REAL scutmonkey dreams

scutmonkeys don't dream of rockstardom. or at least, this scutmonkey does not. not on medicine months. no, this past month, i dreamt of scut.

i've been at the VA, caring for our veterans and generally not caring about anything else. it's consuming. i'd wake up before my alarm at ~4:30-5am in a blind panic, having just had a nightmare about an unsigned order or missing a "panic value" in a lab, etc... i'd go to sleep thinking about how early i'd have to get there the next morning and running through all the things that i'd need to check up on, or all the things that may have been happening to my patients. i know they say that most medicine folks have some OCPD traits, but sometimes i wonder HOW that could possibly be a good fit-> it's an anxiety-provoking profession to start with, so is it really a good idea to have anxious people in it??! sigh.

so now, i sit here at a coffee shop and have the time to type away at something other than CPRS. actually, CPRS is also up- typing off service notes. it never ends. ANYWAY- the point is, i'm slowing peeling off the tentacles of the VA, one by one. it's the emotional suckers that will be the hardest to rip off. gosh, but i do really enjoy this population sometimes- the nicest old guys you'll meet. sure, i had my share of mean meth-using alcoholics, but by and large the veterans are very appreciative and, i suspect, particularly nice to me as a young Asian-American woman.. i try not to think of the memories of "native" women-past that i might evoke, but i'm not above using it to develop a rapport of sorts ;) and i have to say, working at a hospital where people know my name is ... kinda nice. i like the community feel, though believe me i cursed it plenty over the weekends when i would give my left foot for an ultrasound tech or MRI or radiologist to read said unobtainable MRIs or ultrasounds. i've had such an array of experiences here, and right now they're jostling about in my head fighting for attention... so i'll just have to let them out one by one over time.

instead, i shall describe one of my proudest non-medicine accomplishments this past month... i got myself a library card. YAY!!! in a moment of shiny optimism, i borrowed a bunch of books on my day off and started reading... i've never finished a book so slowly in my life, but i guess that's what happens when you have to read snatches of a chapter in the brief moments of lucidity before passing out at night. so, i'm 1 of 4 and very hopeful going into my sports medicine rotation that i'll make some good progress with my "must read" list. thinking back, i guess i was inspired by shomir, my "co-intern" for the month who recommended "the kite runner". he tossed me the book one day, and i DEVOURED it. this was earlier this month when the patient census was decent (as opposed to the indecent wreck i left). and then i just had to keep reading, because i missed it so much. now if only i could feel the same away about, say, THE GYM. ;)

foray to the bay

step 3 is looming in the near future (this week), but no pre-exam weekend would be complete without unabashed playtime/procrastination.

diane & ida are visiting the bay area this weekend (and notably *ahem* NOT sacramento), so i decided to spend a day in SF. first, visited younch's new apartment in SOMA... had lunch at Brainwash Cafe & Laundromat, pictured below with left-most pic stolen from Yelp, then spent some "productive" time at the SF Public Library- which is huge, airy, beautiful, and a popular hangout for the homeless. i sat next to an older vagabond (who by the way would fit RIGHT IN at the treatment center), who was engrossed in a book about some conspiracy theory or another (the beginning of the title: "The REAL Truth about...."), which he held about 2 inches from his face. i most certainly felt like i was IN THE CITY. we convinced suzie to trek in from berkeley, and spent some quality time catching up at Citizen Cupcake... before enjoying dinner with the girls + co. @ Ristorante Milano.

the draw of city life for me should be pretty evident- see highlighted words above. i am SO enthralled by the myriad eating-out options, the opportunity to find tastiness on every corner. i'm a fan of WALKING to places and the subsequent insertion into a whole new milieu of people.
and everytime i go to SF, i bemoan the lack of character in Sacto... but i think it's time i should be honest with myself. i couldn't LIVE in the city- the ample parking spaces, superstores, and general ease of suburban life is even more seductive to me at this point than the urban sprawl. what can i say... i'm weak. and an ah-jum-mah. i'm learning to accept it ;)

foggy beginnings

this is the view from my home's little octagon window that i see every morning before going to work. and no, sadly, that is NOT the sun. it's a streetlamp. but it's pretty all the same.

