Hard Nut to Crack

You know, if you look at it objectively, The Nutcracker is pretty weird.

A family has a party… the crazy uncle arrives with dancing life-sized dolls and he gives the little girl of the house a nutcracker. Is that supposed to be some sort of domestic, gendered statement? If this was a modern story would he be giving her a cuisinart? I mean, a food processor doesn’t lend itself as well to anthropomorphism, but it pretty much boils down to the same thing. And quite frankly, if mutant rats are attacking, I think I’d rather have spinning blades on my side than a wooden novelty utensil.

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So, we made it. Thirty posts in thirty days.

I don’t think I’ll be able to keep up that pace for always and, let’s face it… I probably shouldn’t. The quality of the things I pound out at 11:45p trying to eek under midnight just aren’t worth the blogosphere space. The English language doesn’t deserve to be bastardized so.

There were bad days and there were worse. There were cop-outs and there were photos, but by and large I accomplished what I set out to do in making navapants a cozy new writing home.

Oh, it’s Christmas time in the city, baby.

Tomorrow morning Disturbingly Potent arrives. I’m peacing out early after PBL to collect her at the airport so she doesn’t end up on a bus somewhere in Connecticut or inadvertently stranded in Midtown, ticking New Yorkers off with those pesky Midwestern manners.

We’ll pass through the seven layers of the candy cane forest, through the sea of swirly twirly gumdrops, and then walk through the Lincoln Tunnel to embrace our weekend:

1. Attend The New York City Ballet’s Nutcracker

2. Attend The Radio City Music Hall Rockettes Christmas Spectacular (OH HELL YES)

3. Take a walking tour of all the Christmas windows — Macy’s, Lord and Taylor, Saks, Bloomingdales, etc.

4. Gawk at the mass herds of people at the Rockefeller tree

5. Peruse the pop-up Christmas boutiques at Bryant Park and/or Union Square

6. Ice skate in Central Park

7. Find my will to blog

8. Live it up and pretend I don’t have an exam next week.

Day One of the Physical Exam

So it was pretty much a shit show.

Silly me. I thought our very first physical diagnosis session with our preceptors would include some demonstration, some guidelines, you know, some INSTRUCTION seeing as we’ve never ever done this on anyone ever.

Sure we poked and prodded each other a month or so ago, but we didn’t know what on Earth we were doing. We were just giggling nervously like fools wondering if we would have to disrobe in front of 10 of our classmates and a random proctor. Up until this point we’ve had a single lecture each week over the past six weeks covering various aspects of the physical exam. I… just don’t see how that qualifies as learning how to do it. I mean, maybe this is just me, but to learn a physical exam I would expect some physicality thrown into it. Like say, touching a patient.

Which is what I thought these sessions were going to be about.

I envisioned our preceptor palpating a liver edge, keeping their hand on a patient’s abdomen and dragging my hand to where theirs is saying, “Here. Feel that? THAT is what liver feels like.” Or showing me where to put my stethoscope and saying, “Listen. Hear that swooshing? THAT’S mitral regurgitation.” Obviously I’m an ignorant fool who expects to be spoon fed.

We showed up to meet our preceptor and all he said to us was, “Alright. Well. Here are your patients. I’ll give you an hour and a half to do the full history and physical, then you can present to me and I’ll check your findings.”

UHM. BUDDY.

WE

ARE

GREEN.

Green as green can be. And I don’t know if you missed the memo from the frog, but IT AIN’T EASY.

WTF. I CAN’T PUT MY HANDS ON A PATIENT. I DON’T KNOW WHAT IN THE BLUE BLAZES OF HELL I’M DOING.

I can say with the utmost confidence that my eyes have never been larger, the pit of my stomach never fallen faster, my insecurity never more florid than when he said those words all no nonsense and posthaste.

If there’s one thing I did learn today, it wasn’t how to palpate an abdomen or percuss a diaphragmatic excursion or observe the apical impulse of the heart, no no… I learned how to suck it up and dive right in. I learned that when an attending says jump, you say how high, and that it doesn’t matter if you don’t have legs or have feet nailed to the floor or are in an anti-gravity environment, you FIND a way to jump.

I may have also learned that it’s not what we call tactful to ask a blind woman to read from your visual acuity card.

I have a long way to go.

Wake up little Snoozy, Wake up

There are few moments that horrify me more than those where I realize I’m training to be a physician.

As in, this is for real.

Hypothetically, I am going to walk away from this experience with a license to practice medicine. Uhm. Yeah.

