obese comments

Once again, I was appalled by the conversation in the O.R. today. I was in a General Surgery room that was doing a lap chole on a woman who weighs 350+ pounds. It was a difficult intubation...the anesthesiologist did that whole thing awake because she was worried she might not be able to see the airway. The amount of fat around her neck made it difficult. She did a very good job and was able to intubate the patient and put her to sleep. I was impressed with how much she really tried to be supportive and minimize the pain.

When the surgery attending came in he started making jokes about her weight.
"Do we have an actual weight on her?" he asked the anesthesiologist.
"347 pounds," she replied.
He exposed her belly for the residents and showed how the surgey would be complicated by her large pannus. Then, as he walked out of the room he said:
"Let's fix her gallbladder and make her better so she can eat a fatty diet!"
He was so rude. and the insults continued. Obesity is a disease of economics and education and genetics. It's not as simple as:
"LOSE SOME WEIGHT!" If it was that simple, obesity wouldn't be epidemic.

It's tired and I'm in desperate need of some good sleep.

My mom is here this weekend, and I'm so glad for it. I finally just laid down in her lap and cried and unloaded all of the heavy shit I've been bottling up. my fears about being alone in some obscure program in morgantown, west virginia. my feeling unsupported in life and feeling the shittiness of being of the generation of women that sacrifices love for ambition, success and indepedance. i feel that way a lot. it something you can't appreciate unless you're a young woman trying to enter into a male-dominated field. most fields are dominated by men, but surgery has an attitude associated with it. i have a feeling male surgeons would print out bumper stickers saying "save surgery" and stick them on their cars much like the male students and alumni at the citadel did when women infiltrated that fortress of sexism.

so i just cried and cried. and i think mom thinks i'm a little bit crazy, and doesn't know how to make me feel better. and she was supportive but kind of broad-sided by it all because i have always tried to keep my emotions from her because i don't want her to be stressed or saddened by me. she's stronger than i think. she just rubbed my back and stroked my hair and listened. and i appreciated that.

i am still trying to navigate my place in medicine and trying to have the courage to decide if i'm an asset to the world here or if i will just become another sad doctor trying to convince med students to go into another field.

we'll see how that goes.

compromising position

i'm on my anesthesia rotation and thank god i showed up today cause i was assigned to the program director's room. he cares if i show up, and he actually teaches. anyway, i'm at a small, community hospital. patient rights seem even less protected here than at the university.

i watched a TURP today (trans urethral resection of the prostate). we did it with spinal anesthesia. you put numbing medicine into the space that holds the spinal cord and it numbs everything below where you put the needle in. the patient is awake for the whole thing, but can't feel anything.

i was shocked at the conversation that happened in the OR. the surgeon was talking about the white sox game and his kid's soccer game and lunch and all of this random stuff. meanwhile the patient is laying there, awake, with a camera up his penis and 5 people standing behind the table watching. his english wasn't great either...he only really spoke italian. and this is why i'm not going to be a good doctor, because i was sitting there thinking about how that patient must be feeling. i wasn't paying attention the the monitors or any of that. instead i was obsessing over how incredibly unprofessional it is to completely ignore the person whose penis you have scoped and whose prostate you're removing. it just makes him feel like crap. how much more vulnerable can you get than naked on a table with 5 people hovered around you all attention on your penis?

there is a better way to do this. it's called being sensitive to how the guy is feeling. stop talking about your family and your appetite for 40 minutes (how long the operation took) and focus on the procedure. for the love.

naked

i slept through anesthesia today cause dipti accidentally set left the ringer on the phone off. so i slept until 10:15 and had all of these strange dreams. i always dream more when i'm waking up and falling back asleep.

i went to the gym to swim and lift. whenever i change in the locker room i am always around these 40-something, fat, naked women. they are SO naked. and i don't mind it at all, except it makes me wonder why i am uncomfortable being naked in front of people. i don't like being naked in front of my best friends and i don't like being naked at the gym in front of people i don't know. i mean, i'm not embarassed about my body or anything, i just feel like my nakeness is something i only want to share with my partner. of course, i don't have a partner so no one ever sees me naked, and at times that feels like a damn shame because when i do end up naked in front of someone, i feel SO naked. maybe if i was like that fat lady in her forties, rubbing her crotch with the town in front of me i wouldn't be so timid when i'm naked. who knows? i had a goal to try to be comfortable being naked around people, but i haven't gotten any better about it.

