My break-up with coffee

It became my New Year Resolution so to speak. It wasn't planned, it just kind of happened.

Now this was kind of a bid deal because I absolutely LOVE coffee. Latte. Cafe au lait. Regular cup of joe. I don't care just give me anything fresh roasted, organic or simply non-instant and I'm happy. I probably drink 2-3 cups of coffee on any given day and sometimes much more. There is the obligatory morning cup and then another one sometime in the afternoon. There are countless cups to drink while reading the NYT on Sunday mornings or while studying at whatever coffee shop I choose on the weekends. Coffee is my study buddy, my comfort drink, my friend.

But I was over it. And on January first I had my last real cup of coffee. I switched to black teas for a few days so in an attempt to prevent withdrawal headaches. Then I went to decaf teas only. And I survived. Now there were a few afternoons in clinic when I was convinced all I needed was a shot of espresso to make my headache disappear. (And I did get one migraine, but I think it was probably the dehydration, skipping lunch and a busy overbooked clinic that did it, not the lack of caffeine.)

Somehow I made it, including one night on call without a single cup of coffee. And I didn't miss it as much as I thought I would. However the hospital coffee leaves very little to be desired and there are no good/convenient coffee shops between home and work so that probably helped. But in any case, I now know I can live without coffee, and it isn't even that difficult. But I like LOVE coffee...

And so yesterday for the first time in almost two weeks I drove 10 minutes out of my way and ordered a grande nonfat latte. And it was wonderful. Coffee and I are back together, at least for now.

how to bribe your patient into compliance?

answer: with coffee and tea. No joke!

Geriatric psychiatry is a lot of things... however holding my interest is not one of them. I tried to give it a fair shake. And for about a week I was intrigued and pleasantly surprised by just how much I liked it. But it must have been the newness, or the fun patients I had that week because my enthusiasm quickly wore off.

 Last week was rough. I didn't really want to go to work and once I was there I just couldn't wait to leave. My patients were belligerent, agitated, hostile and demented. I feel bad for them. But not bad enough to make myself bribe them to take their medications like my Attending does. I mean I guess if getting a cup of tea or buying a cup of coffee is all it takes for a patient to become compliant why not do it? But in my short experience it only works for a limited amount of time. And even if patient complies for the moment/day/week then what? Even if the patient is discharged it is not like we won't see the same patient back next week or month for the same thing.

Medication non-compliance is real. Psychiatry is a revolving door. I wish this were not the case or there was something else I could hang my hat on. But so far that is all I've got.

I only have two weeks left. And it is bearable but not exactly fun. Now the admission notes and discharge summaries just feel like scut work. Write this. Dictate that. Go talk to a patient that is laying in bed naked and refusing to take any medications or put on any clothes or eat any food. Wait for said patient to decompensate to point of needing IM meds or become so dehydrated or hypoglycemic that she qualifies for medical transfer. Type up discharge summary for transfer. Repeat.

Did I mention, I only have two weeks left? But on the upside I do have a whole entire weekend (off) to study in NYC so I'll survive. One latte at a time. Maybe I need to be bribed just like my patients. Oh my...

The Coffee Effect

Bored? Love coffee? Want to improve your next timed mile? Look here for an interesting read in the New York Times citing coffee as a performance enhancer. 

Side note: I'm always curious of those people who can make it through the day without a cup of joe. You don't drink coffee? Tea? Why not?!? I guess I started really drinking coffee in high school, it seemed cool, and then in college I discovered Starbucks and the Carmel Macchiato. Those kept me awake through many hours of lecture.  I can skip breakfast but I cannot skip my morning coffee. Does that make me an addict, probably...

I can't say that I've been running many 5Ks since I came to Grenada, okay I confess, I haven't run at all, or gone to the gym, even once... But that's another post.  However, I study with coffee does that count? And in my previous life would work out with coffee. I didn't see anything odd about finishing my afterwork iced coffee while on the treadmill. I never gave it any thought but I guess it improved my ability to run too. How neat!  As for right now, the only thing coffee is improving is my ability to stay awake during lecture...

The Rumor Was True!!!

So I woke up at 6:15am (after going to bed sometime after 1am) to drag myself to lab. On the plus side I did manage to make a pot of coffee and down 2 cups... so at least I'm caffeinated, not the same as awake, but its something. I notice on my walk to lab that it is awfully quiet this morning. Normally I see others in scrubs making their way from down the hill but today, I see no one. I know this is a sign and I start to think... that rumor I heard on Monday- my classmate heard from someone that lab was Friday this week instead of Thursday, maybe I should have investigated it? hmm...  I assumed it was a rumor since no announcements were made in class, no post on Angel (our web server for each course), etc. So, I checked my master blue schedule and it says lab groups C/D 7:45am Thursday 2/12/09. I am not hallucinating,  but WHERE IS EVERYONE? I see another person following behind me and another coming up the hill. I start to feel better but yet I also know that something it just not right. Sure enough I open the door to dry lab and no Dr. Brahim, no one at all... Its 7:37am so I'm early but not that early... I walk back outside and now there are 4 of us. No lab? No lab! Well, yes we have lab, but not until tomorrow. lol! And so it goes. The group slowly grows to about a dozen. I go back inside and find someone official to collaborate my theory. Today is a clinical meeting day so all the professors have to be in meetings and thus are not running lab. Go figure. Sigh. Its now almost 8am and I've had my two cups of coffee, so what to do?  Not a single one of the dozen wants to go into lab with me. I figure I'm already up and in scrubs so why not go in and figure out what I'm suppose to know for tomorrow. Luckily Dr. D (visiting prof from UK, excused from meetings) was there and he gave me the guided tour of the forearm and hand. Then another student showed up and I was able to show him everything I learned and then another friend came in and we showed him and so after 1.5 hours I felt confident in what I was doing.... So not a complete waste, but still... I guess next time I'll believe the rumor! 

Speaking of rumors, if you are a possible or current med student and want the BEST BLOG ever re: SGU you should check out The Rumors Were True by Topher. He has long since left SGU but has some good advice and entertaining posts if you are looking for that.... Or if you just want to watch someone solve the Rubix cube in less than a minute. It is pretty impressive!

So what did I learn today? Maybe the rumors are true after all, at least some of them.... Okay, time to study. Only 4 days until the Unified Quiz!  

Study Space

Some people are dorm studiers while others like the traditional library or quiet study hall. I on the other hand have always preferred to study in a semi-social environment and more importantly to have caffeine at my side while doing so. I made it through undergrad and my post-bac living at Espresso Royalle in Boston and later Starbucks in Long Island. The baristas became my best friends and the the coach/table my living room. 

I was a little worried while being on an island without Starbucks that I might not have the same set up, but that is NOT the case. Just 200 feet off campus is a local coffeehouse, Mocha Jumby and it is great. I've already gone twice to check it out and meet the staff and regulars. They even serve food and the veggie burger I saw looked pretty tasty. I think I've found my new home, Internet is free and the coffee is good. (They even have skim milk and so far it is the only place I've seen skim milk on the island, not even the grocery store had it.) 

Tomorrow is my first day of school. I meet my faculty advisor at 8am and have four hours of lecture from 1-5pm. After which I plan to grab a quick dinner and then head to Mocha Jumby to hit the books. I can't wait!