What Residency Looks Like C: Final Bloopers Edition

Now that I have exited the relatively sheltered realm of training and entered The Real World(TM) of practicing medicine as an attending physician, this will likely be my last bloopers post. Far be it from me to maintain that only medical trainees make funny mistakes--I'm sure every nurse and therapist of any kind has at least one tale of a seasoned physician bungling something that would leave you in stitches. But I have decided to relieve myself, at least for now, of the responsibility of enumerating my own faults (there must be 10 per year, no more, no fewer!). Everyone says the steepest learning curve in medical training is the first year as an attending, when you sometimes look around for "the attendier attending." No doubt for the first couple of years I will continue to feel like a "pre-tending," the term we used for ourselves as senior residents when we ran a service with less supervision than usual. Yet I hope to keep my sense of humor about myself, medicine, and the human body, so if I collect (good) enough anecdotes, I will post them here. For now, it seems right to conclude the series with its 100th post.

Top 10 Bloopers of a Fourth-Year Medical Resident

10. There's the time I made Dear Husband carry my pager: I was on call 24/7 but didn't want to be housebound, so I ventured out to the gym...and forgot my pager. He had to take it on his run just in case it went off! (It didn't.)

9. How about after attending the endocrine fellows' morning lecture, I got myself and an intern stuck in an elevator lobby in one of the fancy research buildings that requires a badge to get in, out, and move around it. We had to call the fellow to stop his elevator on our floor so we could get back on and go to the correct floor.

Last day of 32nd grade!

8. Or when I dropped the rest of my donut on the floor of the residency office, picked it up, ... and after thinking about the three long hours of rounding between me and lunch at noon conference, finished it anyway.

7. Repeatedly diagnosing and treating myself for a skin infection around my mouth that I thought I was contracting from my chapstick, only to finally realize that I had developed contact dermatitis (aka an allergic reaction) to my chapstick (that sometimes damaged the skin so badly that it DID get infected).

6. When I held my hands out to a patient in the hospital and asked her to "Give me a big squeeze," intending that she make a fist around my fingers. Instead, she threw her arms around my neck and hugged me.

5. The morning I got on an elevator after an overnight shift in the emergency room and pressed the button for "1." "You're already on the first floor," said the cafeteria worker in the elevator.

4. When I agreed to cover a resident's patients in clinic so she could travel to see her hubby...I didn't put it on my calendar...and she forgot to remind me...so I didn't know why she hadn't shown up and texted around until it suddenly dawned on me that she wasn't even in the state anymore, much less running very late. I very sheepishly saw her patients.

3. The time I logged in to record my last week of duty hours and discovered 44 requests for faculty evaluations. I had worked a single 10-hour shift in the pediatric emergency room, and rather than ask me with whom I had worked, the residency office sent me a request to evaluate every single attending and fellow in the department.

2. Every resident's nightmare finally came true: I didn't read my schedule correctly and slept in on a Saturday when I was supposed to be starting a 24-hour shift. Thankfully I didn't sleep in that much, realized my mistake when the night resident texted the group WhatsApp, and was ultimately less than an hour late. Good thing the she was understanding; a manslaughter charge wouldn't have stood up in court after making her stay an extra hour after a 12-hour overnight shift.

1. When I offered to heat a patient's homemade "hot pack" made of dried rice in a sock and accidentally put it in the microwave on high for too long, which cooked the rice, which expanded and burned through the sock. The microwave, family kitchen, and my scrubs all smelled like burned rice. I hurriedly turned the end of the sock over the rice that was still in the foot, retied it, and hoped the patient didn't notice...

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What Residency Looks Like XCIX: All Gone!

At the conclusion of residency, I went to the children's hospital to run some errands:

• Filled out yet another check-out form (3 programs = 4x the forms!)

• Dropped off my "pickle phone" and charger for one of the in-coming MedPeds interns (it's the ciiiiircle of technology!); happy to be keeping my pager with its winning number (#5050)

• Took my final portrait (below)

• Purchased $42.50-worth of food with the last of my meal tickets: sushi and a boxed salad for lunches, 2 pints of ice cream (chocolate for me, chocolate chip cookie dough for him), 1/2 dozen bagels, and 1 dozen fizzy drinks

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What Residency Looks Like XCVIII: Tea cups

This tea set--a gift from my in-laws--accurately represents my residency class: four different cups and saucers that are equally good for serving hot beverages, and even though they don't match, they still go together. I think I'm the one on the far left. (With two cups in the background for the two significant others.) I will always remember that one time we decided to teach ourselves how to play bridge, and how--briefly--I was Lord of Catan.

