Where to Start?

I just submitted a paper for my surgical rotation and decided to start writing a blog post (Note: I actually started writing this post on September 21st....this surgery rotation is keeping me busy!).  I didn't realize that it has been over a month since I've posted!  I have so much to write about, but I will have to be brief as I am in the  midst of my most dreaded rotation of my third year of medical school: Surgery.

A few weeks ago, it was Farley and my third year anniversary.  The actual anniversary date we had to be in the psychiatry unit, but after work we went to the gym then out to dinner.  There is an Italian resturant in Astoria that gets great reviews and requires a reservation (which I hear is unusual in Astoria).  Anyway, Farley got reservations for us.  They were running about an hour behind so we had a glass of wine in the wine bar, which was great because they had a pianist playing  Our dinner was fabulous!  The next night, we headed into Midtown  to go see "The Lion King" at the Minskoff Theater.  I really wanted to go see a Broadway show while we were in New York City, so we decided to go for our anniversary.  The only real problem we had was deciding which show to go to.  I wanted to go to the Addams Family, Chicago, West Side Story, Wicked or Lion King.  Farley on the other had, wanted to see the Phantom of the Opera, but he didn't really want to see a show at all.   I had seen the Lion King last winter in Spokane and loved it.  I thought it would be a show Farley would enjoy and so we finally agreed to get tickets for it.  Thankfully, I was correct: he enjoyed it.

The weekend after that was Labor Day Weekend.  We got to have a three day weekend!  We decided to go to the Metropolitan Museum of Art.  We spent all day looking around the museum.  It was such a fun day.  Here are some pictures:

Above and Below are pictures of The Great Hall, where you enter.

A sculpture from the European Sculpture and Decorative Arts exhibit

Below: are pictures from the Robert Lehman Wing Atrium.  

Above: They allowed people to go through the storage

Below: They had rooms set up to show what a time period looked like.  I loved those rooms in the American Wing.  Here are some pictures!

Below: They have a lot of Egyptian art work at the Met.  They even have a real life Temple!  Below is a picture of the Temple of Dendur.

They had middle ages weapons.  I can tell you which one of us enjoyed this exhibit more: Farley!

Here is a Chinese Warrior's uniform!

This is from the "Arts of Africa, Oceania, and the Americas" exhibit.

Locked Down

"How can you tell the difference between the psychiatrist and the patients? The psychiatrist has the keys!"

This is my third and final week on the inpatient psychiatry ward. Next week I will be moving to the chemical dependency unit and after that I will be in the consult and liaison unit. Anyway, I have been thinking about things to write about the inpatient psychiatry unit, but haven't had the time to compile my thoughts yet. I am having a lot of fun with the other medical students, maybe too much fun!

The inpatient until that we are working on is a voluntary lock-down ward, which basically means that the patients agree to come into the hospital voluntarily but that they cannot leave until (1) the physician decides they are ready to go or (2) they write a 72-hour letter (which is similar to when a medical patient leaves against medical advice, AMA, except that the psychiatrist has 72-hours to get the paperwork in place to involuntarily commit the patient if the doctor does not think the patient is stable enough to leave--they usually don't involuntarily commit until the patient is still extremely sick). Since this is a locked ward, we are also locked on the unit. Overall, it has been fun and some of the things I've heard on this unit have tested my ability to keep a serious face and not burst out laughing. Here are some examples of being on the locked ward...

Middle Aged Depressed Lady (MAD L): MAD L was telling me how she is so depressed that she feels nothing but hopelessness and emptiness. (This is a sign of severe depression and should be taken seriously.) Then she told me that she has hurt herself so that she can feel the pain rather than feeling nothing (also very serious). I asked her how do you hurt yourself and she replied, "I hit myself with a fly swatter until I bruised."

MAD L also is a bit overweight. She told me that she had hurt her knee at one point in the past she fell and with all of her weight she landed on this knee. Then she looked me straight in the eye and seriously said, "That is a lot of weight for one knee."

