There goes the neighborhood

Originally uploaded by horseballerina.

After a long (for him) visit (a month), Bryan finally headed north with what’s left of his worldly possessions. He did a really good job this time of getting rid of things and being productive. According to him, it’s harder work being retired than it was being employed.

Among other things, he replaced the ball joints, rear tires, fuel filter, and front speakers in my truck. And perhaps best of all, he installed a brand spanking new CD player in it! So those trips to Pensacola, Kentucky, Miami, or wherever won’t be so bad. It will be sooooooooo nice to have that, especially on those stretches along I-10 and I-75 where there aren’t even any bad radio stations, let alone any good ones.

He also scored me a tractor and did a lot of mowing for me. The boarders love when he visits because the place always looks so much better. He showed me how to drive it though, so hopefully I can keep it up even in his absence.

It was a nice visit, and as always I am sad to see him go. But not too sad, because I know he’s never really GONE. Off to gallivant around the country perhaps, but never more than a phone call away. Except maybe when he’s in the woods of Alaska, but even then he’s only an email away. I’m glad because he really is my bestest friend (except when he’s being obnoxious – then I want to kick him!)

Safe travels, B! Somewhere in the music I ripped to your computer is a Terri Clark song called “Damn Right”. Listen to the words (I know that’s a challenge for you – do it for me) and think of me. Just substitute “Bluebirds” for “T-Birds” and it could be about us.

Josh,Eli,Sam

Originally uploaded by horseballerina.

Sam’s a Marine pilot and amateur filmmaker. He had just learned (courtesy of GQ) that one’s socks should be darker than one’s pants but lighter than one’s shoes and was eager to not only share the knowledge but also proudly display the proof that he had taken the advice to heart.

Josh, on the other hand, is studying to be an RD (that’s Real Doctor) and already knew that. He was wearing what can only be described as nylon almost-socks so that he gave the appearance of being sockless but didn’t get his tootsies sweaty. I found this highly suspicious, but Eli assured me that he’s straight. He says the metrosexual thing is very South Florida. Again, I could not function for long. But it was a nice visit.

More_Towels

Originally uploaded by horseballerina.

So I went down to Miami last weekend to visit my sister and meet her future in-laws. My first trip to South Florida. Wow. It’s definitely a whole different world down there. I could not function more than a few days, I think. But it was fun. Frema, Eli’s mama, throws one hell of a party. Good food, good wine, good people. Luckily Eli had a few friends and his sister there, so there were some other people our age. Although Sam insisted that he was waaaaaaaaaay older than me (he’s 32). And Josh would never admit how old he was.

I love being a senior!!

Originally uploaded by horseballerina.

This absolutely makes up for all the long hours spent in a classroom or nose-planted into books. I got to cut this pony, explore its abdomen, play resident by quizzing my group-mates (they agreed that I’ll be a good resident , perform a small intestinal resection and anastomosis, and close him up. I even learned Dr. Freeman’s nifty sliding-knot trick and then got to teach it to Dr. Broome. Sherry closed the skin (beautifully!) and Linda happily ran anesthesia (no complications and never needed the respirator!). Melissa didn’t do anything, really. Especially set-up or clean-up! Oh well. I’m still on cloud 9. Makes up for the fact that we’re back in class now rather than on clinics which is where I’d always rather be!

Amy,Megan,Sara

Originally uploaded by horseballerina.
Bryan helped me to do this! I’m still trying to learn how to do it. Right now I’m able to post one picture at a time. Still trying to figure out how to get several in one post. In the meantime I’m going to put some more on Flickr .

One big question I have had about the whole Rood and Riddle thing is: can I in fact, as Troy put it, go four days without sleeping and still function? I hope he was exaggerating, but I know they work very hard for very long and don’t get much in the way of sleep at the busy times. And that, Mama, is one of the things that has kept me thinking maybe R&R is too much for me. Not because I don’t want it. But because it’s physically draining and emotionally exhausting. Nothing is all good, even a phenomenal hospital like that. So beyond how badly I want it, there is the Can I Cope factor.

This week I managed to accumulate nine inpatients, between being very lucky on my on-call nights and picking interesting cases that ended up staying in the hospital. Saturday I sent four home (yay!) then Saturday night/Sunday morning I acquired two new ones. I could have turfed them to someone else but I am notoriously stubborn about giving up cases. Plus, I thought, this is a good opportunity to see just how much I can handle.

Quite a lot, as it turns out. From Tuesday on I got minimal sleep and my patients seemed to multiply overnight. I learned that the clipboard is invaluable at a time like this. I learned that Diet Coke doesn’t contain nearly enough caffeine and sometimes I actually wish that I could stomach the thought of coffee. I learned that I can function on far less sleep than I ever would have thought possible. And I learned that you should really try to keep up with the paperwork. I spent the day today (I’m not on clinics this week) catching up on all the paperwork I’d gotten behind on this week. Mostly because every time I’d think “I’ll just do this and then sit down and do paperwork” Sarah would call me and ask me to help with something. Which made me feel good because she gave me a lot more responsibility than the typical student. However, it did bump the paperwork back. This reaffirms my aversion to paperwork and the need for my becoming rich and famous so I can have a secretary. Or at least an intern!