I don’t know if I can really explain it, but there’s a stark difference between going to the lecture hall everyday, kicking around ideas in PBL, writing ridiculous throw-away papers on health systems, aaaand actually treating patients. Or, well okay! That explained it pretty well. Patients are not scantron sheets.
These things that I cram into my head in order to pass quizzes and exams will one day be information that I need to apply to real life human beings. It’s… unsettling because never before in my life have I been expected to be accountable in any REAL sense for learning things. Or at least accountable in any way that would affect anyone besides myself.

We start physical diagnosis sessions tomorrow in which we will be in small groups with a preceptor examining patients.

Patients… weird.

Before the end of our neuro course a few weeks ago we performed neurological exams under a neurologist’s watchful eye. That was the beginning of my wake-up call. My first alarm if you will, and between then and now I’ve been mid snooze cycle

While it’s very obvious to a certain degree, it took that experience to really slap me in the face and make me recognize that we will be responsible for producing the clues we use to make diagnoses. There will be no big PBL leader in the sky that passes out the history and physical of a patient. We won’t be handed the pertinent findings upon which we can flex our analytical logic. We have to PRODUCE that stuff. That’s what’s scary.

I have to know when I hear certain things or observe this or that what it all means clinically. I’m going to have to have enough confidence in myself and my skills to trust my judgment. I don’t think it’s too self-aggrandizing or melodramatic to say peoples’ health will depend on it.

Granted, it won’t until many years in the future that I’ll be doing it all on my own, but… a person’s health is their everything.

Their EVERYTHING.

But, for tomorrow, I’m just going to concentrate on not hurling on anyone and save the rudest awakening for another day.

Forget Santa, Disturbingly Potent is coming to town!

From: Disturbingly Potent “DisturbinglyPo4U@emailplace.com”

To: Pants McSlacks “ItzPantzYo@emailplace.com”

Date: Nov 26, 2007 1:24pm

Subject: Christmas in the City Weekend

Dear Abby had a column today about the holidays being a “blue” time of year. She said you shouldn’t overindulge in alcohol and/or spending to make yourself happy.

There goes our weekend plans…

Wussie Baby NaBloPoMo Post

I got my haircut. I look like a soccer mom. I would post a picture, but then it’s available on the Internet for ever and ever, and that just won’t do since blackmail is similarly timeless.

Doing something that requires original thought and a mild time commitment each and every day is a quick way to hatch resentment. Practice makes perfect? No. It makes exasperated, creatively empty individuals who feel as if they’re going no where.

The End.

Red Power?

Uhm. Pretty sure this should be White People Tea if they’re gonna go w/ the whole victory motif.

Black Friday: Midwestern Style

I can’t even begin to fathom what goes through the minds of people who decide bombarding stores at 4am to battle like-minded crazies for electronics and toys at low low prices is a good idea. I understand even less the people who PITCH A TENT outside their local Best Buy at 8pm on Thanksgiving night. I mean, c’mon. Ride the turkey coma folks. Let it wrap you in thankful, thankful bliss as you watch all the bitchin’ family movies on prime time TV (e.g. The Princess Diaries marathon). No need to ruin the postprandial nirvana that only comes once a year.

I awoke this morning to the newscaster carrying on about “Black Friday,” which I swear is a term made up just this past week, and couldn’t believe that before I de-snuggled myself from my bed there were already people who were done with all their holiday shopping. Freaks. Misers. Lucky Jerks.

I arrived at the breakfast table to find my family perusing the sale circulars that came with the morning paper. The BLACK! FRIDAY! sales circulars.

True, I really couldn’t believe some of the deals that were visually assaulting me: JCPenney’s ladies leather jackets formerly $299.99, now a paltry $49.99! Kohl’s hawking 4.0 ct diamante tennis bracelets, buy one get six FREE! Wal-Mart passing out bottled tears of the baby Jesus to the first 100 customers!

But I think the most unbelievable items were from the local retailers… my oh my, we’re certainly not in Manhattan anymore:

Forget the slutty Bratz doll, this Christmas little Sally is pining for her very own kicky pink John Deere boots.

Perhaps you would like to celebrate the season of good will towards men with a shiny new shotgun? (Does it concern anyone else that this rifle is sold all wrapped in plastic? Kind of like a new CD player or an ink cartridge?)

(While we’re on the topic of concerning… do you really want to buy your cross bow from a company advertising themselves proficient in Monkey Business? Pretty sure I don’t want anyone going bananas when it comes to a PIECE OF WEAPONRY.)

But back to the hot deals for gift giving this season. For that sports fan in your life, how about a nice marinade?

Now, I did grow up here. I know what that thing is actually for. But doesn’t it just seem like… I don’t know, a Sportsman’s Marinade Kit is all about making sure your racquet is nice and juicy or tenderizing that basketball?