There is a younger lady who is going through a manic episode, lets call her Ms. Hyper. Because Ms. Hyper is manic, her thoughts race and she jumps from idea to idea. Some of the things she says are downright funny, but her disease is anything but funny. She is the patient that has bothered me the most because she is the only patient that I haven't seen get better...yet. I know some of the medicines that she is getting take a while to work (psychiatry medications may take up to 12 weeks to work properly--patients don't have to stay in the hospital that long), but I just wish she would start to show signs of getting better soon. Ms. Hyper has said a million interesting things, but I am not sure if they will seem funny outside of the locked unit. Her favorite word is "epic" so anything she likes, is epic. She really wants to get married and have kids "to get it over with already." Whenever, she says, " I want to get it over with, already" at least two staff, medical students, or physicians turn their heads so quickly that they get whip-lash because if you miss the first part about getting married and having kids, it is easy to think she is talking about suicide. It is amusing to see how quickly the heads turn, then realize it is just Ms. Hyper (she is one of the few patients who is not suicidal on the unit and she isn't talking about suicide). Recently, she declared that she had to get home because she has things to do and the energy to do them. She wants to clean out her parents basement to give things to the poor and so that she can have "the most epic house party ever." She told us that if we could help the doctor understand that she has things to do and is ready to go home, we could come to this epic house party.

Ms. Hyper has become friends with Ms. Wilderness. Ms. Wilderness is another young lady who is admitted to the hospital for depression. I call her Ms. Wilderness because she wanted to commit suicide by going to the woods, camping, meditating and not eating until she dies.

Anyway, we were in a group therapy session today. Ms. Wilderness said that she thinks she has four options when she leaves the hospital (1) Continue working full time (at her good job with benefits) and be stressed out working for "The Man" (2) Quit her job and move in with her parents then look for work as a gardener (3) Move to the wilderness, live a quiet, peaceful life and eat at food kitchens or (4) "try to become homeless"

After Ms. Wilderness mentioned the third option, of moving to the wilderness, Ms. Hyper went from sleeping on the table to jumping up and declaring that it was so obvious that Ms. Wilderness had to move to the wilderness because it would be "epic". Then Ms. Hyper fell back asleep on her arm. After Ms. Wilderness spoke more about living in the woods and "trying to become homeless" another patient decided to speak up, we will call him The Voice of Reason. I wish you could hear his voice. He doesn't have the deepest voice, but it is rough like gravel. He is a no-nonsense kind of guy, with a troubled past, who is trying his best to keep on the straight and narrow. I expect him to curse, but he never does; however, he always has a look on his face like he thinks someone in the room is crazy (and technically since they are in a locked psych unit, they are). He looked at Ms. Wilderness, while she was talking, like he wished someone would slap some sense into her and declared her "super crazy" for wanting to move to the streets. Despite the look on his face while she was talking, The Voice of Reason calmly looked her in the eye and told her about life on the streets. I think the look on his face made the situation more humorous in person. He looked like he had just eaten something very sour and was disgusted (in this case disgust with stupidity). Besides the fact, he (and the rest of us for that matter) were not sure what she meant about "trying to become homeless." I don't know how you try to do that....

Another middle aged patient was extremely mad at her family for not calling her for advice about family matters. It was all I could do not to start laughing when she said this in group therapy....this is a lady is a paranoid schizophrenic and she thinks "everyone is out to get" her. I understand that she feels left out of the family (and that isn't right), but I can see why the rest of the family doesn't use her as their primary advise counselor.

Another of my patients is a depressed gentleman. He asked me, "why are you here" and I replied "because I am a medical student." He then said, "But why?" and I told him that I wanted to be a doctor since I was a little girl. He told me, "but you could be a model....or an actress. The guys and I have been trying to figure out why you are here. We all think you could have been a model." I replied thank you (and obviously, I had a new favorite patient). Then he said, "You could have been a supermodel, but you are here. Wow, you must really want to be a doctor." If all of my patients told me I have supermodel potential, I think I would have no choice but to become a psychiatrist--it is great for my ego.