Anyway, the point is I found my limit and pushed past it. Then found my new limit. Which I think is pretty damn impressive. Even for R&R standards. All this plus excellent patient care and no mistakes. I CAN do this, even sleep-deprived. And I still love it.

Okay, fine. I’m not that bad, despite the fact that I’m often accused of causing trouble. But I do tend to leave a trail of confusion in my wake. For example, last spring I was on clinics for 2 months with the class of 2006. I have since been on my neverending road trip. I am now on clinics with the class of 2008 and am rebelling against the godawful standard issue polo shirts (I look like a bag lady AND they’re a shade of gray that looks perpetually dirty). Instead, I am wearing the cute polos that (gasp!) actually FIT me that Mama and I raided from Aeropostale (I look and feel sharp in these). Given the circumstances, it is perhaps not surprising that no less than four (and possibly five or six) technicians have asked me if I’m the new large animal intern. Never mind that that’s a nonexistent position at the vet school. I am feeling like Hot Stuff again because people think I am a doctor already. Except my friend Cathy, who, noting my butterfly logo for the 4th day in a row, asked me if I was the new Aeropostale model.

Also I have been trying to keep myself organized via the Rood and Riddle clipboard approach. Troy first suggested it, saying it helped him immensely during his internship. I kept thinking yes, if in fact I can keep up with it. Knowing me I’ll lose it in 2 seconds flat. Then I went to Kentucky. One of the interns lost his clipboard approximately 142 times a day. Yet it still helped him. This particular intern was also late to rounds routinely (not good since rounds consist of the clinician, the intern, and the technician) and had to wear suspenders over his scrubs to keep from flashing everyone when he bent over. You would think with the advent of drawstring pants this type of thing would not be necessary, yet there he was in his bright red suspenders. He was also told, routinely, that he was a colossal mess. He took it all in stride, partly because that’s his disposition and partly because it’s true. And I thought geez, if he can do it, I can certainly do it! So far I have and it is going very well.

Then there’s Dr. Sarah. She’s my resident this rotation, and she’s catching up to Aric for favorite resident status. I’ve often remarked, wistfully, that there will never be another Aric Adams. I still stand by that, but Sarah is phenomenal in her own right and gets better every day. She gets more done in less time than anyone I’ve ever seen, Aric included. In direct contrast to the last resident I was on with. With him, doing nothing still somehow took until at least 8pm. Every single night, for two weeks. She has given me hope that you don’t actually have to spend 24/7/3 years at the hospital during a surgical residency. You just have to organize and get things done. She has also given me a lot of insight into the Rood and Riddle internship, which she loved. And best of all, yesterday she glanced at my clipboard with its to-do list and little boxes to check off. She laughed as she told me You are SO on your way to becoming an intern!

So I look at her. And I look at Troy. Both of whom I admire immensely, although they are quite a few years apart along their career paths. I wonder just what it takes to make it at Rood and Riddle, and whether I have it. I try to, as Troy suggested, take a good long look in the mirror and ask myself what I really want. I’m not 100% sure, and I may never be. I do know that I am getting it together, little by little, one day at a time. So maybe in 10 months I will be ready for R&R.

But here’s the real question. Are THEY ready for ME?

Since my return to “real life”, my head has been spinning. Prepared to dislike Rood and Riddle, or at most have a good week seeing interesting cases, I was thoroughly unprepared for what happened on my drive home. I realized, driving and chatting with friends and family, that somewhere I had crossed the line from having a good extern experience to truly wanting to learn more from this incredible place. I’m still not sure when exactly it dawned on me.

When I left the girls on the lawn outside the house, we all hugged good-bye and they tried one last time to convince me to stay another week. I needed little convincing. But I was quite sure that Bethany, the angel who cares for my farm while I am gone, would cease her cherubic ways and possibly even sprout horns if I asked her to feed even one more day. I knew I would miss them terribly.

But when Cameron hugged me goodbye and instructed me to “go get my degree and come back up here”, I laughed and told him I didn’t think I could handle the internship. Somewhere on that 10-hour drive, imperceptibly, something shifted. Maybe I realized that I was selling both myself and the practice short. That we both have something invaluable to offer each other, something neither of us is likely to find elsewhere.