fog is much preferred to the torrential downpour we experienced in the past few weeks though. it was pretty crazy at work- pun oh-so-truly intended. one day, we lost power in our outpatient psych clinic (also known as "the base" by a bipolar lady i had to calm down over the phone this morning), the same day we were hosting some family-psych applicants... we had morning rounds by candlelight. i walked around all day basically with sopping feet and straggly hair, because the umbrella i brought was useless against the brutal winds. then, one morning, i walked into the clinic thinking that someone had been a little overenthusiastic with popcorn in the breakroom microwave... then i saw the gaping holes in the ceiling. we had an electrical fire, and luckily noone was hurt, but didn't exactly help dispel the vague ambiance of chaos. never a dull day in psychiatry ;)

in terms of social gatherings, andy's schedule has lightened up so we've been able to have some dinners...
here are a few of andy's co-interns... lovely bunch :) we were also able to take pastor joel out to dinner @ todo un poco pizza & bistro, a mexican-italian place in elk grove- there really should be more fusion mexican/italian places out there... chips + salsa + garlic bread is quite, quite tasty. i made it out to a "journal club" meeting at scott's seafood, and rediscovered my love of sampler dessert plates. it's been a good month.

so, my non sequitur for the entry: i'm a total sucker for food advertising/marketing. particularly when it comes to candy and chocolate... not unlike the subjects of the wine study just published where people thought the more expensive wine tasted better than the cheaper wine (of course, it was all the same wine), i tend to prefer the exotic, boutique, and yes... expensive brands. i loove the thrill of the "find"- discovering the perfect truffle, or tastiest gummy bear... anyhoo, it's an illness, but i'm certainly not alone. i happened upon kookaburra liquorice at my local grocery store, and knew i had to have it. after all, the package said LIQUORICE. when i was checking out, my cashier asked me where i had found the candy, like in detail, as in.. which row, where on the shelf, etc... and kept mentioning how he was going to buy some himself, like at his next break, etc... so i opened up the bag and we both had our first taste of some superior red licorice. it's good stuff. and not just because it's imported from australia... ;)

christmas time is here... and gone

i'm so sad christmas is over. by the graces of this psych rotation, i got both xmas eve and day off... all the better to prepare for MY FIRST CHRISTMAS DINNER. my family decided to visit us this year, as andy had to work on xmas eve, so i was quite set on creating the perfect holiday dinner table... and the perfect holiday meal. here's my menu + recipe links:

Zuni Cafe Bread Salad with Baby Arugula
Bandera's Cheddar-Jack Cornbread
Baked Acorn Squash with Brown Sugar and Butter

Green Beans with Fresh Herbs & Walnuts

Filet Mignon with Chevre and Balsamic Reduction Sauce
Maple Roasted Turkey Parts with Sage Butter and Turkey Pan Gravy

Chocolate Fondue

here's a pic of my sous chef (hehe)

man... i was pooped, and stuffed at the end of the day. but i think my family enjoyed it, and i KNOW andy did, which is ultimately all that matters ;)

************************

on a totally unrelated note, i must document our first trip to ARCO ARENA.

one of andy's attendings is a huge college women's volleyball fan, and happened to have two free tickets to the NCAA women's volleyball semifinals- where STANFORD beat USC for a spot at the finals. sadly, i was too excited during that match to take pictures, so all i have are pictures of the 2nd match- penn state vs. cal.

it was freakin awesome.
*************************************

2007 was a year of milestones, and i'm so grateful to the family and friends who have shared them with me. getting married, graduating med school, starting a new job and moving to a new town... it's been a crazy, wonderful, fulfilling year.

andy and i will be ringing in the new year ON CALL... so for all our loved ones out there, we'll be celebrating with you in spirit! and please, please... BE SAFE.

here's to a similarly spectacular 2008, hopefully a year of change. it's ELECTION YEAR!!! woohoo! on that note, the Dem candidates on their New Year's resolutions... who's your favorite?? [i haven't decided yet...]

everything changes yet stays the same

it's amazing how quickly things that were once bizarre to the senses can become familiar. for example, when i first came to ucdmc, i was puzzled by the nurses' "vocera" phone system. I guess I should have been used to it, what with microscopic Bluetooth devices rampant in the world, but the thing is... the Bluetooth doesn't talk back. i'd be walking down the hall, or in an elevator with a worthy member of the RN lifeforce of the hospital who had a little plastic box hanging around her/his neck (maybe a pager?)... when suddenly, I'd hear:

[musical chimes... "Would you like to talk to?:

MARY SMITH"]

to which the RN in question would say, "Yes," then proceed to have a conversation with Mary Smith, holding the plastic box up to his/her face.
Or, I'd be in the same elevator, minding my own business, and the person next to me would say, "CALL DAVID JONES." That same robotic voice would reply,

"Did you mean: DANILA JOVOVICH?"

