Yikes. I am tired. I've gotten 20-some interviews, accepted something like 16 of them. This will be rather pricey. For most people, the typical interview goes like this: fly in the night before, go out to dinner with the residents, get a hotel, interview the next day, fly out. If you figure on renting a car, that can run about $500 an interview. Luckily, I am cramming them in all sorts of ways, and driving to as many as I can. And I probably won't even go to 15. Anyway. Lots of planning and organizing, which I am terribl at.

There was a bunch of stuff I meant to post recently, but... this is a super busy time so I haven't. The Peds ER is completely and utterly insane. I definitely don't want to work in one later, and probably don't even want to have kids. It turns reasonable people into monsters. Ah well, sleepy time.

Yay I have 6 residency interviews, 2 for programs I really really want. Wuhoo. :-)

I broke upwith Alex. This is going to be awkward in terms of the moving out. But my self esteem just couldn't stomach it anymore. Ah well.

Wuhoo! I have 3 residency interviews so far. I may just end up with a job after all.

Also, a thought on the McCain/Palin situation. If McCain dumps her, as it seems he is gearing up to do (and of course, it won't look quite that crass), and Guilliani steps in and there is such a sigh of relief from the Right that a bunch of middle-types swing back over, I will be super super pissed.

I can't resist posting one jab at Sarah: in part of the Couric interview they talk about how she joked about how old Biden is, and how he has the experience but America wants change. So, just to review, first McCain's argument was that Obama lacks experience, which is what Americans want, then he shot that argument by picking Sarah, and now she is saying that the Obama/Biden ticket has experience, but that nobody wants that. That's awesome.

Alex and I have turned into roommates who hook up. Lately it has been quite obvious that we have very few common interests; this weekend we didn't do anything together. We talk about weekend plans as "hey, what are you doing?" "oh, x,y,z, what about you?" I sometimes make the effort to do stuff he wants to do, but it is rarely reciprocated, and usually just makes me feel bored and vaguely used. We talked about breaking up this week, but I neither of us is quite ready to hit the dating market again yet. (Not to mention the added pain in the ass of separating an apartmentful of stuff.) Anyway, this sucks. Some internal clock finally hit "Time to get married and have babies!" and so the thought of starting over again is quite unpleasant. But. I have been here before... the right thing to do is admit he's the wrong guy and move on.

This is a perfect Fall weekend. I've always despised Fall (because growing up it signaled the end of Fun and the beginning of long Minnesota Winter), but this year is great. Yesterday I went to the local Farmer's market and got an armload of fresh basil and other yummy stuff. Last night I went to Oktoberfest, which was awesome. They were selling beer in those 1/2 gallon jugs you get apple cider in, there was a huge rowdy crowd, and I met some good people. Today I'm going apple picking and then I'm going to make apple crisp, which is definitely one of the better foods ever. And now I am listening to my current favorite songs, Star Mile by Joshua Radin, and Each Coming Night by Iron&Wine. Check it out. Yay!

Ok, Palin is a woman, wuhoo, so exciting... but oh my god, I have never heard of a more anti-feminist woman in my life. There are dozens of things I could mention; how she tried to ban books from her local library, the way she continues to tell bald-faced lies about seeking earmarks, that she is anti-choice, even for rape victims... but by far the most outrageous thing I've learned about Sarah Palin is this:

While she was mayor of Wasilla, she charged rape victims $500-$1200 for the medical exams required to gather forensic evidence. REALLY??? Holy fuck. That is so awful. Any woman who could know that and still vote for her should be punched in the face. She called it an "unnecessary burden on taxpayers" to have to pay for the exams, which, in the state with the highest per capita number of rapes (79/100,000) I guess amounts to a substantial amount of money. Couldn't she just use some of the $250,000,000 she kept for a bridge that she never built to pay for the tests? That is beyond sick.

Full story here:
http://www.usatoday.com/news/politics/election2008/2008-09-10-rape-exams_N.htm

Residency apps are in! (Bye money!) Wuhoo. That took WAY more time than I thought it would. Now I have to take the boards (Step 2) a week from today, and then I am back on track with life in general. Interviews happen in November, and the Match happens in March. Lots of time for stomach to be in knots before a computer decides where I spend the next 3 years of my life.

This is what I hate about the religious right-wing: they are the biggest hypocrites EVER. My sister's in-laws are so far right that I try not to talk about politics with them at all, but my mom likes to--I dunno--poke sleeping bears, and then tell me about it. So this is my sister's in-laws' take on Palin's knocked up kid: "everyone occasionally has family troubles; they are doing the right thing by keeping the baby and getting married." You *know* that if someone in the Democratic party had a knocked up teenager, they would be all over that shit, and label that person as morally unfit to be a leader. I hate that. Democrats, for the love of god, fight dirty for once. I hate that the Republicans seem to be 100% better at exploiting weaknesses in the other party than the Dems. I so so so hope that America doesn't fall for that bullshit again.

Am now on "vacation" month, which I am using to (a) study for/take step 2 of the boards, (b) finish a research project/write paper, (c) apply for residency and (d) go home for a week. Not too much of a vacation really, but if it somehow all miraculously gets done I will be incredibly happy.