So we’ve got the sporty spices in your life covered, but how about baby? Well, look no further. I’m sure every parent would LOVE for their child to be decked out in this little number:

I mean, who WOULDN’T want their child to be as unobtrusive as possible when out and about in the forest. Especially if you’re, I don’t know, hunting. Better make sure baby is incognito so as not to spook the deer. We wouldn’t want to LOSE THE INFANT or anything. I’m sure unexplained movement in the underbrush always turns out well.

One item did manage to legitimately catch my eye…

I don’t know what an ice cream ball is, but I bet it’d make for a very Merry Christmas.

I wrote this early this morning. Nine hours at home and already I’m thinking of deleting the entire post.

My ovaries are bursting. I’m waiting for my plane in the terminal, the only area of the terminal chock full of people here two hours in advance and therefore MUST be headed to the Midwest, and there’s a man at the big windows telling his toddler son about runways (“That’s where they go REAL fast!”), planes (“No, not exactly like a bird, but they both fly.”) and that the traffic controllers won’t be smooshed (“That’s they’re job… it’s okay, they’re supposed to be there. They’re doing their job.).

This whole wanting to have children thing has been something that’s hit me only recently. I have NO idea why. NOOOO idea why.

I can recall an incident a in the not so distant past when I was leaving the grocery store with a bag in one hand and a 24 pack of Diet Coke on my hip. I used my heft to shift the Diet Coke a little higher and that small motion nearly brought me to tears as I thought, “OHMYGODIWANTABABY.”

Usually I am an ogre when it comes to small children. Not by design… and certainly not the kind that’s wildly popular and commercially marketable when animated. But there have been incidents where I just LOOK at a little dude in a stroller and it bursts into tears. Evidently my natural passive face is pretty frightening.

But recently… I don’t know. I don’t know what it is. Maybe my hormones are running amuck, maybe I hit some sort of developmental milestone that made my maternal DNA finally kick in, maybe I am just THAT desperate to not be a doctor… but something has clicked in me that makes me want to have a family.

I saw Dan in Real Life the other weekend. Though the bulk of the plot focuses on a few lovebirds, a big extended family serves as backdrop for the romantic comedy frivolity. I found myself distracted through the whole film, not following the banter or dramatic turns, instead thinking how I wanted to have a big family so we could have flag football games, massive hide and seek adventures and most notably, a big family variety show. Cause if it’s in a movie, it’s obviously not only true, but possible in reality.

Maybe this is just a way my repressed showmanship is trying yet again to rise to the fore (that variety show was really really cool), and sure, I could totally TOHHHTALLY see myself turning into an overzealous stage mom living vicariously through her child, but… I don’t know. I want to have a family.

Part of what has made this realization especially jarring is the whole I’m going to be intensively training for my career through the next oh, seven-ish years. That means I’ll be thirty-ish when I’m done and ready for the real world. I know people are still fertile when they’re thirty, I do, and as a fledgling member of the medical community I can even recognize that viable pregnancies can be crafted well into the forties… or, OR as a marginally civic minded person I DO realize I could always adopt… but that all seems so far away.

But I guess, plenty far. I know I don’t want one now. God, no. I can barely take care of myself let alone a little parasite/life-long, independently thinking pet (I know they’re not pets.).

But I guess it’s just enough to know that I do someday. Enough to scare the bejesus out of myself.

Though who am I kidding. I’m waiting in this airport to head home and see my family. My WHOLE family. That includes my brother and his two little ones.

Fifty bucks says my post Sunday goes to the tune of, “OHMYGOD. BESTBIRTHCONTROLEVER, NEVER EVER EVER HAVING KIDS.”

This is what I think about at 8 in the morning during PBL.

For my birthday a few months back Prom Queen Best Friend gave me a Disney Princesses hot beverage travel mug.

It is all kinds of pink. On one side there’s a picture of Sleeping Beauty/Aurora, Belle and Cinderella. The other features the word “PRINCESS” in hot magenta, ornate letters.

People ask me if I’m going into Peds a lot.

She bought the mug as a way I think to spice up my studying life… I can only assume that when she couldn’t find one featuring buff, nude cowboys, she decided appealing to my inner small child was a better, and perhaps more early morning lecture friendly, way of infusing some life back into me. Cause we all know the tell tale sign of someone losing their grip with reality is the use of one of those silver missile mugs to house their morning coffee. Those are just so intense.

My mug on the other hand… I don’t know. I love it, I do, in fact the only thing I’d change is to add more glitter or perhaps bedazzling gems, but when I drink coffee out of it I feel… iconoclastic.

I feel like I’m violating their pure goodness with my raw, lurid beverage.

I feel like I’m scandalizing the princesses.

I feel like I’m sipping vodka out of a baby bottle.