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What Residency Looks Like CXVII: COVID fashion

Sometimes residency in the time of COVID looks like "business on the top" and "comfort underneath."

Exhibit A: Comfy solid tee with a statement necklace that will look good on Zoom/Team meetings, with shorts because the room with the plain background gets hot from the morning sun.

Exhibit B: Cover your comfy tee with a scarf, cargo pants on the bottom; very busy domestic background.

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What Residency Looks Like CXVI: Med Peds Picnic

What can I say? We're just so photogenic! Which makes it all the more a shame that the Graduate Medical Education office didn't post pictures of us in its online graduation announcement, although almost all the other residents and fellows had at least a head shot, if not a group pic. That may be because when they redesigned the Internal Medicine Residency Program website, they left off the fourth-year residents (!). It's not that *none* of the Med Peds residents were included, just that the *four* of us were nowhere to be found. One of the rising third-years mentioned it in a meeting earlier this month, and I emailed the IM Chiefs about it before we were even off the call, because, come on. Who wouldn't want to look at these mugs? And the class behind us is even more camera ready (they're matching-outfit adorable).

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What Residency Looks Like CXV: Accomplishments

Monday: 

Graduated from Internal Medicine Residency (no more shifts!). I dressed up for the live-stream, although no one could see me except in the selfie I posted on Facebook. Even Dear Husband was on a different Zoom meeting.

Earned a Certificate in Medical Education. Was "voted" most likely to give a history of medicine lesson on rounds. Sore that the foodie award went to someone who isn't even a Yelp Elite.

Friday: 

Took a knee against white supremacy, racism, and police brutality. Medical professionals around the city gathered at noon to reflect and kneel for 8 minutes and 46 seconds, but I was not on campus due to graduation. So I had my own one-woman protest on the busy street corner in scrubs, a white coat, a refurbished version of the "White Coats 4 Black Lives" poster that has lived in my rear car window since medical school. I didn't do it for likes on social media, so I didn't have Dear Husband come take pictures or video or anything. I did it for the white man who started crossing the street, turned around, and came back to ask what I was doing. I did it for the black city bus driver who honked and waved. I did it for the black woman who asked to take my picture. I learned that 8 minutes and 46 seconds is a long time to support my weight on one thigh, and that the pavement is very hard when the soft neck of a Black person isn't underneath.

Graduated from Pediatrics Residency (1 Emergency Department shift, 12 more hours of jeopardy, and 3 weeks of out-patient elective to go!). DH, my parents, and I gathered at my colleague's house for a graduation party. Since Allegheny County had moved to Green that very day and there were still fewer than 10 of us, we figured it was safe. I confess that sitting on a friend's couch to watch a pre-recorded ceremony with an adult beverage in your hand is absolutely a superior way to experience a graduation. Big surprise: I was awarded the American Academy of Pediatrics Med-Peds Resident Recognition Award for my advocacy work, and the program director read my poem, "In the Trenches."

Provided by-stander aid to an older gentleman who fell off his motorcycle due to a near-miss with a car. Good thing there was a house full of doctors on the corner, and good thing he didn't really need us!

The ambulance driver who came to pick up the biker was definitely
laughing at us as she drove down the street after the accident...

Saturday:

Repaired a closet shelf that had collapsed when we moved in and I tried to store too many boxes of books on it. (Credit: Father Man)

Acquired a blister from a lovely walk in Frick Park in inappropriate footwear.

BBQ shish-kabobs (Credit: Father Man, who wore his new "My Favorite Doctor Calls Me DAD" tshirt)

Games after dinner included the tallest-ever Tier auf Tier tower (Credit: DH). We also made up rules for Gluecksferkel, because the instructions were missing from the box (I acquired 3 German children's games for free back in grad school).

Sunday:

Adult Forum finished talking about Barbara Brown Taylor's Holy Envy: Finding God in the Faith of Others; Zoom church went off more or less without a hitch; and DH had very thoughtfully picked up Klondike bars with which to mark the start of "summer church" (we're still meeting at the same time, however, since we don't have to move to the cooler worship area at an earlier time due to the lack of AC).