"NO, CALL DAVID JONES." (slightly irked tone)

"Did you mean: DAVID JAMES??"

"NO!?!, CALL DAVID JONES!!!" (really pissed now)

At which point I'd exit the elevator speedily, cuz conversations with these little walkie-talkie Vocera things don't tend to end quickly. The other day though, I passed by someone having a frustratingly one-sided conversation with the Vocera and didn't blink... until I realized how odd this seemed a few months ago.

And then there are the smells... the particular stink of the ED, the components of which I need not enumerate (you KNOW what I'm talking about)... the fetid odors of unwashed ICU patients who have been unconscious for many days and therefore have not been able to tell the staff who give them bedbaths to pay attention to certain nooks and crannies... the unmistakable scent of the hospital, so familiar while at work and so foreign when I pass by my white coat, hanging on the wall at home.

I've always been intrigued by this transition-> from alien to commonplace; perhaps because I haven't moved that much in my life, so each change is sortof a big deal. The first few times I drive to a new house, I muse to myself how familiar these roads will be in time but how scared I'll be of getting lost til that time (given my dearth of navigational sense)... and sure enough, a few months later I'll muse at how I'm able to trace, almost automatically, my way back home.

holiday cheer

i'm back. on psych-ation, and not a minute too soon. i've accumulated lots of sleep debt, but am finally chipping away at it... which is good, so maybe i'll stop making potentially inappropriate comments in my semi-comatose state, like today on psych consult when i asked a psychotic prisoner to "take a stab" at a few questions before realizing, with a start, that i had NO IDEA what he was in prison for. i tell ya, coulda been a BAD choice of words.

so, tis been an eventful month thus far! on one of our days off, andy and i embarked upon a daunting enterprise- to infuse some xmas spirit into our home- we're preparing for my family's arrival. it started out with a half-hearted jaunt to the dollar store for plastic snowflakes... and ended with handmade dove/poinsettia/pinecone centerpieces and a fiberoptic mini-tree. we were struck with decoration madness, what can i say ;) oh, and for the first time in my life, there are xmas lights outside my house. i'm very proud of my hubby- he's started a trend... a few days after putting up our lights (which was "late" by traditional standards, e.g. 2 weeks after thanksgiving), some of the neighbors decided to put up some twinklers. nothing like a little friendly holiday competition to light up a street. ;)

then, it was my bday. the actual day of, not too fun. workday- 14 hours, hubby- postcall, dinner- takeout. but twas certainly brightened by the texts/phone calls/emails- i appreciate you all!! i just didn't have time to reply, just enough to smile, feel a warm fuzzy, and get back to work. is this what grownup birthdays are supposed to be?! sigh... but i can't complain much, cuz i had a fabulous pre-birthday celebration the weekend before.

we ate brunch at tower cafe, and i CANNOT say enough about their famous french toast. it certainly perked up my poor sleep-deprived belly and tastebuds.

not to mention some delicious hot chocolate... as you can see, the hours have taken a toll on my soul, as evidenced by my bleary eyes.




dinner was at the waterboy, which i've been meaning to try since we moved up here... which also has no relation to the adam sandler movie. lovely atmosphere, tasty cuisine, not a shabby bday dinner by any means.

and dessert? sacto's answer to pinkberry... MOCHII!

one of my last bday surprises- from my sister-in-law, who obviously knows me all too well.

well enough foodie nonsense. what is UP with the tv writers' strike?! and why am i SOO not as excited about this season of project runway?? as you can tell, my life has been: work/eat/tv/sleep/work/eat/tv/sleep/work some more for the past month or so (or at least it feels that way). looking forward this month to studying/reading for step III, working out (so help me, i WILL step foot into a 24 hour fitness this month), developing a semblance of a social life, etc...

non sequitur of the entry: just saw Sicko on DVD. i hate, HATE, hate having to discuss financial concerns about medications/tests/procedures with my patients, and i am so ashamed that physicians have not done more to remedy this broken, limping, decrepit system. sigh.
andy and i are now biding our time til we finish residency to relocate ourselves and our families to a country with free universal healthcare... namely, ANY OTHER WESTERN DEVELOPED NATION. new zealand's lookin pretty good. who's with us?!?!