Now, being on the locked ward is okay overall; however, on Tuesday it was horrible. They are doing construction in the hospital and the fire alarms were set off. So, there are flashing lights, terribly loud sirens, and a ward full of psych patients. I don't think the patients knew it, but the door automatically unlocks (so they could escape), but there were three medical students guarding the door (but heck, if they all came at once, the three of us couldn't stop them). Anyway, this fire alarm went off for half an hour. I already had a horrible headache (it was so bad that Farley suggested that I stay home, but I didn't want to have to make up the day) and then this happened. To top it all off, the patients didn't try to leave, but they all started shouting about the noise and they got louder and louder. My headache got worse and worse, but I couldn't leave because I was guarding the door and once it stopped, the door automatically locked. Besides, they have cameras so they know when we come and go. So, I was stuck in my own personal hell...on the locked unit

Arriving in New York City

I was so excited by the time we were flying over New York City.  I've never been here before and I have always wanted to come.  I don't like sitting in window seats on flights because I get motion sick when I look out the window, but I couldn't help myself.  I love this picture of Central Park with the wing of the plane in the top left corner.  After taking a few pictures, my motion sickness kicked in and I prayed that I wouldn't get sick before we landed (I didn't).  After arriving, we waited for our luggage and luckily it all arrived then we found a cab and headed to Astoria, Queens.  Our landlord was waiting for us and we headed into our little two bedroom, one bathroom apartment straight away.  We decided to move around some of the furniture, which involved literally taking the furniture apart and putting it back together again.  Farley had a blast with this.  Then we decided to explore the area.  It is a cute and quaint area.  Apparently this is an area of town with lots of Italians and even more Greeks and the restaurants show the heritage of the immigrants who moved to this area.  However, it isn't just Italians and Greeks anymore: it is an incredibly mixed area of New York with just about everyone you can think of living in the area.  No one looks out of place. There are lots of fruit stands, bakeries, and butchers on the block.  The majority of the businesses are local, but of course, there are at least two Dunkin' Donuts within a two block radius of the apartments (I prefer Starbucks and there is one 1.5 blocks away.  There are also local coffee joints).

On Sunday, the 1st of August, we headed to Flushing, Queens to find the hospital we would be doing our clerkship at.  If we were driving, it would only be 15 minutes away, but since we are taking the public transportation, it takes us an hour.  I wish I was like a local New Yorker, who can read and be productive on the train.  I get too motion sick to do much of anything.  I don't think the New York trains make me as motion sick as the Miami trains or the BART in San Francisco.  I think the NYC trains move slower because there are more stops.  Anyway, we found the hospital and were ready to go on Monday.  After getting back, we joined a gym, which is just two blocks from our apartment, The Rock.  I don't love going to the gym, but I know that I have to work out and my apartment is too small to work out at home.  Besides, the fee is enough to motivate me to go.  I don't want to fee like it was a waste of money!

On Monday, we headed to the hospital.  We had to do a couple things with occupational health, before they would let us get started with our rotation.  First, we had to have another urine drug screen and second we had to get fitted for N-95 masks (masks that keep out T.B.).  I couldn't get an appointment on Monday, but accompanied Farley to his appointment and they decided to let me go on Monday as well.  After finishing up, we headed home to run more errands (you always need stuff when you move to a new place) and go to the gym.  We also walked down to Astoria Park.

Tuesday, we headed back to the hospital for orientation, which wasn't really much of an orientation.  Then, we were off to the psychiatry department to start the rotation.  Farley was assigned to the "C&L" department for the first week (consults and liaison).  I was assigned to the inpatient unit.  I will write more about the experience later.  The rest of the week, we just went to the hospital and the gym.  We have to be up at 6:00am, which I have not had to do in a long time so adjusting has been a bit difficult.  Overall, it was a good first week.