maybe life" presentable. 

I have been reading this blog by a med student on what she wears for inspiration

http://www.franishtheblog.com/2016/03/what-to-wear-on-clinical-rotations.html

So after yesterday's mall attack I think I am set for the foreseeable future! I have 4 pairs of nice pants, and probably 7 or 8 nice tops in addition to the random piles I already own which may or may not be applicable. 

I got a $7 watch since I need something with a second hand for taking vitals. My favorite part is that the Roman numeral for 4 is "IIII" instead of "IV," a perfect example of "you get what you pay for."

I am still working on the shoe problem. My shoes always need to be close-toed, and for surgery/ER will need to be something that covers the whole foot and maaaybe is rinse-able. 

Lastly, I finally got a full length mirror. I had one before our trip but we got rid of most of our belongings and somehow I just never got one again. Now, though my "if I can't see it it is probably fine" days are over and I need to see what the whole thing looks like!

All in all it was a successful weekend. I could have done this a little later, but i needed some fun happy and this made rotations seem more real. It is good motivation going into finals week to push through and do the best I can.

Bring it on!

P1 Year

Summer semester is flying by! We have ~2 more weeks of class and then finals, and then are officially P2s! 

P2 year is out in the real world on clinical rotations. There are 8 five week blocks, covering family medicine X 2, internal medicine, emergency medicine, general surgery, OBGYN, psychiatric medicine, and an elective. 

There is so much to know, and I'm still just biting away at the edges of everything I'll have to digest by next year's end, but I can't believe how far we have come in 12 months.

We have a "clinical skills" class this semester where we have been learning a range of things from your basic ring removal to how to run a code. My program really goes above and beyond here, and has gotten veeeeery creative in order to give us practice. Abscesses made of tapioca pudding, styrofoam eyeballs dipped in wax and stuck with foreign bodies, not to mention what we practice on each other, from diabetic foot exams to blood draws to injections.

One of the most fun has been learning stitches. Our "simulation lab" made fake skin pieces for us to practice on. Here are some simple interrupted and vertical mattress sutures submitted for judgement:

In addition to the regular work, a classmate and I are doing a research project at our free clinic for homeless men. I have no idea if it is something I am allowed to talk about much, as we are hoping to publish our findings at some point, but it has been really fun to get to be at the clinic more and get to know the men there. They have really embraced us and our work there, and are funny and very insightful into their own lives. It's been great.

This summer semester has been a real grind to get through. There are SO many tests, and so much material to learn. These last couple weeks it is definitely getting to me. For example, why am I awake now at 4 am????!!

The longer the summer goes on the more I can't think of any words I want in coversation--I'll know where I'm going and when I get to the end of the sentence it just isn't there. I'm mixing up letters when I take notes. I've started the coffee maker with nothing underneath to catch the coffee. This post is over 50% composed of just commas and the word "really." 

One classmate of mine went to a rotation with two different shoes on. Another calculated that out of the 220 class days of our P1 year we will have done 157 exams/quizzes and 39 reports.

I can't wait for that to be over and am both excited and terrified for next year. We find out the exact order and location of our different rotations in a few weeks, but I know my first 3 will be general surgery, OBGYN, and psychiatric medicine. Eek!

All this being said, I never lose sight of the razor-thin alternate reality where I didn't get in to PA school at all. Every time I see people interviewing for the program in their little black suits my insides scrunch up. People like to tell them how hard it is but I want to grab them by the shoulders and shout, "IT IS SO AWESOME, I HOPE YOU GET THE CHANCE" before running away to cram for the next test.