I'm going into Emergency Medicine! I know I know, you might think this is weird since I do love to operate, but the one and only fact on Grey's Anatomy is that surgeons are not happy people. A good 50% of them that I know are on antidepressants, the other half should be, and I just don't see myself being happy in surgery in the long run. It is true, there is nothing quite like opening a person up, messing around with their insides, and putting them back together again, but I'd rather never do that again than live like most of the surgeons here live. True, I could put together a decent little life for myself in Trauma or Breast surgery or Ortho or something... but not after blowing the rest of my 20's and first half of my 30's trapped in a hospital 90% of the time. I really cannot convey just how unhappy and bitchy and just overall miserable surgeons are. My first week on EM I was surprised all the time that people were nice to me, and that attendings themselves seemed to be happy, and now I just can't imagine going back to the surgery environment.

Anyway, moving on. Another reason for doing EM is that the stories are fucking crazy. There is something ridiculously bizarre that happens there every day; you see an incredible variety of people; you get to do and treat all sorts of different things. Really, you are an Everything doctor. Surgeons like to think they are, but really, I bet most of them couldn't tell you how to treat a bunch of the disease entities that walk into the ER. Also, it is a really fun atmosphere in the ER. You have the chance to talk with residents and attendings and nurses, and overall it is just a very social environment. I like that. Anyway, here are some stories from the ER:

Late the other night, I was talking to a patient who had just come in, and I heard rustling from the next bed, but didn't look behind the curtain. The rustling goes on for about 10 minutes, followed by CRASH. The guy in the next bed has been in status epilepticus for 10 minutes and writhed himself off his bed onto the floor. I roll him on his side and call for help, noting that he has urinated on himself and is foaming at the mouth. We load him up with Ativan, but he still lapses into seizures a few more times before heading up to the Neuro ICU. The next day I run into a Neuro resident who knows the guy and tells me "oh yeah, he does that a lot... those are pseudoseizures," which is the fancy medical word for "we know you're faking your seizure because you have normal brain wave activity on your EEG asshole." I mean, I can't really say, because I'm not the type to fake a seizure in the first place, but even if I were, I don't think I'd go as far as peeing in my pants and rolling off a bed. Who knows.

Another: several nights ago, 40-something lady comes in with her face all smashed up, saying her husband beat her up. Cops go to her place to arrest the guy, search the house, finally find hubby, who is quite dead of a gunshot wound. Cops come back, tell lady, she flips out and has to be sedated. Still not quite sure what happened, but so far she is the only suspect.

Anyway, lots of other stories, but this is already a long post, so they will have to wait. I'm headed for a Friday night shift in the ER, so I'm sure there will be many more tomorrow.

Yes, I am alive and well, I just finished my Surgery Acting Internship, which was pretty fun. I got to actually manage patients while they were in the hospital, which was kind of a first, and overall people did well while I was taking care of them. It was super busy though--I had to get in at 5, which meant getting up at 4, and I usually got home between 7 and 10. Those are some long hours. It is really fun to operate though. I'm *still* trying to decide if I really wanna live that kind of life just to be able to operate though... it seems like many surgeons make pretty huge personal life sacrifices in order to be surgeons.

Anyway, in other news, this is kind of typical of my love life luck: my ex-boyfriend is moving into my apartment building, and the apartment exactly above mine. He had no idea I had moved there; I had no idea he was moving in, but... yeah. He is moving in in a week. That won't be awkward at all...

Guys checking out girls even when they are in relationships. Some guys just can't seem to keep it in check, but oh god does it drive me nuts. Alex does this shamelessly. I've mentioned it once or twice, but no change. Yesterday was especially bad, because we were at a coffee shop together. Finally I started making a point of looking at every guy who walked into the coffee shop, but it was like 90% girls, and Alex didn't seem to notice. It drives me especially nuts because he is helping to write a textbook right now, and spends most of his time in coffee shops checking out girls. Also, girls ask him out pretty regularly, and I have super huge trust issues with him, so this basically sucks. Also, I start my Surgery Acting Internship (wuhoo! I get to write real orders for the first time!) on Monday, so I'll be gone like 100hrs/week. Yes, I know I shouldn't feel the need to keep tabs on him, but I just really don't trust him so much. This sucks.

This review (http://www.the-editing-room.com/indianajones4.html) totally sums up how I felt about the Indiana Jones movie (full of spoilers).

My aunt and uncle are coming into town tonight. I had hoped to get the place viewable by then, but... not even close. At all. So, we're going out for dinner and around Pittsburgh a bit. Should be fun, except that I have a huge test on Friday that I should be studying for instead. Ah well.

Alex and I just went through moving hell, as I've posted about several times, and the living room is still full of boxes. So what does he do this weekend? Goes an hour out of town to help his friend Andrew move. He called me from the house this morning and said that Andrew has not even put stuff in boxes yet. When we were at that point we were like "aw yeah. 6, maybe 7 hours to pack up..." I wouldn't be surprised if Alex gets back sometime in July.