the most wonderful time of the year

ahhhh how i love holiday season!!! can't you tell from our doormat?? ;)

finally i can start listening to christmas carols, which will be on my ipod/radio 24/7 til xmas. it's one of the simple pleasures of my life, to have this seasonal soundtrack.

andy and i spent our first married thanksgiving together dining at the mccarrons' in davis, and i wish i had the presence of mind to take pictures of the bountiful feast put before us... if for no other reason than to provide myself with happy photographic memories of those culinary delights... but in any case, suffice to say, we ate ourselves silly. felt slightly guilty as my only contributions were of the egg/sugar/butter/flour variety- pumpkin cheesecake with a gingersnap/graham/pecan crust, and pumpkin cranberry walnut cookies... feel like i should learn to cook a thanksgiving meal. ah well. someday, i too will roast a turkey. someday...

we had to work today, unfortunately, so we decided last-minute to make a trip down to socal this past weekend. it was, of course, great to see my family and to visit cksda. but awesomeness truly abounded as the llusm ohana converged for jason oh's birthday. in the tradition of korean sda folks, we had to segregate the photos. don't ask me why, it just happens.

sometimes i worry that we're not really giving sacramento a chance to feel like home, since we're so fixated on going back to socal to (in order of priority) our family, friends, and pinkberry. however, today as i walked from my car to the hospital in the cool crisp fall air, i realized that we are putting down roots- tentative though they may be. it was so great to visit this past weekend, but it felt good to come home as well.

non sequitur comment of the entry: hands down, the best new show of the fall season is CHUCK. we're totally hooked.

the family man is on tv right now. i recently asked my hubby if he ever thought about his other self living in an alternate universe- you know, like what would have happened if he had missed a subway train (e.g. sliding doors) which altered the trajectory of his life. i asked, of course, because i often think about this other "me"... which is NOT in fact disloyalty towards my spouse, as i believe we were meant to be and all that other mushy jazz that i will spare y'all- but i think we could have met and lived in a totally different way. i imagine a totally cosmopolitan/metropolitan life- mostly because my imagined wardrobe would be fabulously chic, and our apartment would be fabulously chic with a gorgeous view of the cityscape, and our schedules and budgets would be so much more flexible than they are now because i, at least, would not be in medicine but instead in something presumably less fulfilling but substantially more glamorous. not that i'm not happy where i am, but these are just the dreams of a thoroughly bedraggled occasionally self-pitying intern... of course, he, being much more practical and grounded than me, does not have such imaginings. which is probably best.

autumn festivities

andy and i have been attempting to enjoy our days off by taking advantage of the cool crisp weather. and what better way to spend a lovely fall afternoon than a leisurely bike ride through the Pocket?

safety first!

we're also trying to create new "family traditions". andy and his family used to go apple picking every year back in michigan, and i have vague memories of hay rides and apple cider from my home-school days... so we decided to take a trip to apple hill. it's this amazing stretch of orchards in the mountains, just about an hour's drive away.

we started out at rainbow orchards, for lunch. having no prior knowledge of the area, we pretty much followed the crowds, lemming-style. this place was PACKED.

we soon discovered why.

fresh apple cider (with some unremarkable bbq-fare)...
and
hot, crispy, moist and delicious apple cider doughnuts.
as you can see, i took a few rapturous bites before remembering to take a picture.

we wandered for a bit, researching the different bake shops and U-Pick orchards. sadly, we visited too late in the season, so no fruit for us.

we happened upon a small stretch of a "nature trail" transformed for halloween (see the little hanging ghosts in the back?).

all in all, quite a beautiful afternoon and definitely a tradition we'd like to continue in the future.

and yesterday was andy's birthday. took the hubby to dinner at bandera, one of the hillstone group restaurants (cousin of rutherford's grill, for all the PUC fans).




cornbread!
[insert sound of Homer-esque drooling here]




it was our first "date night" in a long time. our interactions have become so routine with our work schedules... twas very nice to have an evening out to celebrate the man in my life. :)

schadenfreude

i have a confession. i've realized something about myself. and perhaps, something about doctors in general. but nevermind everyone else- i should claim this vice as my own. so here it is: i do so love to feel intelligent and, dare i say, superior. oftentimes, however, this feeling comes at the expense of my medical colleagues' ineptitude... unabashed schadenfreude. ok maybe it's not so much deriving joy from others' suffering, but it's the closest word/concept i could think of. anyhoo, let me elaborate...