when i was swimming today, there was this bald, older man swimming a few lanes away from me. he was swimming freestyle too at about the same speed. once i saw him there i totally got all competitive and was like "no way is this guy going to swim faster than me." and i started swimming really fast. his wingspan was much longer than mine and i think he should have easily been able to overtake me, but he wasn't even paying attention and the was like 3 lanes away. so i made up this little race and swam my ass off. i think i need some kind of competition in my life right now to make me feel alive. it's sad when i start inventing races in my head.

other events of today:
i got an arabic DVD from Roa so i could start learning the alphabet. Grace is moving out of her boyfriend's apartment and into Dipti's or my place. I tripped going up the stairs in front of a really hot guy. I skipped work.

the weather is getting really cold and i just want to wrap myself up in a blanket and sleep. hopefully this will be my last winter for a long time.

newest Blog

i’m trying out this new blogger website…although i’m super attached to my diaryland blog. we’ll see how it works. today i went into “work” for a couple hours. i only call it work because it feels like work, except that i’m paying for it. i still haven’t had the chance to intubate a patient, hopefully this week. the doctors at the hospital i’m working at are really strange. everyday someone tells me how miserable they are in their job. if they could do it over, they say, they wouldn’t go into medicine. you’re always working, you don’t have time for your family, the money isn’t good anymore. and on and on and on. i’ve already convinced myself that medicine sucks, i don’t need all of this extra reinforcement.

yesterday i went to the museum of science and industry with dipti and her friends sheila and judy (marissa was meeting up with old buddies). we watched this IMAX movie called “Ocean Oasis”. it was so amazing. it was filmed in baja california and mexico. it was all about the web of life and how we’re all connected. just being in that theatre and watching all of those underwater pictures made me feel so at peace. i told dipti to make sure my ashes are scattered over the ocean when i die. she agreed, although we argued over who would die first. she think it’ll be her cause of the loops, i think it’s going to be me cause i’m so accident prone. not to nice of a think to think about. anyway, i thought about how much i love the ocean and how i wish i had gills or lots of whale blubber so i could live there. and i wondered to myself, why didn’t i become a marine biologist or something? i would have loved that. i would have loved waking up in the morning and going to work. i don’t think i’ll feel that way in medicine. trudging over to the stale O.R. early in the morning, standing on my feet all day, making my way to clinic or to the hospital to check on people i will or have operated on. i don’t think it takes an extraordinary person to be a good surgeon. in fact, i think it takes a callous and calculating person to be good. cause if you care, if you’re invested it makes the whole things more difficult and less efficient. if i’ve learned anything in medicine it that caring for your patients get you no where. on my hardest rotation, ct surgery, i tried to get to know the people. i was intrigued by the idea of fixing the heart. i wanted to know how these people felt about the surgeries, about being so sick. i remember almost all of their names. they knew me and they really loved me. they always asked for me and felt better after i came to talk to them. cause i was the only one that really listened. i got the lowest grade of all my sub-i’s on that rotation. on all of my comments they talked about how i could improve my patient care?! I can improve on that? funny, i remembered their names, ages, birthdates, hometowns, occupations, all that stuff, and the attending couldn’t even remember their gender. or perhaps he could, but he just didn’t bother to notice or care. it totally was totally shocking to me how often he talked about mrs. k and referred to her as a him or “this guy.” he did that with mr. k, mrs. v, mr. c, and even mr. r who had been in the SICU on his service for almost 4 months. and i need to work on my patient care? how can you take criticism like that seriously?

so i think i should maybe do something else, cause wanting to balance out the whackness in medicine may not be a good enough reason to hate your life everyday…hate the people you’re around and hate how being around that makes you feel. the thing i fear most it that i will become one of those surgeons who leaves their patient waiting for hours or talks crap about them when they’re under anesthesia or even forgets their name or gender. i don’t want that to happen, and i am so miserable when i’m practicing medicine that i can’t say i won’t eventually end up like that.