Re-upholstering my rocking chair. It was 10 years old when we got it with the dining room table and chairs from another history graduate student; at that time I replaced the stained blue-and-white coverings with green-and-brown stripes. 10 years and 2 cats later, however, it was time to replace the fabric. Mother brought a beautiful dark blue cotton with light blue flowers that remind me of blueberries and Maine for the front and ottoman, which we paired with a sturdy light blue polyester for the back.

45-minute hike in North Park (Mother and I are wearing matching face masks that she sewed)

Successfully ordered burgers to go (it only took two tries in three days, as the first time we accidentally landed on the site for a burger joint 30 minutes out of town!); watched Top Gun; chilled

Monday:

Had second breakfast together and said our good-byes until...mid-August for family vacation?

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Snicker-Doodles

Tomorrow our county exits quarantine after 11 weeks. I figured this was a good time to take stock. I worked from home for 3 (4?) of those weeks and worked at the hospital or clinic for the rest. There still aren't that many patients, and neither Dear Husband nor I is ready to eat at a restaurant or even to take a walk without a face mask. We've spent so long disciplining ourselves (and others, in our minds) that I wonder what kind of culture shock it will be when the stay-at-home orders lift and we stumble outside in the heat of summer. Since we returned from our Spring Break trip to Los Angeles and Santa Monica--perhaps with mild cases of COVID-19?--the following things have happened:

Goods baked:
Raspberry scones
Chocolate chip cookies
Snickerdoodles
Blackberry oatmeal coffee cake
Peanut butter banana bread
Chocolate chip banana bread
Mixed berry pie x2
Cherry pie
Strawberry pie x3

I baked the snickerdoodles according to a recipe from family friend S.H., my Brownie Troop leader. It was a gift at my bridal shower in 2005, at the very end of the era of recipes written down on paper or cut out of newspapers or magazines. Nowadays you can search the internet for any combination of ingredients you want (or have on hand), but there's something heartwarmingly personal about a note at the end about liking soft "snicks" better than crunchy ones.

1. Mix 1 cup shortening, 1 1/2 cups of sugar, and 2 eggs.
2. Separately blend 2 3/4 cups flour, 2 tsp cream of tartar (purchased especially for this occasion), 1 tsp of baking soda, and 1/2 tsp of salt.
3. Mix everything together.
4. Roll into 1" balls, and then roll on a plate with 2 tbsp sugar and 2 tsp cinnamon.
5. Place 2" apart on an ungreased sheet and bake for 8-10 minutes at 375 F.

"They puff, then flatten. (Makes 6 doz.)," she wrote. They certainly do puff, but my idea of 1" must have been generous, because I only got 48 cookies!

Settlers of Catan: Created a character for myself, grew wheat, mined ore, and traded brick up to Level 20! I am now a Master of Catan. I was "Lord of Catan" among my friends here when quarantine started, but I forfeited my kingdom by choosing to stay home and nurse the rest of my illness instead of defending my title when the rest of them gathered for one last round before stay-at-home orders went into effect. We plan to renew the conquest tomorrow during our graduation celebration, now that the county is entering the Green Zone.


Movies watched:
Contagion (2011)
War Games (1983)
Cast Away (2000)
Jaws (1975)
Dial M for Murder (1954)
The Shining (1980)
The Man Who Killed Don Quixote (2018)
Knives Out (2019)
Godzilla (1954)
Snakes on a Plane (2006)
The Towering Inferno (1974)

The very last weekend I had a 24-hour shift (last ever!) that obliterated the weekend. A friend form church H.G. who enjoys theater invited us to a Zoom "staging" of Shakespeare's The Merchant of Venice over two days. Unfortunately, we only got to watch the first half, because by the time we could get back to it, Pittsburgh Public Theater had taken down the recording of the live feed in preparation for the next week's offering. I'm trying to temper my disappointment by remembering that they will put the money we donated for "tickets" toward keeping their lights on and actors employed until we have passed into whatever comes after the Green Zone, when live performances will again be allowed.

Until then, stay safe. What hobbies or skills did you find during your quarantine? And how much longer will you have to stay at home?

What Residency Looks Like XCIV: Lesson on Friendship

Sometimes residency during COVID looks like snuggling up with the kitty, your notebook, and a lecture on social outcomes for kids with severe and/or chronic medical stressors like cancer or sickle cell disease. She got lots of scratches, accidentally knocked me out of the meeting once, and then fell fast asleep.

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