i first thought about this when i was catching up on some recorded private practice episodes one free afternoon. the poor writers- they mean well, but gosh they get a lot of the medical stuff wrong. i mean, it's a glorified soap opera- am i really expecting clinical realism?! i catch myself thinking about how incompetent addison & her colleagues are... "like, puhleeze, you need to diagnose Crohn's disease with a camera swallow study?! like, hello, you could have just asked the patient if she has diarrhea?! how about checking for some extraintestinal stigmata??!" and for a moment, i sit there, warm in my little pocket of smugness and superiority over TV fake doctors- because let's face it, i'll never be as telegenic as they are. ;)

but it doesn't stop there. it's an unpleasant reality that as we physicans choose specialties, we somewhat inevitably tend to devalue others that we did not choose. perhaps devalue isn't the right word, but there's definitely a reason why i chose my particular field over others. in psychology terms, i guess it's an example of an ego-defensive attitude- we adapt our attitudes to confirm the decisions we have already made, or would make. for example, surgeons can't imagine who would willingly choose the interminable rounds of medicine, medicine docs turn up their noses at the crude butchery of surgery, everyone dumps on the family docs, etc...

so here's how it plays out in real life- when i was on surgery, the surgery team (myself included) would bash the poor UrgiCenter docs (a hodgepodge of family & internal medicine docs & moonlighting fellows) with every "stupid" consult that came in. we'd ruthlessly snicker at the mismanagement of a patient at the hands of the one OBGYN surgeon at the hospital. at the med center, with so many specialties in play, it's a veritable smorgasbord of options for evil delight. pity the ED docs who get slammed by everyone unlucky enough to be called to consult or admit a patient. just last week, my team shook our heads in disbelief at the orthopods and general surgeons who had initially misdiagnosed a substantial leg/knee abscess as a "sterile collection of fluid secondary to pseudogout" on a patient. even amongst our own colleagues, one tends to figure out pretty quickly who knows something and who isn't quite up to snuff... and of course, i know that it's a two-way street. i'm sure i'm providing lots of laughs at my own expense.

i honestly don't know how much of it is medicine in general, or just my attitudes overlying it all. i'm a perfectionist, and i can be pretty darn supercritical of others as well as myself. i guess the sad thing is that i'm figuring out that the criticism is sortof an ego defense... if i can say, "dood, i TOTALLY wouldn't have done that", or "i TOTALLY would have caught that abscess" , or... well, you get it... if i can say that, or think that... i'm momentarily reassured, in my own head, that i'm somewhat competent- or at the very least, more competent than the poor saps i'm skewering. because not only would it be very damaging to my ego to be incompetent- patients' lives potentially hang in the balance. not now, of course- as an intern, i kinda get a free pass with lots of supervision... but in the future. scary.

this neurotic monologue has actually been quite therapeutic, i have to say. ;) here's hoping that i'll take the guilt that has fueled this entry and sublimate it into a more accepting, open, nonjudgmental and less snarky attitude towards.... well, life.

vacation is so over...

every fall since... well, since i started medical school... i've gotten sick shortly before getting a flu shot. today, a sore throat and stuffy head marked the first illness of the year... true to form, i'm due for a flu shot later this week. so tonight, instead of frolicking and eating yummy desserts with my co-interns, i'm sitting all bundled up on my couch. something about being a sickie makes me a big crybaby/mama's girl. made some comfort food (dduk gook, o-deng) for dinner, ate dinner sulkily with my hubby throwing random cranky vibes his way (because he didn't read my mind and wait on me hand and foot- JEEZ, am i really asking for so much??!! ;) ), then apologized... now feeling quite guilty as he made me my favorite "good earth" tea with honey & lemon, which i'm nursing as i type.

on a random note, here are my tivo'd and reviewed picks for fall pilots:
#1 Chuck - cuz let's face it, i'm inclined to like any pilots featuring stanfordites - PLUS it's hilarious
#2 Gossip Girl - it's socialite rank (a now defunct website) come to life, but in high school - definitely a guilty pleasure
#3 Dirty Sexy Money - great actors, sufficiently entertaining to warrant at least a season's worth of viewing

~Undecided but following for a few episodes more...~
- Bionic Woman - she kicks ass, but the dialogue is dragging
- Private Practice - oh Addison, why must your show be so infuriatingly slow and why is that psychiatrist so inept and why oh why can't shonda rhimes hire some talented writers who know something about medicine?!
- Pushing Daisies - interesting concept, just wondering if they'll be able to stretch it into a series


and yes, getting cable/dvr was quite possibly the best and worst decision we could have made for this year...