Moving is such a bitch. SUCH a bitch. We're into the new place, but almost everything is still in boxes, and everything is a giant mess. Also, Alex has done exactly jack shit in the unpacking process. He has this nasty habit of looking at a problem, being overwhelmed, and then just doing nothing. Or something like that. I'm not sure that it isn't some organic problem... for instance, when I'm not cooking dinner, he looks around in the kitchen and can stare at cupboards and fridges full of food, and not be able to identify anything that he could turn into a decent dinner, and often ends up eating ramen noodles. I've joked that if I weren't around to show him what food is, he'd starve to death, but really, I'm not sure how far that is from the truth.

Now, the living room is fullllll of boxes, about half his half mine, and he just... does not see anything that he is able to do to help remedy that situation. I makes me crazy. So far I've unpacked all of the kitchen stuff, and much of my clothing, but it pisses me off, because I know that now he'll act like he has noooo idea where anything is in the kitchen, and therefore could not possibly put together a meal for himself (let alone both of us). I am inclined to take responsibility for enabling that shit, but fuck it. He is an adult and should behave like one. The only part I take responsibility for is continuing to date a relative child. Definitely should not have moved in together.

The Penguins lost the Stanley Cup. So sad. I've been in Minnesota for 2 Twins World Series, Boston for 2 Patriots superbowls and a Sox World Series, and Pittsburgh for one Steelers superbowl. The Penguins winning would have been fun... Pittsburgh gets so riled up over sports (and only sports).

Also, it has been raining so much here that the sidewalk has algae on it. No joke. I've never seen that before, but it sort of makes me think we'll be wading around in about 4 feet of water soon.

I have some damn bad luck with scheduling. This month I was supposed to be on the Schizophrenia service, which I requested because it almost never gets out later than 3pm. The first day of the rotation I was told I had been switched to Psych Consult, which gets out around 6 every day, and that my co-medstudent would be this girl Anya who is the most self-important, sycophantically earnest gunner I have ever met. She *loves* filling out paperwork, she *lives* to call families, and has to run everywhere she goes because everything that has anything to do with patient care is so goddamn important. I want to shout at her that patients have no idea whether you ran down the hall to get to their room as soon as you got the consult when they have been there for 3 weeks. It drives me crazy. First year she had a pager because she was volunteering on the liver transplant service, and she would leave class as importantly as possible from the front row to answer pages. Ugh. Maybe we were all like that when we first got to med school, but after 3 years of such charming tasks as doing rectal exams because the resident thinks that is a good medstudent learning opportunity, I am sick to death of this crap, and am extra bitter at anyone who isn't totally burnt out. So I go to meet the team, and Anya's last name is listed under "Attending." Huh, that's funny... surely she hasn't convinced the team she is *that* good... Oh, no, her dad is one of the attendings. And they speak in Russian when it is just the 3 of us going to see a patient. Awesome.

For reasons I totally don't understand, there are many many people out there who go to doctors and simply make shit up. I have a really tough time with this, because I am pretty bad at spotting bullshit. Today I saw two such people, and one of them totally got me. One was pretty much screaming "I am crazy" when she walked through the door: she was dressed like a hooker, she'd had a headache for every second of the last 24 years that did not respond to any known pain medication, she had seen every neurologist in Pittsburgh, and she was taking a seizure medication because it made her lose weight. The other guy, however, had had a stroke, had about 18 serious medical problems, and, according to him, could not speak but only write. My attending figured out that he can actually speak, and just goes to hospitals every few months claiming that he suddenly can no longer speak out of boredom. I'm getting a little better at spotting bullshit, but this guy had me completely convinced that he couldn't speak.

Anyway, there are a few different ways doctors deal with this. Psychiatrists, of course willing choose to see these people on a routine basis; almost everyone else plays the pass-along game of "gosh, I can't help you, but maybe specialist X can..." Another way is to tell the patient that you have a painful procedure that could help you figure out what is wrong with them, and then let them decide whether they are willing to continue the bluff. When my attending was a resident, he had a patient who came in claiming that his urine was pure blood. Dr. B. looked at the blood under a microscope, and saw that the red cells had nuclei, which bird blood cells do, and human blood cells don't, realized it was chicken blood, and told the patient he'd have to shove a garden hose-sized tube in his urethra to figure out what was wrong, at which point the patient jumped up and said "actually, I think it is getting better!" and left. I dunno. I think this method is ok. It spares the risk involved in saying "I think you're full of crap" to a patient (i.e. not treating something real or getting sued), and usually sorts out the real people from the fakers.

Anyway. That was my day. It really does irritate me to spend half an hour talking to someone who is lying to my face. So tiring.

Check out this video:
http://youtube.com/watch?v=JnVV9clHmWg

So every year at Pitt Med the graduating fourth years write and produce an original musical. Intermixed with the scenes they throw in short videos that the students make. I thought this video was awesome... I hope you don't have to be in med school to enjoy it. It is kind of vulgar in points, fair warning.

Anyway, Pitt Med graduation was today, so congrats grads, and wuhoo, somehow I am suddenly in my last year of med school. Holy crap how did that happen so fast.