My preconceived notion was that in a practice that big I would never find the mentorship and willingness to teach that I had found in smaller practices. In a way I was right. I found instead a surgeon whose sarcasm and penchant for bursting into song made me look like a wallflower. Another who somehow works up a million lamenesses a day, but still takes the time to explain everything he’s doing and answer questions. Yet another who appreciates hard work and sharp intellect and who has no patience for the self-serving suckups who come out of the woodwork wherever he goes. An anesthesiologist who I first thought was an intern due to her youthful enthusiasm – until her permanent smile eventually tipped me off. She never looked stressed. I met an internist happy to share both his knowledge and his amazement at a pleuropneumonia so congested that her lung sounds sounded more like gut. And several phenomenal technicians doing their best to keep both their world-class doctors and their frightened new interns in line.

Mostly though, I keep coming back to the patients. Regal Chime, whose claim to fame was that she had sustained “the same injury as Barbaro”. She won my heart for entirely different reasons. She looks an awful lot like Maverick. And when she decided that she had no desire to walk with her cast, she threw every maneuver in her arsenal at the frustrated technicians, whose job was to get her to use all 4 legs. They would lead her up and down the barn aisle, and she would hop, skip, pivot, anything to avoid planting and stepping. Eventually they resorted to leading her around the outside of the barn, stopping occasionally for bites of fresh green grass. They were aggravated. I couldn’t help but admire her artfulness as she forcibly reminded me of another crafty bay thoroughbred.  

Sympatica, “Tica” to those who loved her, was a stately gray mare who had somehow managed to smash most of the bones in her knee. A valiant effort was made to save her – in vain, as it turned out. We all loved her for her sweet nature, soft eyes, and neverending enthusiasm for carrots and peppermints. Real peppermints. She turned up her delicate nose at the peppermint-flavored treats, regardless of the love with which they were offered. She actually looked offended that anyone would suggest her eating such a thing. Her death was a poignant reminder that even the most skilled surgeon cannot save every patient.

I knew and loved both of these girls. But the memories that surface most often are of Zebra ‘06 and Piper ‘06. Fractures of the femur are a fatal lesion in horses. The two that I saw had youth on their side – less weight to bear, and less muscle mass to dissect down through to reach the broken ends of bone. They also had access to a surgeon willing to try. I don’t know exactly how many would attempt to repair these fractures but it’s somewhere between not many and very few. In less than a week I saw two. They have a long way to go still, and complications can occur far down the road. But they were afforded a chance – a gift that very few surgeons could give them.

So, here I am. Spending an awful lot of time thinking about just how much I would like to see all the cases that walk through those doors in the span of a year. Wondering if I can forego sleep for days on end to do so. Talking to anyone who will listen about what I saw there, how they did things, how much I liked it. Shifting ever more from maybe-I’d-like-it to damn-I-really-WANT-it.

Trying to talk myself out of even visiting, I told Wendy that I didn’t want to have to fight to distinguish myself among 10 other interns. She said it’s because I don’t want to be famous - I want to be good. She was almost right. I want to be more than good. And I think that maybe Lexington would give me the best chance to be exceptional. Which is what I REALLY want.

And did I mention 2 bathrooms for 10 girls? It could have been so much worse. As it was there was remarkably little conflict over use of the facilities. The setup definitely was reminiscent of summer camp. When I met the two externs that were staying with friends in town I was at first envious. Peace and quiet, a real bed, space in the fridge. A small sacrifice, I learned, for the chance to visit seedy bars en masse, stay up until the wee hours of the morning playing Truth or Dare, and commiserate about the world’s least friendly intern. By the time I departed I knew I would be a little lost back home in the quiet of my farm. No one else will ever understand what’s so funny about 1-Stroke (2 minutes?) or where to put the trash (right next to the squeegee) or how to hose the floor (let me show you a little trick. . . )

So many great memories from a trip I almost didn’t take.

The side trip to Churchill Downs – where I learned that Sam’s maternal grandsire (Spend A Buck) was the 1985 Kentucky Derby winner, that playing the ponies is pretty dang complicated, and that you should never ever try to save money on parking by following a cross-eyed Kentuckian down a narrow road to her driveway.

Discovering hidden treasure at the tack and leather shop tucked into the Thoroughbred Center – custom belts and bracelets at an insanely great price. Buying the exact same belt as Melinda (other than the name plate) after ordering the exact same thing for dinner (other than the beer) the night before at DeSha’s. Buying the bracelet I’ve always wanted but could never find (brown leather, wide but not overwhelming to my short little arm) with my boys’ names on the plate. Registered names, thanks to Carl’s advice. 

Several trips to the Kentucky Horse Park, first to check out the mini show (quite the spectacle if you’ve never seen one), then the cross-country, then on my last day the Park proper. Dusty the trick horse. Posing with the girls on the giant chair. Museums and shows.

Sara, a fellow bookworm, introduced me to Joseph-Beth’s. It defies description – the word bookstore doesn’t even come close. I found prints of my friend Jorge’s photographs. He is truly talented. Sara and I shared the discovery of the adjoining art gallery, Artique, filled with amazing expressions of creativity. Movie, schmovie. We’ll be in here for a while.

