Sunday, July 18, 2010
Only two more weeks in Miami Beach
I am sad to see my time in Miami coming to an end. I am not really all that excited about moving to New York City. New York will just be another adventure and I am sure that I will have a great time there too, but living on Miami Beach is going to be hard to top. I wish I could be enjoying the last few days in Miami, but I am doing ER work this month so my schedule is a little all over the place, I have a presentation this week and I am trying to get everything packed and ready to go. I've moved many times before so I know what I need to get done, but I really don't want to do any of it. Frankly, I'd rather be on the beach....
Saturday, July 10, 2010
Hello Astoria
Looks like we have found a place to call home in NYC. I am always nervous when moving to a new city (or country for that matter!). As with all of my moves, I am moving to this apartment sight unseen, which always makes me a bit nervous. This is the 5th time I've moved to a new area without seeing the apartment. I've "walked" along the street" on Google maps and I have looked up all sorts of information on the area on the Internet. I don't think that Astoria will be quite as awesome as living on South Beach, but I think it is going to be awesome in it's own way. I am starting to get excited to move to NYC although I am also sad to be leaving the beach. I have grown to love Miami Beach. I don't think I would want to settle here forever (it is too far from family), but I do love this area. Maybe I will come back here for some of my 4th year rotations.
Thursday, July 8, 2010
Interns Give Me Hope
As many of you probably know, the end of June/beginning of July is an exciting time in the medical world: it is residency and fellowship start time. Statically, this is when you do not want to be in the hospital!!! There is a statistical difference in the error rates due to all of the newbies in the hospital.
Anyway, as a medical student, the idea of being an intern is exciting and a little intimidating. I know that I will be ready when the time comes, but sometimes I wonder how anyone is ready to be a doctor. No matter how many years of training you have, when something is new (your intern year, your fellowship, finally being an attending) it is a little intimidating. The other day I heard a few interns that gave me hope: they didn't know exactly what to do either! One had told the patient that they were going to hold his warfarin, the other had written a scrip for the warfarin and a third had told the patient that he would check with "the team" and get back to the patient with the plan. I think they decided to talk to the resident before making the final decision.
I can do this. I too can be an intern and work my way things to figure out what needs to happen....this is just another example that physicians in training are really in training and I am not expected to know everything in just a year and a half.
Anyway, as a medical student, the idea of being an intern is exciting and a little intimidating. I know that I will be ready when the time comes, but sometimes I wonder how anyone is ready to be a doctor. No matter how many years of training you have, when something is new (your intern year, your fellowship, finally being an attending) it is a little intimidating. The other day I heard a few interns that gave me hope: they didn't know exactly what to do either! One had told the patient that they were going to hold his warfarin, the other had written a scrip for the warfarin and a third had told the patient that he would check with "the team" and get back to the patient with the plan. I think they decided to talk to the resident before making the final decision.
I can do this. I too can be an intern and work my way things to figure out what needs to happen....this is just another example that physicians in training are really in training and I am not expected to know everything in just a year and a half.
ER: Mean Doc
I was assigned to Mean Doc for my rotation this week in the ER. He was nice to me, but he really did earn his title of Mean Doc with regards to how he treated everyone else. There were two patients that he yelled at. Yes, yelled at. It was all I could do to keep from laughing. Now, he did have a few good points. He was extremely good (shockingly good) with the patients that were not (1) teenagers or (2) Old Feisty European Man. He was happy to teach me things and explain things when I didn't understand and he was happy when I caught a minor (very minor) error he made. He was mean to the nurses and ER techs. In fact, I can see why they all dislike them. None of the other ER docs are as rough when them as he is.
There was one teenager, who was in the hospital with psychiatric problems. This teenager changed the answers to questions being asked. I don't think the teenager did it intentionally or to trick Mean Doc, but he just blew up at her. He started raising his voice (not quite yelling) and it was all I could do not to start laughing. The look on both of their faces. She was still completely confused and he was so frustrated. I don't think anything was accomplished with their interaction. It may have been one of the few times that I might have been able to get more information from a patient than an attending. He wasn't patient enough.
Oh, and the Old Feisty European Man! He was my favorite patient of the night. He is a sort of regular at this ER. He comes in so often that when fire and rescue brought him in, the entire staff started saying, "Hey Old Feisty European Man, how are you doing? You haven't been here in days." It reminded me of an episode of Cheers. I don't know the whole past medical history, but I know he has chronic pain and he presented to the ER with chest pain. Mean Doc wrote orders for pain medication for his chronic pain because they knew that they were going to have to do some things that would probably make the pain worse. The only problem: Mean Doc didn't write the dose high enough for Old Feisty European Man (he has been taking this pain killer for a long time and needs more than most people would). To make a long story short, Old Feisty European Man was yelling in his room for about an hour. When the test results came back, he did have some problems and they needed to keep him in the hospital. But by that point, Old Feisty European Man was so angry that his pain wasn't being controlled that he decided to go home and give himself the dose of pain medication (which was higher than the dose the ER gave him). I volunteered to go talk to him and beg him to stay. I let him know that Mean Doc ordered more pain medicine and that he would get it immediately if he just returned to his room and that he really did have some concerning health problems. He said to me, "You are such a sweet girl, but if I have to die I'd rather go home and do it alone. At least there won't be any morons there to bother me." He then told me he wanted to sign the papers so he could leave. Mean Doc came out and tried to get him to go back to his room, but Old Feisty European Man refused. Mean Doc started talking as loud as Old Feisty European Man (which is loud because he is hard of hearing). This continued to escalate until they were screaming at each other. Finally, Mean Doc said that he didn't care anymore and would be getting the papers Old Feisty European Man sign out AMA (against medical advice). I wish you could have heard them discussing how Old Feisty European Man was ill and that by leaving the hospital he could die. It was like watching a poorly written comedy. I think it was so humorous to me because it was so absurd. I know that sometime things can get out of control (quickly), but this just seemed a bit crazy and I think Mean Doc added to the situation rather than being a calming force. Oh well, no one is perfect and the rest of his 20+ patients were treated very well. Shockingly well in fact.
