Best of the NYT in article and video. Also my PSA re: MELAS because today is rare disease day!

I cannot help but share the following... After a rather disappointing day at work I needed to have my faith in humanity restored and the NYT has come to the rescue!

You have to read this article: We found our son in the subway. I always love Townies and Modern Love and this article is like the perfect mix of both. It is a story of  family, a story of love and it makes me happy. Life is strange that way, it just somehow has a way of working out....

Or if you would rather watch a video than this is the one: Finding the visible in the invisible.
So amazingly cool, it will make you appreciate the awesomeness of science, I promise!

And as a little bit of a public service announcement, today is rare disease day. There are so many rare diseases and the families they are affect are great in number and ways. As you know I am going to dedicate my career to Child Neurology and there are "just a few" rare diseases in that category. I know a young man who was originally diagnosed with MS (multiple sclerosis) but is now thought to have MELAS however the diagnosis can only be made via genetic testing which is extremely expensive and my young friend has recently turned 18 and does not have insurance.... He is looking for a research study or some way to be diagnosed or treated but he lives in Oklahoma and doesn't have the means to travel super far without some type of travel or financial assistance. I don't know what to do for him but since it is rare disease day I'm posting his story and hoping that maybe the right person will read this. If you have any ideas or know of any ongoing studies, please let me know!

That is all I've got for today. Hope your faith is restored too...


Because I like lemonade....

I am an optimist. I may be accused of being a Pollyanna and sure I most often have on rose-colored glasses (literally, I have rose-red glasses!) but I like that about myself. I don't enjoy being depressed or anxious and I really do want the best out of life, for myself and for everyone else.

And while I like being positive I also have huge expectations. I expect the most and best out of others (and myself) and thus am quite often disappointed. Rarely can a person measure up to my ridiculous expectations and for sure I am the worst culprit of falling short. But the thing is, I can often empathize with the person and see the good in the situation and move on. Being optimistic means I forgive and forget and yet still expect better next time.

What am I trying to say? I'm not sure I even know... this post may be a bit of a ramble but I suppose I just want to say that I realize how lucky I am. I do not take my life and the opportunities I've been given for granted. Sure I've worked hard and going to medical school was not the easy path for me. I sacrificed much for this life/career but I've never felt entitled to it. I realize that a certain amount of luck and genes and a ton of support from my parents, husband, friends has made where I am today possible. Yet I have to say that the struggles, the work, the time invested has been worth it. And for the most part I've enjoyed it and I think know I will love being a doctor! So that is good...

I am so grateful that in just a few weeks (okay 2 and 3/7 weeks, aka 17 days) I will find out where I matched (granted that I do, but the optimist in me doesn't actually believe that not matching is a possibility). And in 17 days we will find out where we will be moving and living and working for the next five years and that is oh so exciting!

Also, I was also going to share some big news with my family and friends on Match Day. You see I am 8+ weeks pregnant and had planned to announce both at the same time. However the pregnancy is not viable and so I'm going to be medically induced this weekend and that kind of sucks. Because I was excited to be pregnant and it was mostly good. The polyuria, constipation, sore boobs, insomnia and fatigue not so much... But the knowing I was pregnant and the minimal morning sickness. The possibility of a brand new baby was inspiring and exciting and good. Of course it was also a bit scary and the timing was less than ideal. It won't be so horrible to NOT be 6 months pregnant when I start residency. There is something to be said for establishing oneself as a person/resident and making an impression before being the "pregnant resident" so for that reason I can say there is a silver lining. Oh and I am very happy to be drinking my two favorite beverages again (coffee and wine). I didn't miss them as much as I feared but I welcome them both back with welcome arms. Being caffeinated on 3 hours of sleep is a definite positive and I do love me some Pinot Noir so I can't say I'm sad that I no longer have to abstain with dinner....

So yeah, lemonade really is okay.

I guess that's all I've got for now. Happy Hump Day!


dog days and date nights

I'm in San Diego for the weekend and it is glorious.

I spent the day with my puppy. We went to the dog park and farmers market. I gave hime a bath and made the apartment smell nice (not like a dog). I visited Dr. Boyfriend at work for lunch and lounged around all afternoon reading, painting my nails and watching West Wing on Netflix.