I in turn introduced Crystal to I Ching and Joe Bologna’s, two of Lexington’s best places to fill the tummy. The two of us then introduced Kirsten to Victoria’s Secret and the whole concept of sexy underwear. Kirsten’s face vascillated between intrigued and appalled. By the end of the shopping spree, Crystal and I had been reduced to tears and giggles and were perilously close to being banned from Vickie’s forevermore. Fortunately the sales staff had a sense of humor and an appreciation for a substantial purchase.  

I expected to make friends with my housemates, at least to some extent. The other friendship I found came completely out of left field. And by left field I mean Barn 2. Cameron made me smile the first time I saw him and continued the tradition for the entire two weeks. He introduced me to the saddlebred world, Redmon’s, Napoleon Dynamite, and his circle of friends. He reminded me that I am in fact Hot Stuff. He also reminded me that I think too much and sometimes I need to just let go and be. His appearance in my life was nothing short of serendipitous. I hope that I gave to him at least a little of what he gave to me – a light shined into a dark place in my soul, when I needed it most. I sincerely hope our paths cross again. 

Knowledge is indeed invaluable, but friendships are beyond priceless. I gained both in the span of two incredible weeks. What I should have written in the book at the end of the visit is this:

Amy, Melinda, Sara, Heidi, Veronica, Kirsten, Australia, and especially Crystal and Cameron – you guys made the good parts of this trip exceptional and the bad parts hilarious (at least in retrospect)! Someone very wise once said “We do not remember days, we remember moments” Thank you all for two weeks of great moments. Take the best possible care of yourselves.

Until we meet again.

I’m finally back home after almost a month of being everywhere else. After spending the aforementioned week in Ocala, I packed it up and headed north for a week in Lexington, KY. After a less-than-stellar trip in October to one major clinic up there I had negligible hopes for the other rock star clinic in the neighborhood. I had come to the conclusion that the gigantic super-clinics were just not for me. However, I have two reliable sources at school that did internships there and loved it. One is my mentor, so I thought I’d at least check it out so that I could tell him I did, and it just wasn’t for me.

So on a Sunday afternoon I got a VERY late start after participating in Operation Catnip that morning. Catnip is a program to trap, spay/neuter, and return feral cats to try to make a dent in the feral cat population. I spayed 5 cats with only one minor problem, and learned a new phrase courtesy of Carl, the surgery resident helping us. When I asked “how much?” in response to his instruction to extend my incision so I could find the ovary I’d dropped, he grinned and said “Go big or go home!!” Thanks, Carl. That’s a keeper! Carl also refused to glove up and made me solve my own problem (cheeky bugger!) hence I came out of this particular Catnip exponentially more confident, having actually encountered a problem and fixed it myself with tech support. Thanks again, Carl. That’s invaluable!

It was 3 am by the time I reached Rood and Riddle, and of course everyone was long ago tucked in for the night. I slept on the couch that first night, and awoke to the sounds of two of the girls making breakfast. Gradually everyone else trickled in and I found myself the 11th houseguest that week. Ten girls plus Casey who shocked everyone by showing up and being male. Before you pity him for being surrounded by all that estrogen, I should mention that by virtue of his Y chromosome, Casey scored his very own room. With a real bed. I had the option of being the 4th roommate in any one of the 3 rooms inhabited by fellow females stacked into bunk beds. Casey also ditched us early, ostensibly because he missed his girlfriend. I personally think Dr. Hopper’s caustic sense of humor was more than the candy-ass could handle.

He was replaced before he even left by Mark, a visiting vet from Australia. Mark had wild hair, a cute Aussie accent, and a self-professed inability to remember people’s names. Places he could remember, for reasons unbeknownst to anyone including himself. So I became Florida, he became Australia, and likewise everyone else started answering to their state as well as their name. Except Melinda. She was always Boston, rather than Massachusetts, and we’re not entirely sure why. On his first night there, Boston, Australia and I went out to the Bluegrass Fair. Not much of a fair, really. No agriculture section to speak of. They did have a sinful funnel cake which, thank God, we split 3 ways. They also had a few rides that Melinda Boston wanted to try. After the funnel cake. A logistical mistake, we decided later, but the queasy stomach at least went away. Not so Australia’s broken rib, obtained due to his insistence that we all three share a cart on the Scrambler. Boston and I exchanged a skeptical look and then said okay, but you get the outside. Righto, he said. He then learned that 2 girls (even small ones) x 5G’s = broken rib for obstinate Aussie. Five days later we dropped him off at the airport. Wincing, he slung his bag over his shoulder and grinned. It was worth it, he said, to ride with two beautiful American girls. 

Safe travels, Australia. We missed you first.