There was one teenager, who was in the hospital with psychiatric problems. This teenager changed the answers to questions being asked. I don't think the teenager did it intentionally or to trick Mean Doc, but he just blew up at her. He started raising his voice (not quite yelling) and it was all I could do not to start laughing. The look on both of their faces. She was still completely confused and he was so frustrated. I don't think anything was accomplished with their interaction. It may have been one of the few times that I might have been able to get more information from a patient than an attending. He wasn't patient enough.
Oh, and the Old Feisty European Man! He was my favorite patient of the night. He is a sort of regular at this ER. He comes in so often that when fire and rescue brought him in, the entire staff started saying, "Hey Old Feisty European Man, how are you doing? You haven't been here in days." It reminded me of an episode of Cheers. I don't know the whole past medical history, but I know he has chronic pain and he presented to the ER with chest pain. Mean Doc wrote orders for pain medication for his chronic pain because they knew that they were going to have to do some things that would probably make the pain worse. The only problem: Mean Doc didn't write the dose high enough for Old Feisty European Man (he has been taking this pain killer for a long time and needs more than most people would). To make a long story short, Old Feisty European Man was yelling in his room for about an hour. When the test results came back, he did have some problems and they needed to keep him in the hospital. But by that point, Old Feisty European Man was so angry that his pain wasn't being controlled that he decided to go home and give himself the dose of pain medication (which was higher than the dose the ER gave him). I volunteered to go talk to him and beg him to stay. I let him know that Mean Doc ordered more pain medicine and that he would get it immediately if he just returned to his room and that he really did have some concerning health problems. He said to me, "You are such a sweet girl, but if I have to die I'd rather go home and do it alone. At least there won't be any morons there to bother me." He then told me he wanted to sign the papers so he could leave. Mean Doc came out and tried to get him to go back to his room, but Old Feisty European Man refused. Mean Doc started talking as loud as Old Feisty European Man (which is loud because he is hard of hearing). This continued to escalate until they were screaming at each other. Finally, Mean Doc said that he didn't care anymore and would be getting the papers Old Feisty European Man sign out AMA (against medical advice). I wish you could have heard them discussing how Old Feisty European Man was ill and that by leaving the hospital he could die. It was like watching a poorly written comedy. I think it was so humorous to me because it was so absurd. I know that sometime things can get out of control (quickly), but this just seemed a bit crazy and I think Mean Doc added to the situation rather than being a calming force. Oh well, no one is perfect and the rest of his 20+ patients were treated very well. Shockingly well in fact.
Miami Beach 4th of July
I really wanted to go down and enjoy some of the 4th of July festivities. Farley really didn't want to go, but I talked him into it. They said that the fireworks were suppose to start at 8:00, which seemed early to me, but we headed to the boardwalk. Here is a picture of the beach at 8:00pm.
We decided to keep walking south, because the festivities were suppose to be at 8th and Ocean. We walked down to 14th and Ocean and waited there for a while. Below is a picture of Ocean drive from the beach entry at 14th street.
Farley seemed ready to go home, but then the fireworks began. They were put to music, but we didn't have an FM radio to hear the classical music that the fireworks were dancing to.
is a picture with the camera in a different setting so you can see the palm trees and people.
Towards the end of the City of Miami Beach fireworks presentation, we could see the City of Miami fireworks in the background. It was amazing. There were fireworks all over the sky. Unfortunately, I couldn't get a picture quickly enough for you to see the amazing fireworks everywhere. Farley and I took our time walking home. There were tons of people on the beach setting off their own fireworks. Here is a picture from the boardwalk looking south with some fireworks people were setting off.
The final two pictures were of the boardwalk right at 26th. There were tons of people right outside our apartment setting off fireworks. It was beautiful.
Farley seemed ready to go home, but then the fireworks began. They were put to music, but we didn't have an FM radio to hear the classical music that the fireworks were dancing to.
is a picture with the camera in a different setting so you can see the palm trees and people.
Towards the end of the City of Miami Beach fireworks presentation, we could see the City of Miami fireworks in the background. It was amazing. There were fireworks all over the sky. Unfortunately, I couldn't get a picture quickly enough for you to see the amazing fireworks everywhere. Farley and I took our time walking home. There were tons of people on the beach setting off their own fireworks. Here is a picture from the boardwalk looking south with some fireworks people were setting off.
The final two pictures were of the boardwalk right at 26th. There were tons of people right outside our apartment setting off fireworks. It was beautiful.
Thursday, July 1, 2010
Acclimated
I've been living in the tropics too long....
Yesterday, I decided to take a walk because I thought it was too hot to jog. After a few blocks, I decided that I could have gone jogging because it wasn't too hot at all. In fact, it was downright pleasant. A few minutes later I walked down past the Lincoln road area (I was on the boardwalk) and I saw a building with the current temperature: 96 degrees (without humidity)! I thought it was mild and temperate. I guess after living in Miami on and off for a year and a half and spending another year and a half in the Caribbean, I am acclimated. I am going to freeze moving back north!
I decided to go jogging today since the heat didn't bother me yesterday. There wasn't as much of a breeze so it was warmer today, but I didn't have any problems in the heat. I can't tell you how much I am going to miss living on Miami Beach. I am sure New York City will be great, but I am dreading leaving the beach.
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