And right now it is time for date night. We are going to a hot new restaurant and then maybe a movie, depending upon how long dinner takes and how awake I am. Either way, I'm just happy to be here.

20 days until match. The waiting continues but life goes on.

Happy Saturday and weekend to you!


One week and one day

Until my ROL (rank order list) is due...

This part is torture. The waiting. I went on a second look today and now I have absolutely nothing else to do but hurry up and wait! (31 days until match, but who's counting???)

I pretty much know how I am ranking programs but still that doesn't mean that I don't spend the greater part of each day trying to decide if #3 should maybe be #6 and #5 should move to #3.... Does it matter more where I live or how the adult neuro year is structured? How important is the PD? Do I want to be at an ultra-academic setting or something more service orientated? Resident run or educationally focused?

These are the questions that I am pondering again and again. #1 and #2 are set and have been for some time. #11 and #12 have no hopes of moving up. But the rest of the programs are in limbo and seem to change positions in my mind by the hour.

So that is it. I'm stuck in limbo. Kind of like how several of my patients are "stuck" in the hospital waiting for placement. All I know is that our health care system is very inefficient. Because the cost of staying in the hospital when you have no active medical issues is enormous. But SNFs/Rehab Centers do not want to accept certain insurance plans or Medicaid and thus the patients are "stuck."

I'm worried that one of my patient's is going to get pneumonia and die before she is placed. And there is no reason for this.  Her nurse is mad at me because I dared write an order for her to be out of bed every day (she suffered a stroke and thus needs assistance to ambulate due to severe right sided hemiparesis). And PT/OT should be coming daily to do rehab with her but they do not have the time or resources to do so, thus she sits in bed on neutropenic precautions because she just finished chemo and I'm very worried that she won't survive this hospital admission. Which is now a week too long and looking to last much longer as per case management as she has been denied from 7 SNFs thus far.

And if that isn't enough, I have another patient that is a ward of state, also waiting for placement. She has been hospitalized for over 3 months and the last 2 months are in excess of her medical needs but she is stuck too.

Being stuck kind of reminds me of my Family Medicine Inpatient rotation at this same hospital and this post which I wrote over a year ago. I guess some things never change. Every year students wait for the match and every day patients sit in the hospital waiting for placement... We are all stuck in our own way but at least I know when my waiting will be up which is more than I can say for my patients. So for that I am grateful. I may complain but I realize how much of a privilege and honor it is to be able to wait for the match and to match and I do not take any of this lightly.... And I still have a week and a day to play with my ROL!


Residency Fate Day Countdown

Just 14 days until rank order lists are due and 37 days until Match Day! Very exciting. And kind of scary, but mostly exciting.... In a month and a week I'll find out where I matched and where we will be living for the next 3-5 years. And then before I know it intern year will be here and I'll be doing what I have only dreamed of up to this point.

Right now I'm doing at IM-TSS (Internal Med, Teaching Selective Service) in Cali and trying to remember all the adult medicine that I have not had to practice or use in months! I think my brain has atrophied during 4th year. It is truly sad how little I remember. I know that I used to know all about CHF, Renal Disease, Liver Failure, you know, the bread and butter adult medicine stuff... but I just don't have the immediate recall and end up having to look up EVERYTHING. Kind of embarrassing as I'm a big, grown-up MS IV. Yet it seems my medical knowledge is a file cabinet that has to be opened and indexed constantly, it is not a ready to read book like I want it to be. Not yet. But I guess that's why you have to do residency... to learn what you have learned and to practice and practice.

On the bright side I love, love, love talking to my patients, explaining diagnosis, getting code status confirmed, calling consults, writing order and just generally acting like a doctor. IM-TSS is a Hospitalist run service with no residents which means the MS IVs are the acting residents. It is like a sub-I without resident support. But I love that part of it. And the taking care of my patients part. I don't love it when my patient ends up needing to be intubated and upgraded to the ICU. But he is okay and I don't think I could have done anything differently or prevented his intubation... Medicine is awesome and I am humbled daily to be reminded that this is what I get to do with my life.

Residency Fate Day countdown is underway.... 37 more wake-ups to go!